hiv aids surveillance report 2006 · the hiv/aids design element on the cover is used with the...

55
Cases of HIV infection and AIDS in the United States and Dependent Areas, 2006 Vol. 18 Diagnosis rates of HIV/AIDS among persons aged 13 and older, by area of residence, 2006—33 states and 5 U.S. dependent areas with confidential name-based HIV infection reporting Note. Reported case counts have been adjusted for reporting delays. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service Centers for Disease Control and Prevention Atlanta, Georgia 30333

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Page 1: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Surveillance ReportCases of HIV infection and AIDS in the United States and Dependent Areas 2006 Vol 18

Diagnosis rates of HIVAIDS among persons aged 13 and older by area of residence 2006mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

Note Reported case counts have been adjusted for reporting delays

DEPARTMENT OF HEALTH AND HUMAN SERVICESPublic Health Service

Centers for Disease Control and PreventionAtlanta Georgia 30333

The HIVAIDS Surveillance Report is published annually by the Division of HIVAIDS Prevention National Center for HIVAIDS Viral Hepatitis STD and TB Prevention Coordinating Center for Infectious Diseases Centers for Disease Control and Prevention (CDC) US Department of Health and Human Services Atlanta Georgia

Data are presented for cases of HIV infection and AIDS reported to CDC through June 2007 All data are provisional

The HIVAIDS Surveillance Report is not copyrighted and may be used and copied without permission Citation of the source is however appreciated

Suggested citation

Centers for Disease Control and Prevention HIVAIDS Surveillance Report 2006 Vol 18 Atlanta US Department of Health and Human Services Centers for Disease Control and Prevention 2008[inclusive page numbers] httpwwwcdcgovhivtopicssurveillanceresourcesreports

Single copiesCDC National Prevention Information NetworkPO Box 6003Rockville MD 20849-6003Telephone 1-800-458-5231 or 1-301-562-1098

Request to be added to mailing listCDC MASOMISBMail Stop E-114770 Buford HighwayChamblee GA 30341-3717

On the Webhttpwwwcdcgovhivtopicssurveillanceresourcesreports

Confidential information referrals and educational material on HIV infection and AIDSCDC-INFO (formerly the CDC National AIDS Hotline)1-800-232-4636 (in English en Espantildeol)1-888-232-6348 (TTY)E-mail cdcinfocdcgov

AcknowledgmentsPublication of this report would not have been possible without the contributions of the state and territorial health departments and the HIVAIDS surveillance programs that provided surveillance data to the Centers for Disease Control and Prevention

This report was prepared by the following staff and contractors of the Division of HIVAIDS Prevention National Center for HIVAIDS Viral Hepatitis STD and TB Prevention CDC Anna Satcher Johnson Denise Hughes Xiaohong Hu Michael Campsmith Irene Hall Marie Morgan (editing) Janet Brzuskiewicz (graphics) and Michael Friend (desktop publishing)

The HIVAIDS design element on the cover is used with the permission of the American Red Cross

Federal Recycling Program Printed on recycled paper

Contents

Commentary 5

Section 1 Cases of HIVAIDS and AIDSTable 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003ndash

2006mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting11

Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

12

Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas

13

Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002ndash2006 and cumulativemdash50 states and the District of Columbia

14

Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992ndash2006mdash50 states and the District of Columbia

14

Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006mdash50 states and the District of Columbia

15

Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006mdash33 states with confidential name-based HIV infection reporting

15

Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006mdashUnited States and dependent areas

16

Section 2 DeathsTable 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics

2002ndash2006 and cumulativemdashUnited States and dependent areas17

Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003ndash

2006mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting19

Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission categorymdash33 states with confidential name-based HIV infection reporting

20

Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

21

Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

21

Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002ndash2006mdashUnited States and dependent areas

22

Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission categorymdash50 states and the District of Columbia

23

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age categorymdashUnited States and dependent areas

24

3

Section 4 Survival after AIDS DiagnosisTable 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002

by selected characteristicsmdashUnited States and dependent areas26

Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by year of diagnosismdashUnited States and dependent areas

27

Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by age groupmdashUnited States and dependent areas

27

Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by raceethnicitymdashUnited States and dependent areas

28

Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and

cumulativemdashUnited States and dependent areas29

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico

31

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

35

Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulativemdashUnited States and dependent areas

37

Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

38

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas

39

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

41

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas

43

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

45

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

47

Technical Notes 48

Web Addresses for Reports of State or Local HIV and AIDS Surveillance 55

4 Contents

Commentary

The HIVAIDS epidemic was first recognized in the United States in 1981 Since that time all states and US dependent areas have conducted AIDS sur-veillance by using a standardized confidential name-based reporting system Because successful treatment delays the progression of HIV infection to AIDS AIDS surveillance data alone are insufficient to moni-tor trends in HIV incidence or to meet federal state or local data needs for planning and allocating resources for HIV prevention and care programs An integrated national HIVAIDS surveillance system will enhance the ability to monitor and characterize populations affected by the HIV epidemic and provide information on the entire population of HIV-infected persons who have been tested confidentially In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confi-dential name-based public health disease surveillance systems to report cases of HIV infection California implemented confidential name-based HIV infection case surveillance in April 2006 and this issue marks the first time that HIV case reports from California have been included in the HIVAIDS Surveillance Report For more information about HIV reporting in California visit httpwwwdhscagovAIDSHIVReporting

This report presents estimated numbers of cases of HIVAIDS (cases of HIV infection regardless whether they have progressed to AIDS) from the 38 areas (33 states and 5 US dependent areas) that have had confi-dential name-based HIV infection reporting for a suf-ficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends According to the number of reported AIDS cases these 33 states repre-sent approximately 63 of the epidemic in the 50 states and the District of Columbia From 2003 through 2006 the total number of new cases of HIVAIDS remained stable in the 33 states however HIVAIDS prevalence (ie the number of persons living with HIVAIDS) increased steadily by the end of 2006 an estimated 491727 persons in the 33 states were living with HIVAIDS The map on the cover depicts the estimated rates of diagnoses of HIVAIDS in 2006 by area of residence at the time of diagnosis

for persons residing in the 33 states and 5 US depen-dent areas with confidential name-based HIV infection reporting since at least 2003

Surveillance data on HIV infections compared with data on AIDS provide a more complete picture of the epidemic and the need for prevention and care services However the number of new HIV diagnoses during a given year(s) does not necessarily reflect a trend in HIV incidence (ie new infections) because some per-sons were infected recently and others were infected at some time in the past CDC has developed the serologic testing algorithm for recent HIV seroconversion (STARHS) which can distinguish recent from long-standing HIV infections at a population level This technology has made it possible to develop a surveil-lance system that will provide more accurate and timely estimates of HIV incidence CDC and its part-ners in state and local health departments have been working during the past several years to develop and evaluate this system Five areas were funded in FY 2002 to pilot the methods by FY 2005 34 areas were funded to conduct incidence surveillance HIVAIDS surveillance data are used by CDCrsquos public health part-ners and by professionals in other federal agencies health departments nonprofit organizations and aca-demic institutions Recognizing the changing needs for data CDC is committed to presenting the data that will best meet those needs The first estimates of HIV inci-dence which require the use of complex estimation methods are expected in 2008 The monitoring of HIV incidence will be critical in evaluating progress toward CDCrsquos goal of reducing the number of new HIV infec-tions in the United States and in allocating resources and evaluating prevention program effectiveness

The 2006 HIVAIDS Surveillance Report is orga-nized in 5 sections (1) cases of HIVAIDS and AIDS (2) deaths of persons with AIDS (3) persons living with HIVAIDS AIDS or HIV infection (not AIDS) (4) length of survival after AIDS diagnosis and (5) reports of cases of HIVAIDS AIDS and HIV infec-tion (not AIDS) In Sections 1ndash3 we present point esti-mates of case counts that have been adjusted for reporting delays and for the redistribution of cases in persons initially reported without an identified risk factor CDC routinely adjusts data for the presentation

5

of trends in the epidemic Data to estimate the number of cases of HIVAIDS or AIDS the number of persons living with HIVAIDS AIDS or HIV infection (not AIDS) and the number of deaths among persons with AIDS have been statistically adjusted to correct for delays in the reporting of cases and deaths

To assess trends in cases deaths or prevalence it is preferable to use adjusted data presented by year of diagnosis instead of year of report to eliminate arti-facts of reporting in the surveillance system Therefore for trends the reader is encouraged to use the tables in Sections 1ndash3 that present trends by year of diagnosis year of death or year-end prevalence Section 4 pre-sents estimates of survival for persons whose AIDS diagnosis was made during 2002 (Table 13) and for persons whose diagnosis was made during 1998ndash2005 (Figures 2ndash4) Proportions of persons who survived for various lengths of time after diagnosis are presented by year of diagnosis age group raceethnicity and HIV transmission category

Finally Section 5 presents reports of cases of HIV infection (not AIDS) and cases of AIDS reported through 2006 The areas included in tabulations of reported cases of HIV infection (not AIDS) are based on the date that confidential name-based HIV infection reporting was implemented For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US dependent areas) to describe reports of HIV infection These data which have not been adjusted for delays in reporting are presented by year of report to CDC Tables that present cases by year of report represent the most up-to-date information reported to CDC however cases by year of report do not represent inci-dent cases the most recent diagnoses trends or deaths

HIGHLIGHTS OF ANALYSES

Cases of HIVAIDS and Cases of AIDS

Cases of HIVAIDSFrom 2003 through 2006 the estimated number of

HIVAIDS cases in the 33 states with confidential name-based HIV infection reporting remained stable (Table 1) In 2006 the estimated rate of HIVAIDS cases in the 33 states was 185 per 100000 population (Table 5b)

bull Age group From 2003 through 2006 the estimated number of newly diagnosed HIVAIDS

6 Comm

cases decreased among children (less than 13 years of age) and in the following age groups 13ndash14 30ndash34 and 35ndash39 years (Table 1) The estimated number of HIVAIDS cases remained stable among persons aged 40ndash44 years and increased among persons aged 15ndash19 20ndash24 25ndash29 45ndash49 50ndash54 55ndash59 60ndash64 and 65 years and older In 2006 the largest number of HIVAIDS cases occurred among persons aged 40ndash44 years who accounted for 16 of all HIVAIDS cases diagnosed during that year

bull Raceethnicity From 2003 through 2006 the estimated number of newly diagnosed HIVAIDS cases increased among whites and AsiansPacific Islanders remained stable among blacks and Hispanics and fluctuated among American IndiansAlaska Natives (Table 1) Blacks accounted for 49 of all HIVAIDS cases diagnosed in 2006 In 2006 rates of HIVAIDS cases were 677 per 100000 in the black population 255 per 100000 in the Hispanic population 88 per 100000 in the American IndianAlaska Native population 82 per 100000 in the white population and 67 per 100000 in the AsianPacific Islander population (Table 5b)

bull Sex From 2003 through 2006 the estimated number of HIVAIDS cases increased approximately 5 among males and decreased 6 among females (Table 1) In 2006 males accounted for 74 of all HIVAIDS cases among adults and adolescents In 2006 rates were 338 per 100000 among males and 115 per 100000 among females (Table 5b)

bull Transmission category From 2003 through 2006 the estimated number of HIVAIDS cases increased among men who have sex with men (MSM) and remained stable among adults and adolescents with HIV infection attributed to high-risk heterosexual contact (heterosexual contact with a person known to have or to be at high risk for HIV infection) (Table 1) The estimated number of HIVAIDS cases decreased among injection drug users (IDUs) MSM who were also IDUs and among children MSM (49) and persons exposed through high-risk heterosexual contact (33) accounted for 82 of all HIVAIDS cases diagnosed in 2006

entary

Of all HIV infections diagnosed in 2005 in the 33 states with confidential name-based HIV reporting 38 progressed to AIDS within 12 months after HIV infection was diagnosed AIDS was diagnosed within 12 months after the diagnosis of HIV infection for larger proportions of persons aged 13ndash14 years and 35 years and older for Hispanics for IDUs and for males with HIV infection attributed to high-risk heterosexual contact (Table 2)

Cases of AIDSFrom 2002 through 2006 the estimated number of

newly diagnosed AIDS cases in the 50 states and the District of Columbia remained stable (Table 3) In 2006 the estimated rate of AIDS cases in the United States was 123 per 100000 population (Table 5a)

bull Age group From 2002 through 2006 the estimated number of AIDS cases decreased 64 among children (less than 13 years of age) (Table 3) The estimated number of AIDS cases also decreased among persons in the age groups 30ndash34 and 35ndash39 years (Table 3) The estimated number of AIDS cases remained stable among persons aged 40ndash44 years and increased in the following age groups 13ndash14 15ndash19 20ndash24 25ndash29 45ndash49 50ndash54 55ndash59 60ndash64 and 65 years and older In 2006 the largest number of AIDS cases occurred among persons aged 40ndash44 years who accounted for 20 of all AIDS cases diagnosed during that year in the 50 states and the District of Columbia

bull Raceethnicity From 2002 through 2006 the estimated number of AIDS cases decreased among blacks and American IndiansAlaska Natives remained stable among whites and Hispanics and increased among AsiansPacific Islanders (Table 3) In 2006 rates of AIDS cases were 476 per 100000 in the black population 156 per 100000 in the Hispanic population 62 per 100000 in the American IndianAlaska Native population 54 per 100000 in the white population and 37 per 100000 in the AsianPacific Islander population (Table 5a)

bull Sex From 2002 through 2006 the estimated number of AIDS cases remained stable among both male and female adults and adolescents (Table 3) Males accounted for 73 of all AIDS cases diagnosed in 2006 for adults and adolescents in the 50 states and the District of Columbia (Table

Comm

3) Rates of AIDS cases in 2006 were 224 per 100000 among males and 78 per 100000 among females (Table 5a)

bull Transmission category From 2002 through 2006 among male adults and adolescents the estimated number of AIDS cases decreased among IDUs and MSM who were also IDUs (Table 3) The numbers of males exposed through male-to-male sexual contact and high-risk heterosexual contact remained stable Among female adults and adolescents the estimated number of AIDS cases decreased among IDUs and fluctuated among females exposed through high-risk heterosexual contact

bull Region From 2002 through 2006 the estimated number of AIDS cases decreased 10 in the West and 6 in the Northeast and remained stable in the South and the Midwest

DeathsFrom 2002 through 2006 the estimated number of

deaths of persons with AIDS who resided in the 50 states and the District of Columbia decreased 17 (Table 7)

bull Age group The estimated number of deaths decreased among children (less than 13 years of age) and in the following age groups 13ndash14 25ndash29 30ndash34 35ndash39 40ndash44 and 45ndash49 years The estimated number of deaths remained stable among persons aged 50ndash54 years and increased in the age groups 15ndash19 20ndash24 55ndash59 60ndash64 and 65 years and older

bull Raceethnicity The estimated number of deaths of persons with AIDS decreased among whites blacks and American IndiansAlaska Natives The estimated number of deaths of persons with AIDS remained stable among Hispanics and increased among AsiansPacific Islanders

bull Sex and transmission category The estimated number of deaths of adults and adolescents decreased among MSM and IDUs and remained stable among persons exposed through high-risk heterosexual contact

bull Region The estimated number of deaths decreased in all regions of the United States

entary 7

Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS

Persons living with HIVAIDSFrom 2003 through 2006 the estimated number of

persons living with HIVAIDS increased steadily in the 33 states with confidential name-based HIV infec-tion reporting (Table 8) At the end of 2006 an esti-mated 491727 persons in these states were living with HIVAIDS

bull By age group most (21) were aged 40ndash44 years

bull By raceethnicity 47 were black 34 white 17 Hispanic and less than 1 each were American IndianAlaska Native or AsianPacific Islander

bull By sex 73 of adults and adolescents living with HIVAIDS were male

bull Of the estimated 353825 male adults and adolescents living with HIVAIDS 62 had been exposed through male-to-male sexual contact 17 had been exposed through injection drug use 13 had been exposed through high-risk heterosexual contact and 7 had been exposed through both male-to-male sexual contact and injection drug use Of the estimated 131195 female adults and adolescents living with HIVAIDS 73 had been exposed through high-risk heterosexual contact and 26 had been exposed through injection drug use Of the estimated 6703 children living with HIVAIDS 92 had been exposed perinatally

Prevalence rates of HIV infection (not AIDS)At the end of 2006 in the 38 areas with confidential

name-based HIV infection reporting since at least 2003 the prevalence rate of HIV infection (not AIDS) among adults and adolescents was estimated at 1437 per 100000 (Map 1) The rate for adults and adoles-cents living with HIV infection (not AIDS) ranged from an estimated 49 per 100000 (American Samoa) to an estimated 2617 per 100000 (New York) The prevalence rate of HIV infection (not AIDS) among children residing in the 38 areas was an estimated 65 per 100000 (Map 2) The rate for children living with HIV infection (not AIDS) ranged from an estimated zero per 100000 in Idaho New Mexico American Samoa Guam and the Northern Mariana Islands to an estimated 253 per 100000 in New York

8 Comm

Persons living with AIDSAIDS prevalence also increased steadily from 2002

through 2006 (Table 10) At the end of 2006 an esti-mated 436693 persons in the 50 states and the District of Columbia were living with AIDS

bull By age group most (22) were aged 40ndash44 years

bull By raceethnicity 44 were black 35 white 19 Hispanic 1 AsianPacific Islander and less than 1 were American IndianAlaska Native

bull By sex 77 of adults and adolescents living with AIDS were male

bull Of the estimated 333244 male adults and adolescents living with AIDS 60 had been exposed through male-to-male sexual contact 19 had been exposed through injection drug use 12 had been exposed through high-risk heterosexual contact and 8 had been exposed through both male-to-male sexual contact and injection drug use Of the estimated 99671 female adults and adolescents living with AIDS 66 had been exposed through high-risk heterosexual contact and 32 had been exposed through injection drug use

bull By region 41 resided in the South 29 in the Northeast 20 in the West and 11 in the Midwest

AIDS prevalence ratesAt the end of 2006 the prevalence rate of AIDS

among adults and adolescents in the United States was estimated at 1786 per 100000 (Map 1) The rate for adults and adolescents living with AIDS ranged from an estimated 25 per 100000 (American Samoa) to an estimated 20165 per 100000 (District of Columbia) The prevalence rate of AIDS among children in the United States was estimated at 22 per 100000 at the end of 2006 (Map 2) The rate for children living with AIDS ranged from an estimated zero per 100000 in Idaho Montana Utah American Samoa Guam and the Northern Mariana Islands to an estimated 365 per 100000 in the District of Columbia

Survival after AIDS DiagnosisTable 13 is limited to data on AIDS cases diagnosed

in 2002 in order to describe the survival of persons whose diagnosis was made relatively recently but far enough in the past to permit a meaningful measure of

entary

survival Figures 2 3 and 4 illustrate the proportion of surviving persons among persons whose diagnoses were made over a longer period 1998 through 2005

bull Survival (the estimated proportion of persons surviving a given length of time after diagnosis) increased with the year of diagnosis for diagnoses made during 1998ndash2000 Year-to-year differences were small during 2001ndash2005 (Figure 2)

bull Survival decreased as age at diagnosis increased among persons at least 35 years old at diagnosis and in comparison with persons younger than 35 Survival was similar for the age groups 13ndash24 and 25ndash34 (Figure 3)

bull Survival was greatest among MSM and among children with perinatally acquired HIV infection (Table 13) Survival was intermediate among male and female adults and adolescents who had heterosexual contact with someone known to be HIV infected or at high risk for HIV infection as well as among MSM who also were IDUs Survival was lowest among male and female adults and adolescents who were IDUs

bull Survival particularly at more than 48 months after diagnosis was greater among AsiansPacific Islanders whites and Hispanics than among blacks (Figure 4) Results were unstable or inconsistent for American IndiansAlaska Natives because the numbers of persons in this racialethnic category were small

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Tables 14ndash23 describe reports of cases of HIVAIDS AIDS and HIV infection (not AIDS) Tables 16 18 20 and 22 are based on reports of cases of HIV infection (not AIDS) through 2006 from the 50 areas that had implemented name-based HIV infection reporting Note that not all cases of HIV infection (not AIDS) or AIDS reported in 2006 reflect diagnoses made during 2006 rather the reported cases include cases diagnosed during earlier years

Reports of cases of HIV infection (not AIDS)Through 2006 a total of 287954 persons were

reported as having HIV infection (not AIDS) in the 50 areas with confidential name-based HIV infection reporting (Table 16) (see Technical Notes for discus-sion of surveillance of HIV infection [not AIDS])

Comm

Five states (Florida New Jersey New York North Carolina and Texas) reported 137507 (48) of the 287954 cumulative cases of HIV infection (not AIDS) reported to CDC In 2006 4 states (California Illinois New York and Pennsylvania) reported 22417 (42) of the 52878 cases of HIV infection (not AIDS)

bull In 2006 of the 52312 reported cases among adults and adolescents 75 were in males and 25 were in females (Table 18)

bull In 2006 566 cases in children were reported

Reports of AIDS casesThrough 2006 a total of 992865 persons in the

United States had been reported as having AIDS (Table 14) Three states (California Florida and New York) reported 43 of the cumulative AIDS cases and 37 of AIDS cases reported to CDC in 2006 In the United States the rate of reported AIDS cases in 2006 was 129 per 100000 population When the US dependent areas were included the rate of reported AIDS cases ranged from zero per 100000 (American Samoa Guam and the Northern Mariana Islands) to 1467 per 100000 (District of Columbia)

bull In 2006 males accounted for 73 and females for 27 of 38916 reported AIDS cases among adults and adolescents (Table 17)

bull In 2006 86 AIDS cases in children were reported

ADDITIONAL RESOURCES

The following were prepared by using HIVAIDS surveillance data

bull Selected MMWR articles at httpwwwcdcgovhivresourcesreportsmmwr

bull Public-use slides at httpwwwcdcgovhivtopicssurveillanceresourcesslides

bull Other surveillance reports at httpwwwcdcgovhivtopicssurveillanceresourcesreports

bull Public-use version of the AIDS surveillance data set (AIDS Public Information Data Set [APIDS]) at httpwwwcdcgovhivsoftwareapidshtm

SUGGESTED READINGS

CDC Advancing HIV Prevention New Strategies for a Changing EpidemicmdashUnited States 2003 MMWR 200352(15)329ndash332

entary 9

CDC Dear colleague letter CDC recommends that all states and territories adopt confidential name-based surveillance systems to report HIV infec-tions httpwwwcdcgovhivpubs070505_dearcolleague_gerberdingpdf Pub-lished July 5 2005 Accessed March 11 2008

1981ndash2005 CDC Epidemiology of HIVAIDSmdashUnited States

MMWR 200655(21)589ndash592CDC Guidelines for national HIV case surveil-

lance including monitoring for HIV infection and AIDS MMWR 199948(RR-13)1ndash31

CDC HIV prevention strategic plan extended through 2010 httpwwwcdcgovhivresourcesreportspsp Published October 2007 Accessed March 11 2008

CDC Revised recommendations for HIV testing of adults adolescents and pregnant women in health-care settings MMWR 200655(RR-14)1ndash17

CDC Twenty-five years of HIVAIDSmdashUnited States 1981ndash2006 MMWR 200655(21)585ndash589

Glynn MK Lee LM McKenna MT The status of national HIV case surveillance United States 2006 Public Health Rep 2007122(suppl 1)63ndash71

Janssen RS Satten GA Stramer SL et al New test-ing strategy to detect early HIV-1 infection for use in incidence estimates and for clinical and prevention purposes JAMA 1998280(1)42ndash48

Lee LM McKenna MT Monitoring the incidence of HIV infection in the United States Public Health Rep 2007122(suppl 1)72ndash79

10 Comm

entary

Cases of HIVAIDS and AIDS

Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003ndash2006mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

Year of diagnosis

2003 2004 2005 2006

Data for 33 statesAge at diagnosis (yrs)lt13 211 183 169 13513ndash14 53 36 40 4115ndash19 993 993 1126 133220ndash24 3163 3368 3592 388625ndash29 4023 4057 4236 460330ndash34 5189 4820 4676 446635ndash39 6369 5807 5535 544240ndash44 5786 5429 5529 571845ndash49 4028 3877 4028 420450ndash54 2451 2401 2547 271855ndash59 1279 1363 1455 143860ndash64 655 702 692 714gt65 570 624 613 618

RaceethnicityWhite not Hispanic 10033 10181 10528 10758Black not Hispanic 17668 16718 16629 17356Hispanic 6355 6010 6217 6481AsianPacific Islander 338 339 373 397American IndianAlaska Native 179 171 182 166

Transmission categoryMale adult or adolescentMale-to-male sexual contact 15409 15880 16833 17465Injection drug use 3514 3083 2978 3016Male-to-male sexual contact and injection drug use 1349 1299 1247 1180High-risk heterosexual contacta 4269 3959 3871 4152Otherb 125 110 107 114Subtotal 24666 24331 25036 25928

Female adult or adolescentInjection drug use 2027 1856 1720 1712High-risk heterosexual contacta 7731 7182 7216 7432Otherb 134 107 97 109Subtotal 9892 9145 9033 9252

Child (lt13 yrs at diagnosis)Perinatal 190 157 147 115Otherc 23 27 23 20Subtotal 213 184 170 135

Subtotal for 33 states 34770 33659 34239 35314

Data for US dependent areas 1331 1234 1395 1503

Totald 36102 34894 35634 36817Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

Cases of HIVAIDS and AIDS 11

Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

gt12 Months after diagnosis aof HIV infection

lt12 Months after diagnosis of HIV infectionb Total

No ()c No ()c No

Data for 33 statesAge at diagnosis (yrs)lt13 148 88 21 12 16913ndash14 22 54 18 46 4015ndash19 912 81 215 19 112620ndash24 2874 80 714 20 358925ndash29 3077 73 1157 27 423430ndash34 3016 65 1655 35 467135ndash39 3353 61 2176 39 553040ndash44 3181 58 2338 42 551945ndash49 2145 53 1874 47 401950ndash54 1307 51 1239 49 254655ndash59 725 50 728 50 145360ndash64 316 46 376 54 692gt65 266 44 346 56 612RaceethnicityWhite not Hispanic 6839 65 3677 35 10516Black not Hispanic 10372 62 6242 38 16614Hispanic 3593 58 2614 42 6206AsianPacific Islander 232 62 139 38 371American IndianAlaska Native 110 61 72 39 182Transmission category

Male adult or adolescentMale-to-male sexual contact 10917 65 5902 35 16819Injection drug use 1544 52 1427 48 2971Male-to-male sexual contact and injection drug use 733 59 512 41 1245High-risk heterosexual contactd 2091 54 1773 46 3864Othere 45 42 61 58 107Subtotal 15331 61 9675 39 25006Female adult or adolescentInjection drug use 1056 62 660 38 1716High-risk heterosexual contactd 4761 66 2450 34 7210Othere 47 48 50 52 97Subtotal 5864 65 3160 35 9023Child (lt13 yrs at diagnosis)Perinatal 126 86 21 14 147Otherf 22 94 2 6 23Subtotal 148 87 22 13 170

Subtotal for 33 states 21343 62 12857 38 34200Data for US dependent areas 855 61 541 39 1395

Totalg 22197 62 13398 38 35595h

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003Data exclude 39 persons whose month of diagnosis of HIV infection is unknowna Includes persons in whom AIDS has not developedb Includes persons whose diagnoses of HIV infection and AIDS were made at the same timec Percentages represent proportions of the total number of diagnoses of HIVAIDS made during 2005 for the corresponding group (see row

entries)d Heterosexual contact with a person known to have or to be at high risk for HIV infectione Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedf Includes hemophilia blood transfusion and risk factor not reported or not identifiedg Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the

column totalh Includes 310 persons of unknown race or multiple races

12 Cases of HIVAIDS and AIDS

Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas

Year of diagnosis2002 2003 2004 2005 2006 Cumulativea

Data for 50 states and the District of ColumbiaAge at diagnosis (yrs)lt13 106 70 53 53 38 915613ndash14 62 74 70 66 73 107815ndash19 316 302 334 410 401 562620ndash24 1399 1568 1624 1675 1669 3622525ndash29 3137 3059 3196 3110 3423 11709930ndash34 5701 5521 5144 4668 4349 19753035ndash39 8217 8017 7072 6479 6402 21357340ndash44 7404 7626 7703 7378 7298 17053145ndash49 5358 5617 5498 5727 5628 10720750ndash54 3271 3364 3491 3527 3687 5990755ndash59 1607 1693 1836 1861 2071 3219060ndash64 872 864 913 872 955 17303gt65 682 763 791 727 835 15074

RaceethnicityWhite not Hispanic 11233 10948 11066 10676 10929 394024Black not Hispanic 19246 19512 18909 18081 17960 409982Hispanic 6712 7102 6771 6823 6907 161505AsianPacific Islander 425 450 444 450 519 7951American IndianAlaska Native 177 176 182 170 155 3345

Transmission categoryMale adult or adolescentMale-to-male sexual contact 15709 16078 16054 15711 16001 465965Injection drug use 5483 5275 4818 4603 4410 170171Male-to-male sexual contact and injection drug use 2075 2029 1925 1930 1803 68516High-risk heterosexual contactb 4547 4471 4506 4306 4558 65241Otherc 253 226 228 237 217 13893Subtotal 28067 28079 27532 26787 26989 783786

Female adult or adolescentInjection drug use 2897 2836 2810 2586 2385 74718High-risk heterosexual contactb 6855 7336 7113 6922 7196 108252Otherc 207 217 217 205 220 6596Subtotal 9959 10389 10141 9713 9801 189566

Child (lt13 yrs at diagnosis)Perinatal 104 70 53 52 37 8508Otherd 2 0 0 0 0 636Subtotal 106 70 53 53 38 9144

Region of residenceNortheast 10092 10342 9412 9396 9486 306241Midwest 4125 4226 4089 4371 4164 101479South 17198 17630 18225 16894 17104 374800West 6718 6339 6000 5891 6074 199978Subtotal for 50 states and the District of Columbia 38132 38538 37726 36552 36828 982498

Data for US dependent areas 1058 1060 921 955 833 31217

Totale 39250 39690 38807 37662 37852 1014797Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes persons of unknown race or multiple races and persons of unknown sex Cumulative total includes 5691 persons of unknown race or multiple

races 3 persons of unknown sex 1079 persons of unknown state of residence and 3 persons who were residents of other areas Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Cases of HIVAIDS and AIDS 13

Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002ndash2006 and cumulativemdash50 states and the District of Columbia

Year of diagnosisCumulativea2002 2003 2004 2005 2006

RaceethnicityWhite not Hispanic 14 12 7 4 4 1599Black not Hispanic 70 46 33 38 30 5654Hispanic 18 10 9 8 3 1748AsianPacific Islander 1 0 1 1 1 54American IndianAlaska Native 1 0 1 0 0 31

Transmission categoryHemophiliacoagulation disorder 0 0 0 0 0 226Mother with documented HIV infection or 1 of the following risk factors 104 70 53 52 37 8508

Injection drug use 12 8 5 3 4 3220Sex with injection drug user 4 6 3 2 1 1397Sex with bisexual male 2 0 3 1 1 209Sex with person with hemophilia 0 0 0 0 0 35Sex with HIV-infected transfusion recipient 0 0 0 0 0 22Sex with HIV-infected person risk factor not specified 36 20 20 25 13 1530Receipt of blood transfusion blood components or tissue 2 1 0 0 0 144Has HIV infection risk factor not specified 47 34 21 21 17 1951

Receipt of blood transfusion blood components or tissue 2 0 0 0 0 374Otherrisk factor not reported or identified 0 0 0 0 0 36

Totalb 106 70 53 53 38 9144

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga From the beginning of the epidemic through 2006b Includes children of unknown race or multiple races Cumulative total includes 58 children of unknown race or multiple races Because column totals

were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992ndash2006mdash50 states and the District of Columbia

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reporting

14 Cases of HIVAIDS and AIDS

Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006mdash50 states and the District of Columbia

Raceethnicity

Adults or adolescents

Children (lt13 yrs) TotalaMales Females Totala

No Rate No Rate No Rate No Rate No Rate

White not Hispanic 9267 112 1659 19 10926 64 4 00 10929 54Black not Hispanic 11540 829 6391 404 17930 603 30 04 17960 476Hispanic 5388 313 1516 95 6903 208 3 00 6907 156AsianPacific Islander 423 75 95 16 518 44 1 00 519 37American IndianAlaska Native 118 122 37 36 155 78 0 00 155 62

Totalb 26989 224 9801 78 36790 149 38 01 36828c 123

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reportingData exclude cases in persons whose state or area of residence is unknown as well as cases from US dependent areas for which census information about race and age categories is lackinga Because row totals were calculated independently of the values for the subpopulations the values in each row may not sum to the row totalb Includes person of unknown race or multiple races Because column totals were calculated independently of the values for the subpopulations the

values in each column may not sum to the column totalc Includes 358 persons of unknown race or multiple races

Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006mdash33 states with confidential name-based HIV infection reporting

Raceethnicity

Adults or adolescents

Children (lt13 yrs) TotalaMales Females Totala

No Rate No Rate No Rate No Rate No Rate

White not Hispanic 9078 167 1664 29 10742 96 16 01 10758 82Black not Hispanic 11230 1191 6033 562 17263 856 93 17 17356 677Hispanic 5058 509 1400 151 6458 337 23 04 6481 255AsianPacific Islander 318 135 79 32 397 82 0 00 397 67American IndianAlaska Native 129 177 35 46 164 110 2 06 166 88

Totalb 25928 338 9252 115 35180 224 135 04 35314c 185

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Because row totals were calculated independently of the values for the subpopulations the values in each row may not sum to the row totalb Includes persons of unknown race or multiple races Because column totals were calculated independently of the values for the subpopulations the

values in each column may not sum to the column totalc Includes 156 persons of unknown race or multiple races

Cases of HIVAIDS and AIDS 15

Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006mdashUnited States and dependent areas

Transmission category

Place of birth

United StatesCentralSouth

America Cuba Mexico Puerto Rico Totala

No No No No No No

Male-to-male sexual contact 1172 45 402 49 89 62 790 59 249 18 3337 43Injection drug use 569 22 83 10 13 9 133 10 533 40 1650 21Male-to-male sexual contact

and injection drug use 158 6 25 3 6 4 59 4 63 5 357 5High-risk heterosexual

contactb 661 25 296 36 35 24 342 26 487 36 2282 30Otherc 47 2 8 1 0 0 9 1 14 1 103 1

Totald 2608 100 814 100 145 100 1334 100 1346 100 7728 100Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Includes 222 persons whose place of birth is not among those listed and 1260 persons whose place of birth is unknownb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the

column total

16 Cases of HIVAIDS and AIDS

Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas

Year of death

Cumulativea2002 2003 2004 2005 2006

Data for 50 states and the District of ColumbiaAge at death (yrs)lt13 25 22 15 7 13 4889

13ndash14 10 6 15 12 5 276

15ndash19 39 36 36 38 44 1104

20ndash24 151 157 175 147 162 8716

25ndash29 553 512 482 458 405 43671

30ndash34 1480 1272 1128 1069 785 95351

35ndash39 2967 2763 2425 2096 1682 116746

40ndash44 3595 3516 3393 3317 2636 104133

45ndash49 3294 3234 3251 3275 2886 72831

50ndash54 2318 2373 2502 2645 2343 44255

55ndash59 1209 1322 1425 1543 1480 25123

60ndash64 616 705 741 797 771 14315

gt65 691 773 807 865 805 14393

RaceethnicityWhite not Hispanic 5214 5097 4836 4758 3860 239529

Black not Hispanic 9037 8675 8581 8679 7426 218392

Hispanic 2429 2632 2641 2513 2425 80690

AsianPacific Islander 97 84 111 87 114 3426

American IndianAlaska Native 83 73 80 65 66 1693

Transmission categoryMale adult or adolescentMale-to-male sexual contact 5960 5937 5735 5641 4930 266272

Injection drug use 3738 3547 3315 3314 2641 107173

Male-to-male sexual contact and injection drug use 1278 1299 1237 1289 1064 40993

High-risk heterosexual contactb 1465 1501 1625 1571 1470 26236

Otherc 160 149 125 117 80 9867

Subtotal 12601 12431 12038 11932 10184 450541

Female adult or adolescentInjection drug use 1923 1825 1855 1768 1456 43143

High-risk heterosexual contactb 2281 2292 2373 2458 2258 42620

Otherc 84 87 72 68 70 4131

Subtotal 4289 4204 4300 4295 3784 89895

Child (lt13 yrs at diagnosis)Perinatal 53 49 56 39 42 4848

Otherd 4 5 1 2 7 521

Subtotal 57 54 57 41 48 5369

Deaths 17

Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas (cont)

Year of death

Cumulativea2002 2003 2004 2005 2006

Region of residenceNortheast 5313 5012 4779 4750 4074 180623

Midwest 1726 1666 1482 1378 1325 54468

South 7337 7427 7535 7907 6475 197209

West 2571 2585 2600 2234 2141 113506

Subtotal for 50 states and the District of Columbia 16948 16690 16395 16268 14016 545805

Data for US dependent areas 667 575 572 562 580 19858

Totale 17628 17283 16982 16865 14627 565927f

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column totalf Includes 2082 persons of unknown race or multiple races 261 persons of unknown state of residence and 2 persons who were residents

of other areas

18 Deaths

Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003ndash2006mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

2003 2004 2005 2006Data for 33 states

Age at end of year (yrs)lt13 4154 3700 3294 286713ndash14 1130 1238 1212 113915ndash19 3298 3627 4024 453920ndash24 12389 12826 13411 1430125ndash29 26167 26924 28164 2960030ndash34 49602 47577 45109 4418935ndash39 80703 77871 75842 7363440ndash44 92040 97109 100102 10176445ndash49 71345 77490 83816 9028350ndash54 45133 51033 56640 6319555ndash59 22793 26610 31186 3600860ndash64 10820 12642 14422 16658gt65 8531 9959 11657 13551

RaceethnicityWhite not Hispanic 145081 151694 158375 166000Black not Hispanic 202951 212425 221439 231957Hispanic 72612 76503 80491 84720AsianPacific Islander 2234 2529 2858 3187American IndianAlaska Native 1788 1889 2008 2119

Transmission categoryMale adult or adolescentMale-to-male sexual contact 181771 193245 205423 218676Injection drug use 57651 58149 58369 59077Male-to-male sexual contact and injection drug use 23965 24434 24725 25085High-risk heterosexual contacta 40084 42559 44915 47562Otherb 3218 3278 3325 3424Subtotal 306689 321665 336756 353825

Female adult or adolescentInjection drug use 32346 32735 32973 33470High-risk heterosexual contacta 80324 85348 90185 95403Otherb 2036 2123 2212 2321Subtotal 114705 120206 125370 131195

Child (lt13 yrs at diagnosis)Perinatal 6137 6154 6178 6143Otherc 570 575 571 560Subtotal 6707 6730 6748 6703

Subtotal for 33 states 428107 448605 468879 491727Data for US dependent areas 15809 16399 17150 17955

Totald 443916 465005 486028 509681Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 19

Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission categorymdash33 states with confidential name-based HIV infection reporting

Transmission category

White not Hispanic

Black not Hispanic Hispanic

AsianPacific Islander

American IndianAlaska

Native Totala

No No No No No No

Male adult or adolescentMale-to-male sexual contact 108259 77 70242 49 36043 57 1669 68 938 62 218676 62Injection drug use 12328 9 31339 22 14472 23 264 11 216 14 59077 17Male-to-male sexual contact

and injection drug use 11283 8 9587 7 3720 6 93 4 205 13 25085 7High-risk heterosexual contactb 6667 5 31140 22 8788 14 395 16 143 9 47562 13Otherc 1458 1 1492 1 404 1 30 1 17 1 3424 1Subtotal 139994 100 143799 100 63427 100 2450 100 1519 100 353825 100

Female adult or adolescentInjection drug use 8262 33 19136 23 5528 28 106 15 175 30 33470 26High-risk heterosexual contactb 16338 65 63204 75 14132 71 573 82 392 68 95403 73Otherc 450 2 1469 2 344 2 24 3 12 2 2321 2Subtotal 25050 100 83809 100 20004 100 703 100 578 100 131195 100

Child (lt13 yrs at diagnosis)Perinatal 801 84 4064 93 1183 92 28 82 20 95 6143 92Otherd 154 16 283 7 107 8 6 18 1 5 560 8Subtotal 955 100 4347 100 1290 100 34 100 21 100 6703 100

Totale 166000 231957 84720 3187 2119 491727Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of 33 states that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Includes 3745 persons of unknown race or multiple racesb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes 5 persons of unknown sex Because column totals were calculated independently of the values for the subpopulations the values

in each column may not sum to the column total

20 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Map 1 Estimated rates (per 100000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

Note Rates adjusted for reporting delays Rates of HIV infection include only persons living with HIV infection that has not progressed to AIDSSince 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 Islandsa Includes persons whose area of residence is unknown

Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

Note Rates adjusted for reporting delays Rates of HIV infection include only persons living with HIV infection that has not progressed to AIDSSince 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 Islandsa Includes persons whose area of residence is unknown

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 21

Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002ndash2006mdashUnited States and dependent areas

2002 2003 2004 2005 2006Data for 50 states and the District of Columbia

Age at end of year (yrs)lt13 2308 2006 1684 1394 111513ndash14 685 747 784 762 71115ndash19 1465 1694 1974 2243 248720ndash24 3910 4292 4629 5033 536725ndash29 12725 12743 13045 13505 1435930ndash34 35558 33870 32057 29949 2882435ndash39 70107 68106 65076 62235 5964940ndash44 80377 86294 91335 94021 9517445ndash49 64702 71276 77417 84153 9077550ndash54 41270 46855 53333 59256 6647655ndash59 20113 24145 28356 33522 3901460ndash64 9681 11293 13305 15380 18072gt65 7520 8946 10604 12430 14669

RaceethnicityWhite not Hispanic 129426 135278 141508 147426 154495Black not Hispanic 150488 161326 171654 181056 191590Hispanic 63424 67895 72024 76334 80815AsianPacific Islander 3060 3426 3759 4121 4526American IndianAlaska Native 1254 1356 1458 1562 1651

Transmission categoryMale adult or adolescentMale-to-male sexual contact 158092 168233 178551 188622 199693Injection drug use 56708 58436 59940 61229 62998Male-to-male sexual contact and injection drug use 24726 25457 26144 26785 27523High-risk heterosexual contacta 27329 30300 33181 35916 39004Otherb 3588 3665 3769 3888 4026Subtotal 270444 286091 301585 316440 333244

Female adult or adolescentInjection drug use 27863 28874 29828 30646 31575High-risk heterosexual contacta 46445 51489 56229 60693 65631Otherb 1903 2033 2178 2315 2465Subtotal 76210 82395 88236 93653 99671

Child (lt13 yrs at diagnosis)Perinatal 3633 3654 3651 3664 3660Otherc 129 124 123 122 115Subtotal 3762 3778 3774 3786 3775

Region of residenceNortheast 105599 110929 115562 120208 125620Midwest 36011 38571 41178 44171 47010South 137081 147284 157975 166962 177591West 71729 75483 78883 82540 86473

Subtotal for 50 states and the District of Columbia 350419 372267 393598 413882 436693

Data for US dependent areas 9880 10365 10713 11106 11359

Totald 360617 383024 404849 425646 448871Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

22 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission categorymdash50 states and the District of Columbia

Transmission category

White not Hispanic

Black not Hispanic Hispanic

AsianPacific Islander

American IndianAlaska

Native Totala

No No No No No No

Male adult or adolescentMale-to-male sexual contact 101299 75 57520 45 36087 57 2715 72 704 57 199693 60Injection drug use 13168 10 33911 27 14795 23 325 9 201 16 62998 19Male-to-male sexual contact and

injection drug use 12393 9 10121 8 4352 7 198 5 220 18 27523 8High-risk heterosexual contactb 6081 5 24205 19 7816 12 444 12 105 8 39004 12Otherc 1743 1 1602 1 574 1 69 2 16 1 4026 1Subtotal 134683 100 127359 100 63623 100 3752 100 1246 100 333244 100

Female adult or adolescentInjection drug use 7407 38 18531 30 5025 30 115 15 153 39 31575 32High-risk heterosexual contactb 11350 59 41741 68 11092 67 588 78 227 58 65631 66Otherc 508 3 1456 2 413 2 51 7 13 3 2465 2Subtotal 19264 100 61728 100 16531 100 753 100 393 100 99671 100

Child (lt13 yrs at diagnosis)Perinatal 500 92 2468 99 629 95 20 94 12 100 3660 97Otherd 46 8 34 1 33 5 1 6 0 0 115 3Subtotal 546 100 2503 100 662 100 21 100 12 100 3775 100

Totale 154495 191590 80815 4526 1651 436693

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Includes 3616 persons of unknown race or multiple racesb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes 3 person of unknown sex Because column totals were calculated independently of the values for the subpopulations the values in each column

may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 23

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by

area of residence and age categorymdashUnited States and dependent areas

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

Alabama 5469 17 5486 3744 11 3755Alaska 272 1 273 330 1 331Arizona 5744 49 5793 4922 7 4929Arkansas 2291 7 2298 2139 6 2145California mdash mdash mdash 61451 105 61555Colorado 5855 13 5869 4083 2 4085Connecticut mdash mdash mdash 7406 15 7421Delaware mdash mdash mdash 1753 7 1760District of Columbia mdash mdash mdash 10059 30 10089Floridab 35461 263 35723 46469 194 46663Georgia mdash mdash mdash 17336 47 17383Hawaii mdash mdash mdash 1234 3 1237Idaho 356 0 356 313 0 313Illinois mdash mdash mdash 16139 46 16185Indiana 3849 21 3870 3996 14 4010Iowa 588 2 590 869 3 872Kansas 1230 7 1237 1272 2 1274Kentucky mdash mdash mdash 2589 13 2602Louisiana 7361 101 7462 8052 21 8074Maine mdash mdash mdash 512 2 514Maryland mdash mdash mdash 14540 41 14581Massachusetts mdash mdash mdash 8806 20 8826Michigan 6118 55 6173 6615 12 6627Minnesota 3227 21 3248 2314 9 2323Mississippi 4200 32 4232 3155 13 3168Missouri 4999 33 5033 5479 7 5486Montana mdash mdash mdash 205 0 205Nebraska 688 12 700 771 2 773Nevada 3402 13 3415 2969 3 2972New Hampshire mdash mdash mdash 556 3 559New Jersey 16059 153 16212 17168 57 17226New Mexico 910 0 909 1252 3 1255New York 42220 801 43021 70697 148 70845North Carolina 11700 60 11760 8451 12 8463North Dakota 87 2 89 73 1 74Ohio 8266 57 8323 7054 30 7084Oklahoma 2191 17 2208 2191 3 2194Oregon mdash mdash mdash 2840 4 2844Pennsylvania mdash mdash mdash 18633 71 18703Rhode Island mdash mdash mdash 1296 7 1303South Carolina 6349 45 6394 7035 23 7058South Dakota 195 4 199 139 1 140Tennessee 6579 51 6631 6403 11 6414Texas 24741 262 25003 34010 53 34063Utah 893 10 903 1164 0 1164Vermont mdash mdash mdash 238 2 240Virginia 9937 41 9978 8423 24 8447Washington mdash mdash mdash 5471 5 5476West Virginia 660 5 665 749 5 754Wisconsin 2322 15 2337 2153 12 2165Wyoming 86 2 88 102 1 103

Subtotal 224303 2174 226477 435621 1115 436736

24 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age categorymdashUnited States and dependent areas (cont)

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

US dependent areasAmerican Samoa 2 0 2 1 0 1Guam 63 0 63 36 0 36Northern Mariana Islands 7 0 7 3 0 3Puerto Rico 6269 31 6300 10971 26 10997US Virgin Islands 228 2 230 312 2 314Otherc mdash mdash mdash 1 0 1

Totald 230872 2207 233079 447724 1147 448871

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reporting a See Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at

least 2003b Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterc Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasd Total number of persons living with HIV infection (not AIDS) includes persons reported from areas with confidential name-based HIV

infection reporting who were residents of other states or whose area of residence is unknown Total number of persons living with AIDS includes persons whose area of residence is unknown Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 25

Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristicsmdashUnited States and dependent areas

No of persons

Survival in months

gt12 gt24 gt36Data for 50 states and the District of Columbia

Age at diagnosis (yrs)lt13 101 096 094 09413ndash14 60 098 098 09515ndash19 305 098 096 09520ndash24 1351 096 093 09225ndash29 3034 095 092 09130ndash34 5499 094 091 08935ndash39 7888 093 090 08740ndash44 7085 092 088 08545ndash49 5090 089 085 08250ndash54 3067 086 081 07855ndash59 1505 083 078 07460ndash64 806 080 073 069gt65 614 073 068 065

RaceethnicityWhite not Hispanic 10706 092 089 087Black not Hispanic 18406 090 086 082Hispanic 6398 092 090 088AsianPacific Islander 404 094 092 090American IndianAlaska Native 167 084 081 075

Transmission categoryMale adult or adolescentMale-to-male sexual contact 12830 093 090 088Injection drug use 4048 089 084 081Male-to-male sexual contact and injection drug use 1701 093 089 086High-risk heterosexual contacta 3170 091 088 085Otherb 5019 086 083 080Subtotal 26768 091 088 085

Female adult or adolescentInjection drug use 2101 089 083 078High-risk heterosexual contacta 4686 093 089 086Otherb 2749 090 085 083Subtotal 9536 091 087 083

Child (lt13 yrs at diagnosis)Perinatal 98 096 095 095Otherc 3 100 067 067Subtotal 101 096 094 094

Subtotal for 50 states and the District of Columbia 36405 091 087 085

Data for US dependent areas 891 083 078 075

Total 37352d 091 087 084Note Excludes persons whose date of death was before or in the same month as date of diagnosis Excludes persons whose month of diagnosis or month of death is unknowna Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes 325 persons of unknown race or multiple races

26 Survival after AIDS Diagnosis

Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by year of diagnosismdashUnited States and dependent areas

Months after AIDS diagnosis

Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by age groupmdashUnited States and dependent areas

Months after AIDS diagnosis

Survival after AIDS Diagnosis 27

Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by raceethnicitymdashUnited States and dependent areas

Months after AIDS diagnosis

28 Survival after AIDS Diagnosis

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006

and cumulativemdashUnited States and dependent areas

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Alabama 510 112 462 100 8626 76 8702Alaska 24 36 38 57 648 7 655Arizona 626 105 539 87 10396 46 10442Arkansas 237 85 252 90 3891 36 3927California 4069 113 3960 109 142254 664 142918Colorado 351 75 322 68 8742 31 8773Connecticut 658 188 422 120 14716 183 14899Delaware 177 210 116 136 3547 26 3573District of Columbia 672 1155 853 1467 17372 189 17561Florida 4921 277 4932 273 104084 1530 105614Georgia 2325 255 1605 171 31734 231 31965Hawaii 105 82 93 72 2927 17 2944Idaho 24 17 26 18 604 2 606Illinois 1886 148 1382 108 33620 282 33902Indiana 407 65 346 55 8239 56 8295Iowa 93 31 86 29 1727 13 1740Kansas 105 38 120 43 2781 14 2795Kentucky 249 60 207 49 4600 32 4632Louisiana 936 208 824 192 17612 128 17740Maine 21 16 68 51 1110 8 1118Maryland 1558 279 1626 290 30252 319 30571Massachusetts 666 104 533 83 19181 214 19395Michigan 821 81 672 67 14941 113 15054Minnesota 226 44 212 41 4817 28 4845Mississippi 368 127 365 125 6642 56 6698Missouri 385 66 469 80 11016 61 11077Montana 21 22 7 07 373 3 376Nebraska 53 30 118 67 1479 11 1490Nevada 293 121 294 118 5733 29 5762New Hampshire 33 25 55 42 1074 10 1084New Jersey 1262 145 1065 122 48750 778 49528New Mexico 134 70 93 48 2603 7 2610New York 6201 321 5495 285 174908 2354 177262North Carolina 916 106 1229 139 15954 118 16072North Dakota 10 16 6 09 144 1 145Ohio 753 66 767 67 14957 138 15095Oklahoma 281 79 205 57 4836 26 4862Oregon 217 60 281 76 5995 20 6015Pennsylvania 1486 120 1893 152 33417 365 33782Rhode Island 87 81 111 104 2580 28 2608South Carolina 682 161 705 163 13301 105 13406South Dakota 18 23 18 23 255 5 260Tennessee 818 137 680 113 12457 59 12516Texas 3045 133 2998 128 69735 392 70127Utah 63 25 57 22 2295 20 2315Vermont 5 08 18 29 461 6 467Virginia 638 84 605 79 16802 177 16979Washington 485 77 389 61 11792 34 11826West Virginia 74 41 67 37 1500 11 1511Wisconsin 122 22 217 39 4513 33 4546Wyoming 6 12 8 16 228 2 230

Subtotal 40123 135 37911 127 952221 9094 961315

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 29

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulativemdashUnited States and dependent areas (cont)

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

US dependent areasAmerican Samoa 0 0 0 0 1 0 1Guam 0 0 0 0 68 1 69Northern Mariana Islands 0 0 0 0 3 0 3Puerto Rico 1029 263 850 216 29511 400 29911US Virgin Islands 17 156 32 295 629 18 647Otherb 0 0 0 0 3 0 3

Totalc 41357 138 39002 129 983343 9522 992865d

a From the beginning of the epidemic through 2006b Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasc Includes persons whose state or area of residence is unknownd Includes 916 persons whose state or area of residence is unknown

30 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

MSA (population gt 500000)

Akron Ohio 66 94 32 46 762 1 763

AlbanyndashSchenectadyndashTroy NY 97 114 105 123 2253 24 2277

Albuquerque N Mex 70 88 50 61 1404 2 1406

AllentownndashBethlehemndashEaston PandashNJ 72 91 119 149 1352 17 1369

AtlantandashSandy SpringsndashMarietta Ga 1586 319 1006 196 21896 128 22024

AugustandashRichmond County GandashSC 106 205 32 61 1851 24 1875

AustinndashRound Rock Tex 227 156 186 123 4830 26 4856

Bakersfield Calif 76 100 122 156 1528 8 1536

BaltimorendashTowson Md 1064 401 1001 377 20352 218 20570

Baton Rouge La 222 304 231 301 3732 20 3752

BirminghamndashHoover Ala 151 139 110 100 2614 25 2639

Boise CityndashNampa Idaho 14 26 14 25 281 0 281

Boston MassndashNHa 441 99 355 80 13476 147 13623

Boston Division 269 146 185 101 8451 91 8542

Cambridge Division 108 74 102 70 3126 35 3161

Essex Division 52 71 51 69 1577 20 1597

BridgeportndashStamfordndashNorwalk Conn 181 201 135 150 3733 57 3790

BuffalondashNiagara Falls NY 117 102 96 84 2476 20 2496

Cape CoralndashFort Myers Fla 44 81 91 159 1692 24 1716

CharlestonndashNorth Charleston SC 92 155 91 151 2034 18 2052

CharlottendashGastoniandashConcord NCndashSC 214 141 285 180 3242 22 3264

Chicago IllndashIndndashWis 1716 182 1159 122 30118 261 30379

Chicago Division 1604 203 1073 135 28300 248 28548

Gary Division 61 88 50 71 1038 8 1046

Lake Division 51 59 36 41 780 5 785

CincinnatindashMiddletown OhiondashKyndashInd 111 53 199 95 2735 17 2752

ClevelandndashElyriandashMentor Ohio 228 107 170 80 4226 48 4274

Colorado Springs Colo 19 32 21 35 576 5 581

Columbia SC 177 256 197 280 3274 24 3298

Columbus Ohio 166 97 165 96 3112 15 3127

Dallas Tex 874 150 929 155 20238 63 20301

Dallas Division 681 175 714 178 16038 37 16075

Fort Worth Division 193 100 215 108 4200 26 4226

Dayton Ohio 58 69 54 64 1217 15 1232

DenverndashAurora Colo 274 116 236 98 6899 22 6921

Des Moines Iowa 30 57 23 43 530 4 534

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 31

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Detroit Mich 570 127 445 100 10373 73 10446

Detroit Division 443 223 330 167 8268 57 8325

Warren Division 127 51 115 46 2105 16 2121

El Paso Tex 56 78 40 54 1476 10 1486

Fresno Calif 52 59 64 72 1430 11 1441

Grand RapidsndashWyoming Mich 46 60 51 66 816 6 822

GreensborondashHigh Point NC 52 77 66 96 1265 14 1279

Greenville SC 70 119 67 111 1292 4 1296

HarrisburgndashCarlisle Pa 23 44 67 128 1224 8 1232

HartfordndashWest HartfordndashEast Hartford Conn 256 216 135 114 5126 46 5172

Honolulu Hawaii 54 60 69 76 2121 14 2135

HoustonndashBaytownndashSugar Land Tex 1017 190 1092 197 25821 172 25993

Indianapolis Ind 191 116 150 90 3824 25 3849

Jackson Miss 134 257 117 221 2419 30 2449

Jacksonville Fla 309 248 315 246 6020 75 6095

Kansas City MondashKans 183 94 160 81 4669 15 4684

Knoxville Tenn 47 72 35 52 882 5 887

Lakeland Fla 103 190 112 199 1811 21 1832

Las VegasndashParadise Nev 245 143 258 145 4616 28 4644

Little RockndashNorth Little Rock Ark 87 135 75 115 1383 14 1397

Los Angeles Calif 1529 118 1684 130 57953 293 58246

Los Angeles Division 1339 135 1435 144 51098 250 51348

Santa Anna Division 190 63 249 83 6855 43 6898

Louisville KyndashInd 123 102 97 79 2286 22 2308

Madison Wis 10 19 29 53 520 4 524

McAllenndashEdinburgndashPharr Tex 57 84 45 64 630 11 641

Memphis TennndashMissndashArk 402 320 346 271 5128 19 5147

Miami Fla 2420 446 2289 419 55807 997 56804

Fort Lauderdale Division 810 455 769 430 16412 262 16674

Miami Division 1243 523 1165 485 29703 512 30215

West Palm Beach Division 367 290 355 279 9692 223 9915

MilwaukeendashWaukeshandashWest Allis Wis 68 45 109 72 2507 18 2525

MinneapolisndashSt PaulndashBloomington MinnndashWis 186 59 184 58 4259 22 4281

Modesto Calif 36 71 22 43 671 6 677

NashvillendashDavidsonndashMurfreesboro Tenn 224 158 172 118 3848 20 3868

New HavenndashMilford Conn 169 200 107 127 4573 73 4646

New OrleansndashMetairiendashKenner La 393 299 271 264 8835 67 8902

32 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

New York NYndashNJndashPa 6215 330 5500 292 195177 2906 198083

Edison Division 191 83 130 56 6709 139 6848

Nassau Division 262 93 246 88 8141 110 8251

New York Division 5266 456 4716 408 160408 2323 162731

Newark Division 496 231 408 190 19919 334 20253

Oklahoma City Okla 125 108 88 75 2255 5 2260

OmahandashCouncil Bluffs NebndashIowa 37 46 80 97 1035 3 1038

Orlando Fla 544 282 517 260 8653 92 8745

OxnardndashThousand OaksndashVentura Calif 49 62 21 26 1008 3 1011

Palm BayndashMelbournendashTitusville Fla 68 129 61 114 1512 11 1523

Philadelphia PandashNJndashDelndashMd 1261 217 1348 231 28221 313 28534

Camden Division 108 87 111 89 3118 42 3160

Philadelphia Division 1022 263 1144 294 22112 250 22362

Wilmington Division 131 191 93 134 2991 21 3012

PhoenixndashMesandashScottsdale Ariz 460 119 376 93 7459 31 7490

Pittsburgh Pa 143 60 135 57 3182 19 3201

PortlandndashSouth Portland Maine 9 18 34 66 562 1 563

PortlandndashVancouverndashBeaverton OrendashWash 170 81 215 101 4825 10 4835

PoughkeepsiendashNewburghndashMiddletown NY 136 204 113 168 3162 24 3186

ProvidencendashNew BedfordndashFall River RIndashMass 132 82 155 96 3900 44 3944

RaleighndashCary NC 138 145 201 202 1987 13 2000

Richmond Va 119 101 122 102 3371 35 3406

RiversidendashSan BernardinondashOntario Calif 361 92 306 76 8568 60 8628

Rochester NY 165 159 124 120 3134 13 3147

SacramentondashArden-ArcadendashRoseville Calif 154 75 169 82 4000 26 4026

St Louis MondashIll 192 69 366 131 5965 40 6005

Salt Lake City Utah 46 44 40 37 1743 10 1753

San Antonio Tex 215 114 247 127 4987 30 5017

San DiegondashCarlsbadndashSan Marcos Calif 491 167 384 131 12934 61 12995

San Francisco Calif 867 209 690 165 40152 96 40248

Oakland Division 312 126 246 99 9546 48 9594

San Francisco Division 555 329 444 261 30606 48 30654

San JosendashSunnyvalendashSanta Clara Calif 88 50 145 81 3747 15 3762

San JuanndashCaguasndashGuaynabo PR 745 289 578 223 21402 277 21679

SarasotandashBradentonndashVenice Fla 82 122 104 152 1978 27 2005

ScrantonndashWilkes-Barre Pa 27 49 47 85 572 6 578

Seattle Wash 353 110 280 86 9172 27 9199

Seattle Division 316 129 255 102 8161 18 8179

Tacoma Division 37 49 25 33 1011 9 1020

Springfield Mass 88 128 45 66 2075 26 2101

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 33

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Stockton Calif 52 78 52 77 1076 15 1091

Syracuse NY 52 80 49 75 1317 8 1325

TampandashSt PetersburgndashClearwater Fla 559 211 605 224 11174 112 11286

Toledo Ohio 25 38 66 101 812 14 826

Tucson Ariz 103 111 100 106 2010 10 2020

Tulsa Okla 83 94 65 72 1494 10 1504

Virginia BeachndashNorfolkndashNewport News VandashNC 183 111 132 80 4711 63 4774

Washington DCndashVandashMdndashWV 1322 252 1684 318 31130 315 31445

Bethesda Division 135 118 173 150 2774 23 2797

Washington Division 1187 289 1511 365 28356 292 28648

Wichita Kans 35 60 38 64 851 2 853

Worcester Mass 76 97 79 101 1783 20 1803

YoungstownndashWarrenndashBoardman OhiondashPa 27 46 26 44 519 0 519

Subtotal for MSAs (population gt500000) 33602 173 31274 159 829633 8171 837804

Metropolitan areas (population of 50000 to 499999) 4477 80 4466 79 94829 847 95676

Nonmetropolitan areas 2666 54 2732 55 52063 445 52508

Totalb 41144 137 38749 128 981708 9494 991202

Note Because of the lack of census information for all US dependent areas includes data for only the 50 states the District of Columbia and Puerto RicoMSA metropolitan statistical areaMSA definitions for this report can be found at httpwwwcensusgovpopulationwwwestimatesmetrodefhtmla Reported case counts for the metropolitan divisions do not sum to the MSA total MSA total includes data from 1 metropolitan division with

population of lt500000b Includes persons whose county of residence is unknown

34 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Alabama (January 1988) 502 6041 48 6089

Alaska (February 1999) 38 285 2 287

Arizona (January 1987) 617 5877 80 5957

Arkansas (July 1989) 206 2349 20 2369

California (April 2006) 6581 7056 92 7148

Colorado (November 1985) 319 6084 31 6115

Connecticut (January 2005)b 826 2500 101 2601

Delaware (February 2006) 788 801 18 819

Florida (July 1997)c 4163 36386 397 36783

Georgia (December 2003) 2245 8197 194 8391

Idaho (June 1986) 35 340 4 344

Illinois (January 2006) 6241 6661 162 6823

Indiana (July 1988) 399 4027 43 4070

Iowa (July 1998) 69 586 5 591

Kansas (July 1999) 142 1225 15 1240

Kentucky (October 2004) 333 1303 13 1316

Louisiana (February 1993) 728 8149 166 8315

Maine (January 2006) 386 393 3 396

Michigan (April 1992) 635 6702 134 6836

Minnesota (October 1985) 309 3356 40 3396

Mississippi (August 1988) 352 4549 59 4608

Missouri (October 1987) 502 5086 55 5141

Nebraska (September 1995) 91 672 14 686

Nevada (February 1992) 339 3532 24 3556

New Hampshire (January 2005) 59 466 9 475

New Jersey (January 1992) 1477 17513 325 17838

New Mexico (January 1998) 114 949 4 953

New York (June 2000) 5326 42345 1820 44165

North Carolina (February 1990) 1615 13879 143 14022

North Dakota (January 1988) 4 82 1 83

Ohio (June 1990) 867 8222 101 8323

Oklahoma (June 1988) 229 2401 30 2431

Oregon (April 2006) 49 95 19 114

Pennsylvania (October 2002)d 4269 9537 179 9716

Rhode Island (July 2006) 14 21 0 21

South Carolina (February 1986) 493 6970 93 7063

South Dakota (January 1988) 18 215 6 221

Tennessee (January 1992) 732 7115 90 7205

Texas (January 1999)e 3370 24282 417 24699

Utah (April 1989) 106 893 14 907

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 35

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Virginia (July 1989) 864 10257 95 10352

Washington (March 2006) 4048 4157 40 4197

West Virginia (January 1989) 66 673 8 681

Wisconsin (November 1985) 261 2500 31 2531

Wyoming (June 1989) 7 93 1 94

Subtotal 50834 274822 5146 279968

US dependent areas

American Samoa (August 2001) 0 1 0 1

Guam (March 2000) 2 66 0 66

Northern Mariana Islands (October 2001) 2 7 0 7

Puerto Rico (January 2003) 1471 5610 91 5701

US Virgin Islands (December 1998) 22 247 6 253

Persons reported from areas with confidential name-based HIV infection reporting but who were residents of other areas 132 685 21 706

Totalf 52878 282640 5314 287954

Note Includes data from 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through 2006b Beginning in 1992 Connecticut had name-based HIV reporting for cases in children only From January 2002 through December 2004

Connecticut had name- or code-based HIV reporting for cases in adolescents and adults As of January 2005 Connecticut has name-based reporting of all cases of HIV infection

c Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterd On October 18 2002 Pennsylvania initiated confidential name-based HIV infection reporting in all areas except Philadelphia Code-based

reporting was implemented in Philadelphia in March 2004 and the switch to name-based reporting was made in October 2005e From February 1994 through December 1998 Texas reported HIV infection in children onlyf Includes 1252 persons reported from areas with confidential name-based HIV infection reporting but whose area of residence is unknown

36 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulativemdashUnited States and dependent areas

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No Adult or adolescentMale-to-male sexual contact 13775 49 429897 54 mdash mdash mdash mdash 13775 35 429897 44Injection drug use 3413 12 163070 21 1826 17 67693 35 5239 13 230763 23Male-to-male sexual contact and

injection drug use 1603 6 65524 8 mdash mdash mdash mdash 1603 4 65524 7Hemophiliacoagulation disorder 43 0 5176 1 11 0 348 0 54 0 5524 1High-risk heterosexual contactc 2997 11 49610 6 4839 46 85186 44 7836 20 134796 14

Sex with injection drug user 330 1 11683 1 706 7 26073 14 1036 3 37756 4Sex with bisexual male mdash mdash mdash mdash 234 2 5162 3 234 1 5162 1Sex with person with hemophilia 1 0 84 0 11 0 502 0 12 0 586 0Sex with HIV-infected transfusion

recipient 22 0 553 0 21 0 793 0 43 0 1346 0Sex with HIV-infected person risk

factor not specified 2644 9 37290 5 3867 37 52656 27 6511 17 89946 9Receipt of blood transfusion blood

d components or tissue 63 0 5213 1 68 1 4176 2 131 0 9389 1Otherrisk factor not reported or

identifiede 6484 23 73136 9 3793 36 34311 18 10278 26 107450 11Subtotal 28378 100 791626 100 10537 100 191714 100 38916 100 983343 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 0 0 222 5 0 0 7 0 0 0 229 2Mother with documented HIV infection or

1 of the following risk factors 24 75 4315 89 50 93 4423 95 74 86 8738 92Injection drug use 4 13 1676 35 4 7 1665 36 8 9 3341 35Sex with injection drug user 4 13 789 16 4 7 750 16 8 9 1539 16Sex with bisexual male 1 3 101 2 2 4 110 2 3 3 211 2Sex with person with hemophilia 0 0 20 0 0 0 16 0 0 0 36 0Sex with HIV-infected transfusion

recipient 0 0 11 0 0 0 15 0 0 0 26 0Sex with HIV-infected person risk

factor not specified 6 19 742 15 17 31 790 17 23 27 1532 16Receipt of blood transfusion blood

components or tissue 0 0 70 1 0 0 82 2 0 0 152 2Has HIV infection risk factor not

specified 9 28 906 19 23 43 995 21 32 37 1901 20Receipt of blood transfusion blood

fcomponents or tissue 1 3 243 5 0 0 144 3 1 1 387 4Otherrisk factor not reported or

identifiedg 7 22 75 2 4 7 93 2 11 13 168 2Subtotal 32 100 4855 100 54 100 4667 100 86 100 9522 100

Total 28410 100 796481 100 10591 100 196381 100 39002 100 992865 100a From the beginning of the epidemic through 2006b From the beginning of the epidemic through 2006 Includes 3 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infectiond AIDS developed in 47 adultsadolescents after they received blood that had tested negative for HIV antibodies AIDS developed in 14 additional adults

after they received tissue organs or artificial insemination from HIV-infected donors Four of the 14 received tissue or organs from a donor who was negative for HIV antibody at the time of donation

e Includes 37 adultsadolescents who were exposed to HIV-infected blood body fluids or concentrated virus in health care laboratory or household settings as supported by seroconversion epidemiologic andor laboratory evidence One person was infected after intentional inoculation with HIV-infected blood Includes an additional 740 persons who acquired HIV infection perinatally but who were more than 12 years of age when AIDS was diagnosed These 740 persons are not counted in the values for the pediatric transmission category

f AIDS developed in 3 children after they received blood that had tested negative for HIV antibodiesg Includes 5 children who were exposed to HIV-infected blood as supported by seroconversion epidemiologic andor laboratory evidence 1 child was

infected after intentional inoculation with HIV-infected blood and 5 children were exposed to HIV-infected blood in a household setting Of the 168 children 26 had sexual contact with an adult with or at high risk for HIV infection

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 37

Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No

Adult or adolescentMale-to-male sexual contact 22912 59 103679 52 mdash mdash mdash mdash 22912 44 103679 37

Injection drug use 3503 9 24255 12 2124 16 13925 17 5627 11 38181 14

Male-to-male sexual contact and injection drug use 1946 5 10704 5 mdash mdash mdash mdash 1946 4 10704 4

Hemophiliacoagulation disorder 43 0 495 0 6 0 73 0 49 0 568 0

High-risk heterosexual contactc 2874 7 16830 8 5939 45 38315 47 8813 17 55145 20

Sex with injection drug user 308 1 2601 1 757 6 6791 8 1065 2 9392 3

Sex with bisexual male mdash mdash mdash mdash 328 2 2265 3 328 1 2265 1

Sex with person with hemophilia 4 0 31 0 16 0 201 0 20 0 232 0

Sex with HIV-infected transfusion recipient 13 0 131 0 28 0 223 0 41 0 354 0

Sex with HIV-infected person risk factor not specified 2549 7 14067 7 4810 36 28835 35 7359 14 42902 15

Receipt of blood transfusion blood components or tissue 61 0 489 0 50 0 536 1 111 0 1025 0

Otherrisk factor not reported or identified 7748 20 44021 22 5106 39 29312 36 12854 25 73338 26

Subtotal 39087 100 200473 100 13225 100 82161 100 52312 100 282640 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 8 3 106 4 0 0 1 0 8 1 107 2

Mother with documented HIV infection or 1 of the following risk factors 197 74 2195 85 254 85 2417 89 451 80 4612 87

Injection drug use 34 13 532 21 53 18 561 21 87 15 1093 21

Sex with injection drug user 12 5 208 8 21 7 213 8 33 6 421 8

Sex with bisexual male 5 2 37 1 4 1 32 1 9 2 69 1

Sex with person with hemophilia 0 0 3 0 1 0 7 0 1 0 10 0

Sex with HIV-infected transfusion recipient 0 0 4 0 0 0 4 0 0 0 8 0

Sex with HIV-infected person risk factor not specified 54 20 534 21 76 25 629 23 130 23 1163 22

Receipt of blood transfusion blood components or tissue 0 0 17 1 2 1 20 1 2 0 37 1

Has HIV infection risk factor not specified 92 35 860 33 97 32 951 35 189 33 1811 34

Receipt of blood transfusion blood components or tissue 6 2 28 1 3 1 24 1 9 2 52 1

Otherrisk factor not reported or identified 55 21 260 10 43 14 283 10 98 17 543 10

Subtotal 266 100 2589 100 300 100 2725 100 566 100 5314 100

Total 39353 100 203062 100 13525 100 84886 100 52878 100 287954 100

Note See Table 16 for the list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006b From the beginning of the epidemic through December 2006 Includes 6 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infection

38 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity

2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 6251 65 253927 73Injection drug use 733 8 31737 9Male-to-male sexual contact and injection drug use 732 8 31434 9Hemophiliacoagulation disorder 26 0 3989 1High-risk heterosexual contactb 416 4 7850 2

Sex with injection drug user 74 1 2310 1

Sex with person with hemophilia 0 0 36 0

Sex with HIV-infected transfusion recipient 2 0 176 0

Sex with HIV-infected person risk factor not specified 340 4 5328 2Receipt of blood transfusion blood components or tissue 20 0 3194 1Otherrisk factor not reported or identified 1400 15 16469 5

Total 9578 100 348600 100

Black not HispanicMale-to-male sexual contact 4309 36 103297 37Injection drug use 1635 14 83369 30Male-to-male sexual contact and injection drug use 526 4 22134 8Hemophiliacoagulation disorder 10 0 604 0High-risk heterosexual contactb 1875 16 29952 11

Sex with injection drug user 167 1 6823 2Sex with person with hemophilia 1 0 36 0Sex with HIV-infected transfusion recipient 15 0 237 0Sex with HIV-infected person risk factor not specified 1692 14 22856 8

Receipt of blood transfusion blood components or tissue 24 0 1218 0Otherrisk factor not reported or identified 3579 30 40268 14

Total 11958 100 280842 100

HispanicMale-to-male sexual contact 2816 47 64893 44Injection drug use 965 16 46337 31Male-to-male sexual contact and injection drug use 287 5 10884 7Hemophiliacoagulation disorder 6 0 466 0High-risk heterosexual contactb 638 11 10950 7

Sex with injection drug user 84 1 2409 2Sex with person with hemophilia 0 0 11 0Sex with HIV-infected transfusion recipient 5 0 125 0Sex with HIV-infected person risk factor not specified 549 9 8405 6

Receipt of blood transfusion blood components or tissue 17 0 657 0Otherrisk factor not reported or identified 1326 22 14832 10

Total 6055 100 149019 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 39

a

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulative

No No

AsianPacific IslanderMale-to-male sexual contact 225 54 4475 68Injection drug use 20 5 317 5Male-to-male sexual contact and injection drug use 17 4 284 4Hemophiliacoagulation disorder 1 0 70 1High-risk heterosexual contactb 34 8 376 6

Sex with injection drug user 1 0 54 1Sex with person with hemophilia 0 0 1 0Sex with HIV-infected transfusion recipient 0 0 8 0Sex with HIV-infected person risk factor not specified 33 8 313 5

Receipt of blood transfusion blood components or tissue 2 0 112 2Otherrisk factor not reported or identified 114 28 949 14

Total 413 100 6583 100

American IndianAlaska NativeMale-to-male sexual contact 61 49 1403 55Injection drug use 15 12 395 15Male-to-male sexual contact and injection drug use 23 19 457 18Hemophiliacoagulation disorder 0 0 27 1High-risk heterosexual contactb 9 7 118 5

Sex with injection drug user 1 1 33 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 8 6 82 3

Receipt of blood transfusion blood components or tissue 0 0 8 0Otherrisk factor not reported or identified 16 13 155 6

Total 124 100 2563 100

Total casesMale-to-male sexual contact 13775 49 429897 54Injection drug use 3413 12 163070 21Male-to-male sexual contact and injection drug use 1603 6 65524 8Hemophiliacoagulation disorder 43 0 5176 1High-risk heterosexual contactb 2997 11 49610 6

Sex with injection drug user 330 1 11683 1Sex with person with hemophilia 1 0 84 0Sex with HIV-infected transfusion recipient 22 0 553 0Sex with HIV-infected person risk factor not specified 2644 9 37290 5

Receipt of blood transfusion blood components or tissue 63 0 5213 1Otherrisk factor not reported or identified 6484 23 73136 9

Total 28378c 100 791626d 100a From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 4019 males of unknown race or multiple races

40 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 11963 73 55725 69Injection drug use 858 5 5512 7Male-to-male sexual contact and injection drug use 1092 7 5578 7Hemophiliacoagulation disorder 29 0 355 0High-risk heterosexual contactb 522 3 2658 3

Sex with injection drug user 65 0 544 1Sex with person with hemophilia 0 0 8 0Sex with HIV-infected transfusion recipient 3 0 33 0Sex with HIV-infected person risk factor not specified 454 3 2073 3

Receipt of blood transfusion blood components or tissue 14 0 197 0Otherrisk factor not reported or identified 1956 12 11147 14

Total 16434 100 81172 100

Black not HispanicMale-to-male sexual contact 6203 44 30148 37Injection drug use 1594 11 11997 15Male-to-male sexual contact and injection drug use 483 3 3489 4Hemophiliacoagulation disorder 10 0 109 0High-risk heterosexual contactb 1714 12 10905 13

Sex with injection drug user 169 1 1554 2Sex with person with hemophilia 4 0 17 0Sex with HIV-infected transfusion recipient 6 0 77 0Sex with HIV-infected person risk factor not specified 1535 11 9257 11

Receipt of blood transfusion blood components or tissue 32 0 223 0Otherrisk factor not reported or identified 4151 29 24632 30

Total 14187 100 81503 100

HispanicMale-to-male sexual contact 4094 55 15623 47Injection drug use 993 13 6407 19Male-to-male sexual contact and injection drug use 316 4 1402 4Hemophiliacoagulation disorder 3 0 26 0High-risk heterosexual contactb 582 8 2963 9

Sex with injection drug user 65 1 455 1Sex with person with hemophilia 0 0 6 0Sex with HIV-infected transfusion recipient 4 0 18 0Sex with HIV-infected person risk factor not specified 513 7 2484 7

Receipt of blood transfusion blood components or tissue 11 0 55 0Otherrisk factor not reported or identified 1475 20 6977 21

Total 7474 100 33453 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 41

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderMale-to-male sexual contact 402 70 1006 63Injection drug use 17 3 55 3Male-to-male sexual contact and injection drug use 15 3 38 2Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 25 4 96 6

Sex with injection drug user 3 1 10 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 22 4 83 5

Receipt of blood transfusion blood components or tissue 4 1 7 0Otherrisk factor not reported or identified 109 19 397 25

Total 572 100 1600 100

American IndianAlaska NativeMale-to-male sexual contact 104 61 516 57Injection drug use 13 8 101 11Male-to-male sexual contact and injection drug use 19 11 110 12Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 10 6 53 6

Sex with injection drug user 2 1 14 2Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 8 5 39 4

Receipt of blood transfusion blood components or tissue 0 0 2 0Otherrisk factor not reported or identified 24 14 125 14

Total 170 100 907 100

Total casesMale-to-male sexual contact 22912 59 103679 52Injection drug use 3503 9 24255 12Male-to-male sexual contact and injection drug use 1946 5 10704 5Hemophiliacoagulation disorder 43 0 495 0High-risk heterosexual contactb 2874 7 16830 8

Sex with injection drug user 308 1 2601 1Sex with person with hemophilia 4 0 31 0Sex with HIV-infected transfusion recipient 13 0 131 0Sex with HIV-infected person risk factor not specified 2549 7 14067 7

Receipt of blood transfusion blood components or tissue 61 0 489 0Otherrisk factor not reported or identified 7748 20 44021 22

Total 39087c 100 200473d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 1838 males of unknown race or multiple races

42 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race

ethnicity 2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 482 28 14981 40Hemophiliacoagulation disorder 4 0 123 0High-risk heterosexual contactb 725 42 15799 42

Sex with injection drug user 153 9 5650 15Sex with bisexual male 63 4 1859 5Sex with person with hemophilia 5 0 329 1Sex with HIV-infected transfusion recipient 5 0 338 1Sex with HIV-infected person risk factor not specified 499 29 7623 20

Receipt of blood transfusion blood components or tissue 15 1 1870 5Otherrisk factor not reported or identified 499 29 4801 13

Total 1725 100 37574 100

Black not HispanicInjection drug use 982 15 38914 34Hemophiliacoagulation disorder 3 0 145 0High-risk heterosexual contactb 3103 46 49876 44

Sex with injection drug user 373 6 13530 12Sex with bisexual male 136 2 2352 2Sex with person with hemophilia 4 0 121 0Sex with HIV-infected transfusion recipient 8 0 277 0Sex with HIV-infected person risk factor not specified 2582 38 33596 29

Receipt of blood transfusion blood components or tissue 39 1 1546 1Otherrisk factor not reported or identified 2612 39 23894 21

Total 6739 100 114375 100

HispanicInjection drug use 322 18 12892 35Hemophiliacoagulation disorder 4 0 67 0High-risk heterosexual contactb 894 49 17995 49

Sex with injection drug user 166 9 6522 18Sex with bisexual male 32 2 818 2Sex with person with hemophilia 1 0 45 0Sex with HIV-infected transfusion recipient 7 0 141 0Sex with HIV-infected person risk factor not specified 688 38 10469 29

Receipt of blood transfusion blood components or tissue 12 1 619 2Otherrisk factor not reported or identified 592 32 5023 14

Total 1824 100 36596 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 43

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 8 8 125 12Hemophiliacoagulation disorder 0 0 7 1High-risk heterosexual contactb 49 47 574 53

Sex with injection drug user 4 4 114 11Sex with bisexual male 2 2 80 7Sex with person with hemophilia 0 0 4 0Sex with HIV-infected transfusion recipient 1 1 25 2Sex with HIV-infected person risk factor not specified 42 40 351 33

Receipt of blood transfusion blood components or tissue 1 1 93 9Otherrisk factor not reported or identified 46 44 279 26

Total 104 100 1078 100

American IndianAlaska NativeInjection drug use 13 32 280 42Hemophiliacoagulation disorder 0 0 3 0High-risk heterosexual contactb 15 37 277 41

Sex with injection drug user 4 10 107 16Sex with bisexual male 1 2 27 4Sex with person with hemophilia 0 0 2 0Sex with HIV-infected transfusion recipient 0 0 6 1Sex with HIV-infected person risk factor not specified 10 24 135 20

Receipt of blood transfusion blood components or tissue 1 2 17 3Otherrisk factor not reported or identified 12 29 95 14

Total 41 100 672 100

Total casesInjection drug use 1826 17 67693 35Hemophiliacoagulation disorder 11 0 348 0High-risk heterosexual contactb 4839 46 85186 44

Sex with injection drug user 706 7 26073 14Sex with bisexual male 234 2 5162 3Sex with person with hemophilia 11 0 502 0Sex with HIV-infected transfusion recipient 21 0 793 0Sex with HIV-infected person risk factor not specified 3867 37 52656 27

Receipt of blood transfusion blood components or tissue 68 1 4176 2Otherrisk factor not reported or identified 3793 36 34311 18

Total 10537c 100 191714d 100a From the beginning of the epidemic through 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 104 females of unknown race or multiple racesd Includes 1419 females of unknown race or multiple races

44 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 690 26 4260 26Hemophiliacoagulation disorder 3 0 24 0

bHigh-risk heterosexual contact 1132 42 7593 46Sex with injection drug user 205 8 1876 11Sex with bisexual male 98 4 659 4Sex with person with hemophilia 10 0 115 1Sex with HIV-infected transfusion recipient 7 0 64 0Sex with HIV-infected person risk factor not specified 812 30 4879 29

Receipt of blood transfusion blood components or tissue 12 0 146 1Otherrisk factor not reported or identified 850 32 4567 28

Total 2687 100 16590 100

Black not HispanicInjection drug use 1034 13 7105 14Hemophiliacoagulation disorder 1 0 35 0

bHigh-risk heterosexual contact 3451 44 23732 46Sex with injection drug user 313 4 3473 7Sex with bisexual male 155 2 1294 3Sex with person with hemophilia 5 0 71 0Sex with HIV-infected transfusion recipient 14 0 120 0Sex with HIV-infected person risk factor not specified 2964 38 18774 36

Receipt of blood transfusion blood components or tissue 26 0 324 1Otherrisk factor not reported or identified 3370 43 20244 39

Total 7882 100 51440 100

HispanicInjection drug use 339 15 2280 18Hemophiliacoagulation disorder 2 0 11 0

bHigh-risk heterosexual contact 1198 52 6264 50Sex with injection drug user 218 9 1324 11Sex with bisexual male 62 3 266 2Sex with person with hemophilia 1 0 11 0Sex with HIV-infected transfusion recipient 7 0 39 0Sex with HIV-infected person risk factor not specified 910 39 4624 37

Receipt of blood transfusion blood components or tissue 12 1 58 0Otherrisk factor not reported or identified 767 33 3843 31

Total 2318 100 12456 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 45

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 2: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

The HIVAIDS Surveillance Report is published annually by the Division of HIVAIDS Prevention National Center for HIVAIDS Viral Hepatitis STD and TB Prevention Coordinating Center for Infectious Diseases Centers for Disease Control and Prevention (CDC) US Department of Health and Human Services Atlanta Georgia

Data are presented for cases of HIV infection and AIDS reported to CDC through June 2007 All data are provisional

The HIVAIDS Surveillance Report is not copyrighted and may be used and copied without permission Citation of the source is however appreciated

Suggested citation

Centers for Disease Control and Prevention HIVAIDS Surveillance Report 2006 Vol 18 Atlanta US Department of Health and Human Services Centers for Disease Control and Prevention 2008[inclusive page numbers] httpwwwcdcgovhivtopicssurveillanceresourcesreports

Single copiesCDC National Prevention Information NetworkPO Box 6003Rockville MD 20849-6003Telephone 1-800-458-5231 or 1-301-562-1098

Request to be added to mailing listCDC MASOMISBMail Stop E-114770 Buford HighwayChamblee GA 30341-3717

On the Webhttpwwwcdcgovhivtopicssurveillanceresourcesreports

Confidential information referrals and educational material on HIV infection and AIDSCDC-INFO (formerly the CDC National AIDS Hotline)1-800-232-4636 (in English en Espantildeol)1-888-232-6348 (TTY)E-mail cdcinfocdcgov

AcknowledgmentsPublication of this report would not have been possible without the contributions of the state and territorial health departments and the HIVAIDS surveillance programs that provided surveillance data to the Centers for Disease Control and Prevention

This report was prepared by the following staff and contractors of the Division of HIVAIDS Prevention National Center for HIVAIDS Viral Hepatitis STD and TB Prevention CDC Anna Satcher Johnson Denise Hughes Xiaohong Hu Michael Campsmith Irene Hall Marie Morgan (editing) Janet Brzuskiewicz (graphics) and Michael Friend (desktop publishing)

The HIVAIDS design element on the cover is used with the permission of the American Red Cross

Federal Recycling Program Printed on recycled paper

Contents

Commentary 5

Section 1 Cases of HIVAIDS and AIDSTable 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003ndash

2006mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting11

Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

12

Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas

13

Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002ndash2006 and cumulativemdash50 states and the District of Columbia

14

Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992ndash2006mdash50 states and the District of Columbia

14

Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006mdash50 states and the District of Columbia

15

Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006mdash33 states with confidential name-based HIV infection reporting

15

Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006mdashUnited States and dependent areas

16

Section 2 DeathsTable 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics

2002ndash2006 and cumulativemdashUnited States and dependent areas17

Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003ndash

2006mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting19

Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission categorymdash33 states with confidential name-based HIV infection reporting

20

Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

21

Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

21

Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002ndash2006mdashUnited States and dependent areas

22

Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission categorymdash50 states and the District of Columbia

23

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age categorymdashUnited States and dependent areas

24

3

Section 4 Survival after AIDS DiagnosisTable 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002

by selected characteristicsmdashUnited States and dependent areas26

Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by year of diagnosismdashUnited States and dependent areas

27

Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by age groupmdashUnited States and dependent areas

27

Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by raceethnicitymdashUnited States and dependent areas

28

Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and

cumulativemdashUnited States and dependent areas29

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico

31

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

35

Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulativemdashUnited States and dependent areas

37

Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

38

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas

39

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

41

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas

43

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

45

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

47

Technical Notes 48

Web Addresses for Reports of State or Local HIV and AIDS Surveillance 55

4 Contents

Commentary

The HIVAIDS epidemic was first recognized in the United States in 1981 Since that time all states and US dependent areas have conducted AIDS sur-veillance by using a standardized confidential name-based reporting system Because successful treatment delays the progression of HIV infection to AIDS AIDS surveillance data alone are insufficient to moni-tor trends in HIV incidence or to meet federal state or local data needs for planning and allocating resources for HIV prevention and care programs An integrated national HIVAIDS surveillance system will enhance the ability to monitor and characterize populations affected by the HIV epidemic and provide information on the entire population of HIV-infected persons who have been tested confidentially In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confi-dential name-based public health disease surveillance systems to report cases of HIV infection California implemented confidential name-based HIV infection case surveillance in April 2006 and this issue marks the first time that HIV case reports from California have been included in the HIVAIDS Surveillance Report For more information about HIV reporting in California visit httpwwwdhscagovAIDSHIVReporting

This report presents estimated numbers of cases of HIVAIDS (cases of HIV infection regardless whether they have progressed to AIDS) from the 38 areas (33 states and 5 US dependent areas) that have had confi-dential name-based HIV infection reporting for a suf-ficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends According to the number of reported AIDS cases these 33 states repre-sent approximately 63 of the epidemic in the 50 states and the District of Columbia From 2003 through 2006 the total number of new cases of HIVAIDS remained stable in the 33 states however HIVAIDS prevalence (ie the number of persons living with HIVAIDS) increased steadily by the end of 2006 an estimated 491727 persons in the 33 states were living with HIVAIDS The map on the cover depicts the estimated rates of diagnoses of HIVAIDS in 2006 by area of residence at the time of diagnosis

for persons residing in the 33 states and 5 US depen-dent areas with confidential name-based HIV infection reporting since at least 2003

Surveillance data on HIV infections compared with data on AIDS provide a more complete picture of the epidemic and the need for prevention and care services However the number of new HIV diagnoses during a given year(s) does not necessarily reflect a trend in HIV incidence (ie new infections) because some per-sons were infected recently and others were infected at some time in the past CDC has developed the serologic testing algorithm for recent HIV seroconversion (STARHS) which can distinguish recent from long-standing HIV infections at a population level This technology has made it possible to develop a surveil-lance system that will provide more accurate and timely estimates of HIV incidence CDC and its part-ners in state and local health departments have been working during the past several years to develop and evaluate this system Five areas were funded in FY 2002 to pilot the methods by FY 2005 34 areas were funded to conduct incidence surveillance HIVAIDS surveillance data are used by CDCrsquos public health part-ners and by professionals in other federal agencies health departments nonprofit organizations and aca-demic institutions Recognizing the changing needs for data CDC is committed to presenting the data that will best meet those needs The first estimates of HIV inci-dence which require the use of complex estimation methods are expected in 2008 The monitoring of HIV incidence will be critical in evaluating progress toward CDCrsquos goal of reducing the number of new HIV infec-tions in the United States and in allocating resources and evaluating prevention program effectiveness

The 2006 HIVAIDS Surveillance Report is orga-nized in 5 sections (1) cases of HIVAIDS and AIDS (2) deaths of persons with AIDS (3) persons living with HIVAIDS AIDS or HIV infection (not AIDS) (4) length of survival after AIDS diagnosis and (5) reports of cases of HIVAIDS AIDS and HIV infec-tion (not AIDS) In Sections 1ndash3 we present point esti-mates of case counts that have been adjusted for reporting delays and for the redistribution of cases in persons initially reported without an identified risk factor CDC routinely adjusts data for the presentation

5

of trends in the epidemic Data to estimate the number of cases of HIVAIDS or AIDS the number of persons living with HIVAIDS AIDS or HIV infection (not AIDS) and the number of deaths among persons with AIDS have been statistically adjusted to correct for delays in the reporting of cases and deaths

To assess trends in cases deaths or prevalence it is preferable to use adjusted data presented by year of diagnosis instead of year of report to eliminate arti-facts of reporting in the surveillance system Therefore for trends the reader is encouraged to use the tables in Sections 1ndash3 that present trends by year of diagnosis year of death or year-end prevalence Section 4 pre-sents estimates of survival for persons whose AIDS diagnosis was made during 2002 (Table 13) and for persons whose diagnosis was made during 1998ndash2005 (Figures 2ndash4) Proportions of persons who survived for various lengths of time after diagnosis are presented by year of diagnosis age group raceethnicity and HIV transmission category

Finally Section 5 presents reports of cases of HIV infection (not AIDS) and cases of AIDS reported through 2006 The areas included in tabulations of reported cases of HIV infection (not AIDS) are based on the date that confidential name-based HIV infection reporting was implemented For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US dependent areas) to describe reports of HIV infection These data which have not been adjusted for delays in reporting are presented by year of report to CDC Tables that present cases by year of report represent the most up-to-date information reported to CDC however cases by year of report do not represent inci-dent cases the most recent diagnoses trends or deaths

HIGHLIGHTS OF ANALYSES

Cases of HIVAIDS and Cases of AIDS

Cases of HIVAIDSFrom 2003 through 2006 the estimated number of

HIVAIDS cases in the 33 states with confidential name-based HIV infection reporting remained stable (Table 1) In 2006 the estimated rate of HIVAIDS cases in the 33 states was 185 per 100000 population (Table 5b)

bull Age group From 2003 through 2006 the estimated number of newly diagnosed HIVAIDS

6 Comm

cases decreased among children (less than 13 years of age) and in the following age groups 13ndash14 30ndash34 and 35ndash39 years (Table 1) The estimated number of HIVAIDS cases remained stable among persons aged 40ndash44 years and increased among persons aged 15ndash19 20ndash24 25ndash29 45ndash49 50ndash54 55ndash59 60ndash64 and 65 years and older In 2006 the largest number of HIVAIDS cases occurred among persons aged 40ndash44 years who accounted for 16 of all HIVAIDS cases diagnosed during that year

bull Raceethnicity From 2003 through 2006 the estimated number of newly diagnosed HIVAIDS cases increased among whites and AsiansPacific Islanders remained stable among blacks and Hispanics and fluctuated among American IndiansAlaska Natives (Table 1) Blacks accounted for 49 of all HIVAIDS cases diagnosed in 2006 In 2006 rates of HIVAIDS cases were 677 per 100000 in the black population 255 per 100000 in the Hispanic population 88 per 100000 in the American IndianAlaska Native population 82 per 100000 in the white population and 67 per 100000 in the AsianPacific Islander population (Table 5b)

bull Sex From 2003 through 2006 the estimated number of HIVAIDS cases increased approximately 5 among males and decreased 6 among females (Table 1) In 2006 males accounted for 74 of all HIVAIDS cases among adults and adolescents In 2006 rates were 338 per 100000 among males and 115 per 100000 among females (Table 5b)

bull Transmission category From 2003 through 2006 the estimated number of HIVAIDS cases increased among men who have sex with men (MSM) and remained stable among adults and adolescents with HIV infection attributed to high-risk heterosexual contact (heterosexual contact with a person known to have or to be at high risk for HIV infection) (Table 1) The estimated number of HIVAIDS cases decreased among injection drug users (IDUs) MSM who were also IDUs and among children MSM (49) and persons exposed through high-risk heterosexual contact (33) accounted for 82 of all HIVAIDS cases diagnosed in 2006

entary

Of all HIV infections diagnosed in 2005 in the 33 states with confidential name-based HIV reporting 38 progressed to AIDS within 12 months after HIV infection was diagnosed AIDS was diagnosed within 12 months after the diagnosis of HIV infection for larger proportions of persons aged 13ndash14 years and 35 years and older for Hispanics for IDUs and for males with HIV infection attributed to high-risk heterosexual contact (Table 2)

Cases of AIDSFrom 2002 through 2006 the estimated number of

newly diagnosed AIDS cases in the 50 states and the District of Columbia remained stable (Table 3) In 2006 the estimated rate of AIDS cases in the United States was 123 per 100000 population (Table 5a)

bull Age group From 2002 through 2006 the estimated number of AIDS cases decreased 64 among children (less than 13 years of age) (Table 3) The estimated number of AIDS cases also decreased among persons in the age groups 30ndash34 and 35ndash39 years (Table 3) The estimated number of AIDS cases remained stable among persons aged 40ndash44 years and increased in the following age groups 13ndash14 15ndash19 20ndash24 25ndash29 45ndash49 50ndash54 55ndash59 60ndash64 and 65 years and older In 2006 the largest number of AIDS cases occurred among persons aged 40ndash44 years who accounted for 20 of all AIDS cases diagnosed during that year in the 50 states and the District of Columbia

bull Raceethnicity From 2002 through 2006 the estimated number of AIDS cases decreased among blacks and American IndiansAlaska Natives remained stable among whites and Hispanics and increased among AsiansPacific Islanders (Table 3) In 2006 rates of AIDS cases were 476 per 100000 in the black population 156 per 100000 in the Hispanic population 62 per 100000 in the American IndianAlaska Native population 54 per 100000 in the white population and 37 per 100000 in the AsianPacific Islander population (Table 5a)

bull Sex From 2002 through 2006 the estimated number of AIDS cases remained stable among both male and female adults and adolescents (Table 3) Males accounted for 73 of all AIDS cases diagnosed in 2006 for adults and adolescents in the 50 states and the District of Columbia (Table

Comm

3) Rates of AIDS cases in 2006 were 224 per 100000 among males and 78 per 100000 among females (Table 5a)

bull Transmission category From 2002 through 2006 among male adults and adolescents the estimated number of AIDS cases decreased among IDUs and MSM who were also IDUs (Table 3) The numbers of males exposed through male-to-male sexual contact and high-risk heterosexual contact remained stable Among female adults and adolescents the estimated number of AIDS cases decreased among IDUs and fluctuated among females exposed through high-risk heterosexual contact

bull Region From 2002 through 2006 the estimated number of AIDS cases decreased 10 in the West and 6 in the Northeast and remained stable in the South and the Midwest

DeathsFrom 2002 through 2006 the estimated number of

deaths of persons with AIDS who resided in the 50 states and the District of Columbia decreased 17 (Table 7)

bull Age group The estimated number of deaths decreased among children (less than 13 years of age) and in the following age groups 13ndash14 25ndash29 30ndash34 35ndash39 40ndash44 and 45ndash49 years The estimated number of deaths remained stable among persons aged 50ndash54 years and increased in the age groups 15ndash19 20ndash24 55ndash59 60ndash64 and 65 years and older

bull Raceethnicity The estimated number of deaths of persons with AIDS decreased among whites blacks and American IndiansAlaska Natives The estimated number of deaths of persons with AIDS remained stable among Hispanics and increased among AsiansPacific Islanders

bull Sex and transmission category The estimated number of deaths of adults and adolescents decreased among MSM and IDUs and remained stable among persons exposed through high-risk heterosexual contact

bull Region The estimated number of deaths decreased in all regions of the United States

entary 7

Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS

Persons living with HIVAIDSFrom 2003 through 2006 the estimated number of

persons living with HIVAIDS increased steadily in the 33 states with confidential name-based HIV infec-tion reporting (Table 8) At the end of 2006 an esti-mated 491727 persons in these states were living with HIVAIDS

bull By age group most (21) were aged 40ndash44 years

bull By raceethnicity 47 were black 34 white 17 Hispanic and less than 1 each were American IndianAlaska Native or AsianPacific Islander

bull By sex 73 of adults and adolescents living with HIVAIDS were male

bull Of the estimated 353825 male adults and adolescents living with HIVAIDS 62 had been exposed through male-to-male sexual contact 17 had been exposed through injection drug use 13 had been exposed through high-risk heterosexual contact and 7 had been exposed through both male-to-male sexual contact and injection drug use Of the estimated 131195 female adults and adolescents living with HIVAIDS 73 had been exposed through high-risk heterosexual contact and 26 had been exposed through injection drug use Of the estimated 6703 children living with HIVAIDS 92 had been exposed perinatally

Prevalence rates of HIV infection (not AIDS)At the end of 2006 in the 38 areas with confidential

name-based HIV infection reporting since at least 2003 the prevalence rate of HIV infection (not AIDS) among adults and adolescents was estimated at 1437 per 100000 (Map 1) The rate for adults and adoles-cents living with HIV infection (not AIDS) ranged from an estimated 49 per 100000 (American Samoa) to an estimated 2617 per 100000 (New York) The prevalence rate of HIV infection (not AIDS) among children residing in the 38 areas was an estimated 65 per 100000 (Map 2) The rate for children living with HIV infection (not AIDS) ranged from an estimated zero per 100000 in Idaho New Mexico American Samoa Guam and the Northern Mariana Islands to an estimated 253 per 100000 in New York

8 Comm

Persons living with AIDSAIDS prevalence also increased steadily from 2002

through 2006 (Table 10) At the end of 2006 an esti-mated 436693 persons in the 50 states and the District of Columbia were living with AIDS

bull By age group most (22) were aged 40ndash44 years

bull By raceethnicity 44 were black 35 white 19 Hispanic 1 AsianPacific Islander and less than 1 were American IndianAlaska Native

bull By sex 77 of adults and adolescents living with AIDS were male

bull Of the estimated 333244 male adults and adolescents living with AIDS 60 had been exposed through male-to-male sexual contact 19 had been exposed through injection drug use 12 had been exposed through high-risk heterosexual contact and 8 had been exposed through both male-to-male sexual contact and injection drug use Of the estimated 99671 female adults and adolescents living with AIDS 66 had been exposed through high-risk heterosexual contact and 32 had been exposed through injection drug use

bull By region 41 resided in the South 29 in the Northeast 20 in the West and 11 in the Midwest

AIDS prevalence ratesAt the end of 2006 the prevalence rate of AIDS

among adults and adolescents in the United States was estimated at 1786 per 100000 (Map 1) The rate for adults and adolescents living with AIDS ranged from an estimated 25 per 100000 (American Samoa) to an estimated 20165 per 100000 (District of Columbia) The prevalence rate of AIDS among children in the United States was estimated at 22 per 100000 at the end of 2006 (Map 2) The rate for children living with AIDS ranged from an estimated zero per 100000 in Idaho Montana Utah American Samoa Guam and the Northern Mariana Islands to an estimated 365 per 100000 in the District of Columbia

Survival after AIDS DiagnosisTable 13 is limited to data on AIDS cases diagnosed

in 2002 in order to describe the survival of persons whose diagnosis was made relatively recently but far enough in the past to permit a meaningful measure of

entary

survival Figures 2 3 and 4 illustrate the proportion of surviving persons among persons whose diagnoses were made over a longer period 1998 through 2005

bull Survival (the estimated proportion of persons surviving a given length of time after diagnosis) increased with the year of diagnosis for diagnoses made during 1998ndash2000 Year-to-year differences were small during 2001ndash2005 (Figure 2)

bull Survival decreased as age at diagnosis increased among persons at least 35 years old at diagnosis and in comparison with persons younger than 35 Survival was similar for the age groups 13ndash24 and 25ndash34 (Figure 3)

bull Survival was greatest among MSM and among children with perinatally acquired HIV infection (Table 13) Survival was intermediate among male and female adults and adolescents who had heterosexual contact with someone known to be HIV infected or at high risk for HIV infection as well as among MSM who also were IDUs Survival was lowest among male and female adults and adolescents who were IDUs

bull Survival particularly at more than 48 months after diagnosis was greater among AsiansPacific Islanders whites and Hispanics than among blacks (Figure 4) Results were unstable or inconsistent for American IndiansAlaska Natives because the numbers of persons in this racialethnic category were small

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Tables 14ndash23 describe reports of cases of HIVAIDS AIDS and HIV infection (not AIDS) Tables 16 18 20 and 22 are based on reports of cases of HIV infection (not AIDS) through 2006 from the 50 areas that had implemented name-based HIV infection reporting Note that not all cases of HIV infection (not AIDS) or AIDS reported in 2006 reflect diagnoses made during 2006 rather the reported cases include cases diagnosed during earlier years

Reports of cases of HIV infection (not AIDS)Through 2006 a total of 287954 persons were

reported as having HIV infection (not AIDS) in the 50 areas with confidential name-based HIV infection reporting (Table 16) (see Technical Notes for discus-sion of surveillance of HIV infection [not AIDS])

Comm

Five states (Florida New Jersey New York North Carolina and Texas) reported 137507 (48) of the 287954 cumulative cases of HIV infection (not AIDS) reported to CDC In 2006 4 states (California Illinois New York and Pennsylvania) reported 22417 (42) of the 52878 cases of HIV infection (not AIDS)

bull In 2006 of the 52312 reported cases among adults and adolescents 75 were in males and 25 were in females (Table 18)

bull In 2006 566 cases in children were reported

Reports of AIDS casesThrough 2006 a total of 992865 persons in the

United States had been reported as having AIDS (Table 14) Three states (California Florida and New York) reported 43 of the cumulative AIDS cases and 37 of AIDS cases reported to CDC in 2006 In the United States the rate of reported AIDS cases in 2006 was 129 per 100000 population When the US dependent areas were included the rate of reported AIDS cases ranged from zero per 100000 (American Samoa Guam and the Northern Mariana Islands) to 1467 per 100000 (District of Columbia)

bull In 2006 males accounted for 73 and females for 27 of 38916 reported AIDS cases among adults and adolescents (Table 17)

bull In 2006 86 AIDS cases in children were reported

ADDITIONAL RESOURCES

The following were prepared by using HIVAIDS surveillance data

bull Selected MMWR articles at httpwwwcdcgovhivresourcesreportsmmwr

bull Public-use slides at httpwwwcdcgovhivtopicssurveillanceresourcesslides

bull Other surveillance reports at httpwwwcdcgovhivtopicssurveillanceresourcesreports

bull Public-use version of the AIDS surveillance data set (AIDS Public Information Data Set [APIDS]) at httpwwwcdcgovhivsoftwareapidshtm

SUGGESTED READINGS

CDC Advancing HIV Prevention New Strategies for a Changing EpidemicmdashUnited States 2003 MMWR 200352(15)329ndash332

entary 9

CDC Dear colleague letter CDC recommends that all states and territories adopt confidential name-based surveillance systems to report HIV infec-tions httpwwwcdcgovhivpubs070505_dearcolleague_gerberdingpdf Pub-lished July 5 2005 Accessed March 11 2008

1981ndash2005 CDC Epidemiology of HIVAIDSmdashUnited States

MMWR 200655(21)589ndash592CDC Guidelines for national HIV case surveil-

lance including monitoring for HIV infection and AIDS MMWR 199948(RR-13)1ndash31

CDC HIV prevention strategic plan extended through 2010 httpwwwcdcgovhivresourcesreportspsp Published October 2007 Accessed March 11 2008

CDC Revised recommendations for HIV testing of adults adolescents and pregnant women in health-care settings MMWR 200655(RR-14)1ndash17

CDC Twenty-five years of HIVAIDSmdashUnited States 1981ndash2006 MMWR 200655(21)585ndash589

Glynn MK Lee LM McKenna MT The status of national HIV case surveillance United States 2006 Public Health Rep 2007122(suppl 1)63ndash71

Janssen RS Satten GA Stramer SL et al New test-ing strategy to detect early HIV-1 infection for use in incidence estimates and for clinical and prevention purposes JAMA 1998280(1)42ndash48

Lee LM McKenna MT Monitoring the incidence of HIV infection in the United States Public Health Rep 2007122(suppl 1)72ndash79

10 Comm

entary

Cases of HIVAIDS and AIDS

Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003ndash2006mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

Year of diagnosis

2003 2004 2005 2006

Data for 33 statesAge at diagnosis (yrs)lt13 211 183 169 13513ndash14 53 36 40 4115ndash19 993 993 1126 133220ndash24 3163 3368 3592 388625ndash29 4023 4057 4236 460330ndash34 5189 4820 4676 446635ndash39 6369 5807 5535 544240ndash44 5786 5429 5529 571845ndash49 4028 3877 4028 420450ndash54 2451 2401 2547 271855ndash59 1279 1363 1455 143860ndash64 655 702 692 714gt65 570 624 613 618

RaceethnicityWhite not Hispanic 10033 10181 10528 10758Black not Hispanic 17668 16718 16629 17356Hispanic 6355 6010 6217 6481AsianPacific Islander 338 339 373 397American IndianAlaska Native 179 171 182 166

Transmission categoryMale adult or adolescentMale-to-male sexual contact 15409 15880 16833 17465Injection drug use 3514 3083 2978 3016Male-to-male sexual contact and injection drug use 1349 1299 1247 1180High-risk heterosexual contacta 4269 3959 3871 4152Otherb 125 110 107 114Subtotal 24666 24331 25036 25928

Female adult or adolescentInjection drug use 2027 1856 1720 1712High-risk heterosexual contacta 7731 7182 7216 7432Otherb 134 107 97 109Subtotal 9892 9145 9033 9252

Child (lt13 yrs at diagnosis)Perinatal 190 157 147 115Otherc 23 27 23 20Subtotal 213 184 170 135

Subtotal for 33 states 34770 33659 34239 35314

Data for US dependent areas 1331 1234 1395 1503

Totald 36102 34894 35634 36817Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

Cases of HIVAIDS and AIDS 11

Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

gt12 Months after diagnosis aof HIV infection

lt12 Months after diagnosis of HIV infectionb Total

No ()c No ()c No

Data for 33 statesAge at diagnosis (yrs)lt13 148 88 21 12 16913ndash14 22 54 18 46 4015ndash19 912 81 215 19 112620ndash24 2874 80 714 20 358925ndash29 3077 73 1157 27 423430ndash34 3016 65 1655 35 467135ndash39 3353 61 2176 39 553040ndash44 3181 58 2338 42 551945ndash49 2145 53 1874 47 401950ndash54 1307 51 1239 49 254655ndash59 725 50 728 50 145360ndash64 316 46 376 54 692gt65 266 44 346 56 612RaceethnicityWhite not Hispanic 6839 65 3677 35 10516Black not Hispanic 10372 62 6242 38 16614Hispanic 3593 58 2614 42 6206AsianPacific Islander 232 62 139 38 371American IndianAlaska Native 110 61 72 39 182Transmission category

Male adult or adolescentMale-to-male sexual contact 10917 65 5902 35 16819Injection drug use 1544 52 1427 48 2971Male-to-male sexual contact and injection drug use 733 59 512 41 1245High-risk heterosexual contactd 2091 54 1773 46 3864Othere 45 42 61 58 107Subtotal 15331 61 9675 39 25006Female adult or adolescentInjection drug use 1056 62 660 38 1716High-risk heterosexual contactd 4761 66 2450 34 7210Othere 47 48 50 52 97Subtotal 5864 65 3160 35 9023Child (lt13 yrs at diagnosis)Perinatal 126 86 21 14 147Otherf 22 94 2 6 23Subtotal 148 87 22 13 170

Subtotal for 33 states 21343 62 12857 38 34200Data for US dependent areas 855 61 541 39 1395

Totalg 22197 62 13398 38 35595h

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003Data exclude 39 persons whose month of diagnosis of HIV infection is unknowna Includes persons in whom AIDS has not developedb Includes persons whose diagnoses of HIV infection and AIDS were made at the same timec Percentages represent proportions of the total number of diagnoses of HIVAIDS made during 2005 for the corresponding group (see row

entries)d Heterosexual contact with a person known to have or to be at high risk for HIV infectione Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedf Includes hemophilia blood transfusion and risk factor not reported or not identifiedg Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the

column totalh Includes 310 persons of unknown race or multiple races

12 Cases of HIVAIDS and AIDS

Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas

Year of diagnosis2002 2003 2004 2005 2006 Cumulativea

Data for 50 states and the District of ColumbiaAge at diagnosis (yrs)lt13 106 70 53 53 38 915613ndash14 62 74 70 66 73 107815ndash19 316 302 334 410 401 562620ndash24 1399 1568 1624 1675 1669 3622525ndash29 3137 3059 3196 3110 3423 11709930ndash34 5701 5521 5144 4668 4349 19753035ndash39 8217 8017 7072 6479 6402 21357340ndash44 7404 7626 7703 7378 7298 17053145ndash49 5358 5617 5498 5727 5628 10720750ndash54 3271 3364 3491 3527 3687 5990755ndash59 1607 1693 1836 1861 2071 3219060ndash64 872 864 913 872 955 17303gt65 682 763 791 727 835 15074

RaceethnicityWhite not Hispanic 11233 10948 11066 10676 10929 394024Black not Hispanic 19246 19512 18909 18081 17960 409982Hispanic 6712 7102 6771 6823 6907 161505AsianPacific Islander 425 450 444 450 519 7951American IndianAlaska Native 177 176 182 170 155 3345

Transmission categoryMale adult or adolescentMale-to-male sexual contact 15709 16078 16054 15711 16001 465965Injection drug use 5483 5275 4818 4603 4410 170171Male-to-male sexual contact and injection drug use 2075 2029 1925 1930 1803 68516High-risk heterosexual contactb 4547 4471 4506 4306 4558 65241Otherc 253 226 228 237 217 13893Subtotal 28067 28079 27532 26787 26989 783786

Female adult or adolescentInjection drug use 2897 2836 2810 2586 2385 74718High-risk heterosexual contactb 6855 7336 7113 6922 7196 108252Otherc 207 217 217 205 220 6596Subtotal 9959 10389 10141 9713 9801 189566

Child (lt13 yrs at diagnosis)Perinatal 104 70 53 52 37 8508Otherd 2 0 0 0 0 636Subtotal 106 70 53 53 38 9144

Region of residenceNortheast 10092 10342 9412 9396 9486 306241Midwest 4125 4226 4089 4371 4164 101479South 17198 17630 18225 16894 17104 374800West 6718 6339 6000 5891 6074 199978Subtotal for 50 states and the District of Columbia 38132 38538 37726 36552 36828 982498

Data for US dependent areas 1058 1060 921 955 833 31217

Totale 39250 39690 38807 37662 37852 1014797Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes persons of unknown race or multiple races and persons of unknown sex Cumulative total includes 5691 persons of unknown race or multiple

races 3 persons of unknown sex 1079 persons of unknown state of residence and 3 persons who were residents of other areas Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Cases of HIVAIDS and AIDS 13

Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002ndash2006 and cumulativemdash50 states and the District of Columbia

Year of diagnosisCumulativea2002 2003 2004 2005 2006

RaceethnicityWhite not Hispanic 14 12 7 4 4 1599Black not Hispanic 70 46 33 38 30 5654Hispanic 18 10 9 8 3 1748AsianPacific Islander 1 0 1 1 1 54American IndianAlaska Native 1 0 1 0 0 31

Transmission categoryHemophiliacoagulation disorder 0 0 0 0 0 226Mother with documented HIV infection or 1 of the following risk factors 104 70 53 52 37 8508

Injection drug use 12 8 5 3 4 3220Sex with injection drug user 4 6 3 2 1 1397Sex with bisexual male 2 0 3 1 1 209Sex with person with hemophilia 0 0 0 0 0 35Sex with HIV-infected transfusion recipient 0 0 0 0 0 22Sex with HIV-infected person risk factor not specified 36 20 20 25 13 1530Receipt of blood transfusion blood components or tissue 2 1 0 0 0 144Has HIV infection risk factor not specified 47 34 21 21 17 1951

Receipt of blood transfusion blood components or tissue 2 0 0 0 0 374Otherrisk factor not reported or identified 0 0 0 0 0 36

Totalb 106 70 53 53 38 9144

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga From the beginning of the epidemic through 2006b Includes children of unknown race or multiple races Cumulative total includes 58 children of unknown race or multiple races Because column totals

were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992ndash2006mdash50 states and the District of Columbia

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reporting

14 Cases of HIVAIDS and AIDS

Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006mdash50 states and the District of Columbia

Raceethnicity

Adults or adolescents

Children (lt13 yrs) TotalaMales Females Totala

No Rate No Rate No Rate No Rate No Rate

White not Hispanic 9267 112 1659 19 10926 64 4 00 10929 54Black not Hispanic 11540 829 6391 404 17930 603 30 04 17960 476Hispanic 5388 313 1516 95 6903 208 3 00 6907 156AsianPacific Islander 423 75 95 16 518 44 1 00 519 37American IndianAlaska Native 118 122 37 36 155 78 0 00 155 62

Totalb 26989 224 9801 78 36790 149 38 01 36828c 123

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reportingData exclude cases in persons whose state or area of residence is unknown as well as cases from US dependent areas for which census information about race and age categories is lackinga Because row totals were calculated independently of the values for the subpopulations the values in each row may not sum to the row totalb Includes person of unknown race or multiple races Because column totals were calculated independently of the values for the subpopulations the

values in each column may not sum to the column totalc Includes 358 persons of unknown race or multiple races

Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006mdash33 states with confidential name-based HIV infection reporting

Raceethnicity

Adults or adolescents

Children (lt13 yrs) TotalaMales Females Totala

No Rate No Rate No Rate No Rate No Rate

White not Hispanic 9078 167 1664 29 10742 96 16 01 10758 82Black not Hispanic 11230 1191 6033 562 17263 856 93 17 17356 677Hispanic 5058 509 1400 151 6458 337 23 04 6481 255AsianPacific Islander 318 135 79 32 397 82 0 00 397 67American IndianAlaska Native 129 177 35 46 164 110 2 06 166 88

Totalb 25928 338 9252 115 35180 224 135 04 35314c 185

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Because row totals were calculated independently of the values for the subpopulations the values in each row may not sum to the row totalb Includes persons of unknown race or multiple races Because column totals were calculated independently of the values for the subpopulations the

values in each column may not sum to the column totalc Includes 156 persons of unknown race or multiple races

Cases of HIVAIDS and AIDS 15

Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006mdashUnited States and dependent areas

Transmission category

Place of birth

United StatesCentralSouth

America Cuba Mexico Puerto Rico Totala

No No No No No No

Male-to-male sexual contact 1172 45 402 49 89 62 790 59 249 18 3337 43Injection drug use 569 22 83 10 13 9 133 10 533 40 1650 21Male-to-male sexual contact

and injection drug use 158 6 25 3 6 4 59 4 63 5 357 5High-risk heterosexual

contactb 661 25 296 36 35 24 342 26 487 36 2282 30Otherc 47 2 8 1 0 0 9 1 14 1 103 1

Totald 2608 100 814 100 145 100 1334 100 1346 100 7728 100Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Includes 222 persons whose place of birth is not among those listed and 1260 persons whose place of birth is unknownb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the

column total

16 Cases of HIVAIDS and AIDS

Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas

Year of death

Cumulativea2002 2003 2004 2005 2006

Data for 50 states and the District of ColumbiaAge at death (yrs)lt13 25 22 15 7 13 4889

13ndash14 10 6 15 12 5 276

15ndash19 39 36 36 38 44 1104

20ndash24 151 157 175 147 162 8716

25ndash29 553 512 482 458 405 43671

30ndash34 1480 1272 1128 1069 785 95351

35ndash39 2967 2763 2425 2096 1682 116746

40ndash44 3595 3516 3393 3317 2636 104133

45ndash49 3294 3234 3251 3275 2886 72831

50ndash54 2318 2373 2502 2645 2343 44255

55ndash59 1209 1322 1425 1543 1480 25123

60ndash64 616 705 741 797 771 14315

gt65 691 773 807 865 805 14393

RaceethnicityWhite not Hispanic 5214 5097 4836 4758 3860 239529

Black not Hispanic 9037 8675 8581 8679 7426 218392

Hispanic 2429 2632 2641 2513 2425 80690

AsianPacific Islander 97 84 111 87 114 3426

American IndianAlaska Native 83 73 80 65 66 1693

Transmission categoryMale adult or adolescentMale-to-male sexual contact 5960 5937 5735 5641 4930 266272

Injection drug use 3738 3547 3315 3314 2641 107173

Male-to-male sexual contact and injection drug use 1278 1299 1237 1289 1064 40993

High-risk heterosexual contactb 1465 1501 1625 1571 1470 26236

Otherc 160 149 125 117 80 9867

Subtotal 12601 12431 12038 11932 10184 450541

Female adult or adolescentInjection drug use 1923 1825 1855 1768 1456 43143

High-risk heterosexual contactb 2281 2292 2373 2458 2258 42620

Otherc 84 87 72 68 70 4131

Subtotal 4289 4204 4300 4295 3784 89895

Child (lt13 yrs at diagnosis)Perinatal 53 49 56 39 42 4848

Otherd 4 5 1 2 7 521

Subtotal 57 54 57 41 48 5369

Deaths 17

Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas (cont)

Year of death

Cumulativea2002 2003 2004 2005 2006

Region of residenceNortheast 5313 5012 4779 4750 4074 180623

Midwest 1726 1666 1482 1378 1325 54468

South 7337 7427 7535 7907 6475 197209

West 2571 2585 2600 2234 2141 113506

Subtotal for 50 states and the District of Columbia 16948 16690 16395 16268 14016 545805

Data for US dependent areas 667 575 572 562 580 19858

Totale 17628 17283 16982 16865 14627 565927f

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column totalf Includes 2082 persons of unknown race or multiple races 261 persons of unknown state of residence and 2 persons who were residents

of other areas

18 Deaths

Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003ndash2006mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

2003 2004 2005 2006Data for 33 states

Age at end of year (yrs)lt13 4154 3700 3294 286713ndash14 1130 1238 1212 113915ndash19 3298 3627 4024 453920ndash24 12389 12826 13411 1430125ndash29 26167 26924 28164 2960030ndash34 49602 47577 45109 4418935ndash39 80703 77871 75842 7363440ndash44 92040 97109 100102 10176445ndash49 71345 77490 83816 9028350ndash54 45133 51033 56640 6319555ndash59 22793 26610 31186 3600860ndash64 10820 12642 14422 16658gt65 8531 9959 11657 13551

RaceethnicityWhite not Hispanic 145081 151694 158375 166000Black not Hispanic 202951 212425 221439 231957Hispanic 72612 76503 80491 84720AsianPacific Islander 2234 2529 2858 3187American IndianAlaska Native 1788 1889 2008 2119

Transmission categoryMale adult or adolescentMale-to-male sexual contact 181771 193245 205423 218676Injection drug use 57651 58149 58369 59077Male-to-male sexual contact and injection drug use 23965 24434 24725 25085High-risk heterosexual contacta 40084 42559 44915 47562Otherb 3218 3278 3325 3424Subtotal 306689 321665 336756 353825

Female adult or adolescentInjection drug use 32346 32735 32973 33470High-risk heterosexual contacta 80324 85348 90185 95403Otherb 2036 2123 2212 2321Subtotal 114705 120206 125370 131195

Child (lt13 yrs at diagnosis)Perinatal 6137 6154 6178 6143Otherc 570 575 571 560Subtotal 6707 6730 6748 6703

Subtotal for 33 states 428107 448605 468879 491727Data for US dependent areas 15809 16399 17150 17955

Totald 443916 465005 486028 509681Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 19

Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission categorymdash33 states with confidential name-based HIV infection reporting

Transmission category

White not Hispanic

Black not Hispanic Hispanic

AsianPacific Islander

American IndianAlaska

Native Totala

No No No No No No

Male adult or adolescentMale-to-male sexual contact 108259 77 70242 49 36043 57 1669 68 938 62 218676 62Injection drug use 12328 9 31339 22 14472 23 264 11 216 14 59077 17Male-to-male sexual contact

and injection drug use 11283 8 9587 7 3720 6 93 4 205 13 25085 7High-risk heterosexual contactb 6667 5 31140 22 8788 14 395 16 143 9 47562 13Otherc 1458 1 1492 1 404 1 30 1 17 1 3424 1Subtotal 139994 100 143799 100 63427 100 2450 100 1519 100 353825 100

Female adult or adolescentInjection drug use 8262 33 19136 23 5528 28 106 15 175 30 33470 26High-risk heterosexual contactb 16338 65 63204 75 14132 71 573 82 392 68 95403 73Otherc 450 2 1469 2 344 2 24 3 12 2 2321 2Subtotal 25050 100 83809 100 20004 100 703 100 578 100 131195 100

Child (lt13 yrs at diagnosis)Perinatal 801 84 4064 93 1183 92 28 82 20 95 6143 92Otherd 154 16 283 7 107 8 6 18 1 5 560 8Subtotal 955 100 4347 100 1290 100 34 100 21 100 6703 100

Totale 166000 231957 84720 3187 2119 491727Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of 33 states that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Includes 3745 persons of unknown race or multiple racesb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes 5 persons of unknown sex Because column totals were calculated independently of the values for the subpopulations the values

in each column may not sum to the column total

20 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Map 1 Estimated rates (per 100000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

Note Rates adjusted for reporting delays Rates of HIV infection include only persons living with HIV infection that has not progressed to AIDSSince 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 Islandsa Includes persons whose area of residence is unknown

Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

Note Rates adjusted for reporting delays Rates of HIV infection include only persons living with HIV infection that has not progressed to AIDSSince 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 Islandsa Includes persons whose area of residence is unknown

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 21

Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002ndash2006mdashUnited States and dependent areas

2002 2003 2004 2005 2006Data for 50 states and the District of Columbia

Age at end of year (yrs)lt13 2308 2006 1684 1394 111513ndash14 685 747 784 762 71115ndash19 1465 1694 1974 2243 248720ndash24 3910 4292 4629 5033 536725ndash29 12725 12743 13045 13505 1435930ndash34 35558 33870 32057 29949 2882435ndash39 70107 68106 65076 62235 5964940ndash44 80377 86294 91335 94021 9517445ndash49 64702 71276 77417 84153 9077550ndash54 41270 46855 53333 59256 6647655ndash59 20113 24145 28356 33522 3901460ndash64 9681 11293 13305 15380 18072gt65 7520 8946 10604 12430 14669

RaceethnicityWhite not Hispanic 129426 135278 141508 147426 154495Black not Hispanic 150488 161326 171654 181056 191590Hispanic 63424 67895 72024 76334 80815AsianPacific Islander 3060 3426 3759 4121 4526American IndianAlaska Native 1254 1356 1458 1562 1651

Transmission categoryMale adult or adolescentMale-to-male sexual contact 158092 168233 178551 188622 199693Injection drug use 56708 58436 59940 61229 62998Male-to-male sexual contact and injection drug use 24726 25457 26144 26785 27523High-risk heterosexual contacta 27329 30300 33181 35916 39004Otherb 3588 3665 3769 3888 4026Subtotal 270444 286091 301585 316440 333244

Female adult or adolescentInjection drug use 27863 28874 29828 30646 31575High-risk heterosexual contacta 46445 51489 56229 60693 65631Otherb 1903 2033 2178 2315 2465Subtotal 76210 82395 88236 93653 99671

Child (lt13 yrs at diagnosis)Perinatal 3633 3654 3651 3664 3660Otherc 129 124 123 122 115Subtotal 3762 3778 3774 3786 3775

Region of residenceNortheast 105599 110929 115562 120208 125620Midwest 36011 38571 41178 44171 47010South 137081 147284 157975 166962 177591West 71729 75483 78883 82540 86473

Subtotal for 50 states and the District of Columbia 350419 372267 393598 413882 436693

Data for US dependent areas 9880 10365 10713 11106 11359

Totald 360617 383024 404849 425646 448871Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

22 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission categorymdash50 states and the District of Columbia

Transmission category

White not Hispanic

Black not Hispanic Hispanic

AsianPacific Islander

American IndianAlaska

Native Totala

No No No No No No

Male adult or adolescentMale-to-male sexual contact 101299 75 57520 45 36087 57 2715 72 704 57 199693 60Injection drug use 13168 10 33911 27 14795 23 325 9 201 16 62998 19Male-to-male sexual contact and

injection drug use 12393 9 10121 8 4352 7 198 5 220 18 27523 8High-risk heterosexual contactb 6081 5 24205 19 7816 12 444 12 105 8 39004 12Otherc 1743 1 1602 1 574 1 69 2 16 1 4026 1Subtotal 134683 100 127359 100 63623 100 3752 100 1246 100 333244 100

Female adult or adolescentInjection drug use 7407 38 18531 30 5025 30 115 15 153 39 31575 32High-risk heterosexual contactb 11350 59 41741 68 11092 67 588 78 227 58 65631 66Otherc 508 3 1456 2 413 2 51 7 13 3 2465 2Subtotal 19264 100 61728 100 16531 100 753 100 393 100 99671 100

Child (lt13 yrs at diagnosis)Perinatal 500 92 2468 99 629 95 20 94 12 100 3660 97Otherd 46 8 34 1 33 5 1 6 0 0 115 3Subtotal 546 100 2503 100 662 100 21 100 12 100 3775 100

Totale 154495 191590 80815 4526 1651 436693

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Includes 3616 persons of unknown race or multiple racesb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes 3 person of unknown sex Because column totals were calculated independently of the values for the subpopulations the values in each column

may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 23

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by

area of residence and age categorymdashUnited States and dependent areas

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

Alabama 5469 17 5486 3744 11 3755Alaska 272 1 273 330 1 331Arizona 5744 49 5793 4922 7 4929Arkansas 2291 7 2298 2139 6 2145California mdash mdash mdash 61451 105 61555Colorado 5855 13 5869 4083 2 4085Connecticut mdash mdash mdash 7406 15 7421Delaware mdash mdash mdash 1753 7 1760District of Columbia mdash mdash mdash 10059 30 10089Floridab 35461 263 35723 46469 194 46663Georgia mdash mdash mdash 17336 47 17383Hawaii mdash mdash mdash 1234 3 1237Idaho 356 0 356 313 0 313Illinois mdash mdash mdash 16139 46 16185Indiana 3849 21 3870 3996 14 4010Iowa 588 2 590 869 3 872Kansas 1230 7 1237 1272 2 1274Kentucky mdash mdash mdash 2589 13 2602Louisiana 7361 101 7462 8052 21 8074Maine mdash mdash mdash 512 2 514Maryland mdash mdash mdash 14540 41 14581Massachusetts mdash mdash mdash 8806 20 8826Michigan 6118 55 6173 6615 12 6627Minnesota 3227 21 3248 2314 9 2323Mississippi 4200 32 4232 3155 13 3168Missouri 4999 33 5033 5479 7 5486Montana mdash mdash mdash 205 0 205Nebraska 688 12 700 771 2 773Nevada 3402 13 3415 2969 3 2972New Hampshire mdash mdash mdash 556 3 559New Jersey 16059 153 16212 17168 57 17226New Mexico 910 0 909 1252 3 1255New York 42220 801 43021 70697 148 70845North Carolina 11700 60 11760 8451 12 8463North Dakota 87 2 89 73 1 74Ohio 8266 57 8323 7054 30 7084Oklahoma 2191 17 2208 2191 3 2194Oregon mdash mdash mdash 2840 4 2844Pennsylvania mdash mdash mdash 18633 71 18703Rhode Island mdash mdash mdash 1296 7 1303South Carolina 6349 45 6394 7035 23 7058South Dakota 195 4 199 139 1 140Tennessee 6579 51 6631 6403 11 6414Texas 24741 262 25003 34010 53 34063Utah 893 10 903 1164 0 1164Vermont mdash mdash mdash 238 2 240Virginia 9937 41 9978 8423 24 8447Washington mdash mdash mdash 5471 5 5476West Virginia 660 5 665 749 5 754Wisconsin 2322 15 2337 2153 12 2165Wyoming 86 2 88 102 1 103

Subtotal 224303 2174 226477 435621 1115 436736

24 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age categorymdashUnited States and dependent areas (cont)

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

US dependent areasAmerican Samoa 2 0 2 1 0 1Guam 63 0 63 36 0 36Northern Mariana Islands 7 0 7 3 0 3Puerto Rico 6269 31 6300 10971 26 10997US Virgin Islands 228 2 230 312 2 314Otherc mdash mdash mdash 1 0 1

Totald 230872 2207 233079 447724 1147 448871

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reporting a See Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at

least 2003b Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterc Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasd Total number of persons living with HIV infection (not AIDS) includes persons reported from areas with confidential name-based HIV

infection reporting who were residents of other states or whose area of residence is unknown Total number of persons living with AIDS includes persons whose area of residence is unknown Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 25

Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristicsmdashUnited States and dependent areas

No of persons

Survival in months

gt12 gt24 gt36Data for 50 states and the District of Columbia

Age at diagnosis (yrs)lt13 101 096 094 09413ndash14 60 098 098 09515ndash19 305 098 096 09520ndash24 1351 096 093 09225ndash29 3034 095 092 09130ndash34 5499 094 091 08935ndash39 7888 093 090 08740ndash44 7085 092 088 08545ndash49 5090 089 085 08250ndash54 3067 086 081 07855ndash59 1505 083 078 07460ndash64 806 080 073 069gt65 614 073 068 065

RaceethnicityWhite not Hispanic 10706 092 089 087Black not Hispanic 18406 090 086 082Hispanic 6398 092 090 088AsianPacific Islander 404 094 092 090American IndianAlaska Native 167 084 081 075

Transmission categoryMale adult or adolescentMale-to-male sexual contact 12830 093 090 088Injection drug use 4048 089 084 081Male-to-male sexual contact and injection drug use 1701 093 089 086High-risk heterosexual contacta 3170 091 088 085Otherb 5019 086 083 080Subtotal 26768 091 088 085

Female adult or adolescentInjection drug use 2101 089 083 078High-risk heterosexual contacta 4686 093 089 086Otherb 2749 090 085 083Subtotal 9536 091 087 083

Child (lt13 yrs at diagnosis)Perinatal 98 096 095 095Otherc 3 100 067 067Subtotal 101 096 094 094

Subtotal for 50 states and the District of Columbia 36405 091 087 085

Data for US dependent areas 891 083 078 075

Total 37352d 091 087 084Note Excludes persons whose date of death was before or in the same month as date of diagnosis Excludes persons whose month of diagnosis or month of death is unknowna Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes 325 persons of unknown race or multiple races

26 Survival after AIDS Diagnosis

Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by year of diagnosismdashUnited States and dependent areas

Months after AIDS diagnosis

Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by age groupmdashUnited States and dependent areas

Months after AIDS diagnosis

Survival after AIDS Diagnosis 27

Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by raceethnicitymdashUnited States and dependent areas

Months after AIDS diagnosis

28 Survival after AIDS Diagnosis

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006

and cumulativemdashUnited States and dependent areas

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Alabama 510 112 462 100 8626 76 8702Alaska 24 36 38 57 648 7 655Arizona 626 105 539 87 10396 46 10442Arkansas 237 85 252 90 3891 36 3927California 4069 113 3960 109 142254 664 142918Colorado 351 75 322 68 8742 31 8773Connecticut 658 188 422 120 14716 183 14899Delaware 177 210 116 136 3547 26 3573District of Columbia 672 1155 853 1467 17372 189 17561Florida 4921 277 4932 273 104084 1530 105614Georgia 2325 255 1605 171 31734 231 31965Hawaii 105 82 93 72 2927 17 2944Idaho 24 17 26 18 604 2 606Illinois 1886 148 1382 108 33620 282 33902Indiana 407 65 346 55 8239 56 8295Iowa 93 31 86 29 1727 13 1740Kansas 105 38 120 43 2781 14 2795Kentucky 249 60 207 49 4600 32 4632Louisiana 936 208 824 192 17612 128 17740Maine 21 16 68 51 1110 8 1118Maryland 1558 279 1626 290 30252 319 30571Massachusetts 666 104 533 83 19181 214 19395Michigan 821 81 672 67 14941 113 15054Minnesota 226 44 212 41 4817 28 4845Mississippi 368 127 365 125 6642 56 6698Missouri 385 66 469 80 11016 61 11077Montana 21 22 7 07 373 3 376Nebraska 53 30 118 67 1479 11 1490Nevada 293 121 294 118 5733 29 5762New Hampshire 33 25 55 42 1074 10 1084New Jersey 1262 145 1065 122 48750 778 49528New Mexico 134 70 93 48 2603 7 2610New York 6201 321 5495 285 174908 2354 177262North Carolina 916 106 1229 139 15954 118 16072North Dakota 10 16 6 09 144 1 145Ohio 753 66 767 67 14957 138 15095Oklahoma 281 79 205 57 4836 26 4862Oregon 217 60 281 76 5995 20 6015Pennsylvania 1486 120 1893 152 33417 365 33782Rhode Island 87 81 111 104 2580 28 2608South Carolina 682 161 705 163 13301 105 13406South Dakota 18 23 18 23 255 5 260Tennessee 818 137 680 113 12457 59 12516Texas 3045 133 2998 128 69735 392 70127Utah 63 25 57 22 2295 20 2315Vermont 5 08 18 29 461 6 467Virginia 638 84 605 79 16802 177 16979Washington 485 77 389 61 11792 34 11826West Virginia 74 41 67 37 1500 11 1511Wisconsin 122 22 217 39 4513 33 4546Wyoming 6 12 8 16 228 2 230

Subtotal 40123 135 37911 127 952221 9094 961315

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 29

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulativemdashUnited States and dependent areas (cont)

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

US dependent areasAmerican Samoa 0 0 0 0 1 0 1Guam 0 0 0 0 68 1 69Northern Mariana Islands 0 0 0 0 3 0 3Puerto Rico 1029 263 850 216 29511 400 29911US Virgin Islands 17 156 32 295 629 18 647Otherb 0 0 0 0 3 0 3

Totalc 41357 138 39002 129 983343 9522 992865d

a From the beginning of the epidemic through 2006b Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasc Includes persons whose state or area of residence is unknownd Includes 916 persons whose state or area of residence is unknown

30 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

MSA (population gt 500000)

Akron Ohio 66 94 32 46 762 1 763

AlbanyndashSchenectadyndashTroy NY 97 114 105 123 2253 24 2277

Albuquerque N Mex 70 88 50 61 1404 2 1406

AllentownndashBethlehemndashEaston PandashNJ 72 91 119 149 1352 17 1369

AtlantandashSandy SpringsndashMarietta Ga 1586 319 1006 196 21896 128 22024

AugustandashRichmond County GandashSC 106 205 32 61 1851 24 1875

AustinndashRound Rock Tex 227 156 186 123 4830 26 4856

Bakersfield Calif 76 100 122 156 1528 8 1536

BaltimorendashTowson Md 1064 401 1001 377 20352 218 20570

Baton Rouge La 222 304 231 301 3732 20 3752

BirminghamndashHoover Ala 151 139 110 100 2614 25 2639

Boise CityndashNampa Idaho 14 26 14 25 281 0 281

Boston MassndashNHa 441 99 355 80 13476 147 13623

Boston Division 269 146 185 101 8451 91 8542

Cambridge Division 108 74 102 70 3126 35 3161

Essex Division 52 71 51 69 1577 20 1597

BridgeportndashStamfordndashNorwalk Conn 181 201 135 150 3733 57 3790

BuffalondashNiagara Falls NY 117 102 96 84 2476 20 2496

Cape CoralndashFort Myers Fla 44 81 91 159 1692 24 1716

CharlestonndashNorth Charleston SC 92 155 91 151 2034 18 2052

CharlottendashGastoniandashConcord NCndashSC 214 141 285 180 3242 22 3264

Chicago IllndashIndndashWis 1716 182 1159 122 30118 261 30379

Chicago Division 1604 203 1073 135 28300 248 28548

Gary Division 61 88 50 71 1038 8 1046

Lake Division 51 59 36 41 780 5 785

CincinnatindashMiddletown OhiondashKyndashInd 111 53 199 95 2735 17 2752

ClevelandndashElyriandashMentor Ohio 228 107 170 80 4226 48 4274

Colorado Springs Colo 19 32 21 35 576 5 581

Columbia SC 177 256 197 280 3274 24 3298

Columbus Ohio 166 97 165 96 3112 15 3127

Dallas Tex 874 150 929 155 20238 63 20301

Dallas Division 681 175 714 178 16038 37 16075

Fort Worth Division 193 100 215 108 4200 26 4226

Dayton Ohio 58 69 54 64 1217 15 1232

DenverndashAurora Colo 274 116 236 98 6899 22 6921

Des Moines Iowa 30 57 23 43 530 4 534

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 31

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Detroit Mich 570 127 445 100 10373 73 10446

Detroit Division 443 223 330 167 8268 57 8325

Warren Division 127 51 115 46 2105 16 2121

El Paso Tex 56 78 40 54 1476 10 1486

Fresno Calif 52 59 64 72 1430 11 1441

Grand RapidsndashWyoming Mich 46 60 51 66 816 6 822

GreensborondashHigh Point NC 52 77 66 96 1265 14 1279

Greenville SC 70 119 67 111 1292 4 1296

HarrisburgndashCarlisle Pa 23 44 67 128 1224 8 1232

HartfordndashWest HartfordndashEast Hartford Conn 256 216 135 114 5126 46 5172

Honolulu Hawaii 54 60 69 76 2121 14 2135

HoustonndashBaytownndashSugar Land Tex 1017 190 1092 197 25821 172 25993

Indianapolis Ind 191 116 150 90 3824 25 3849

Jackson Miss 134 257 117 221 2419 30 2449

Jacksonville Fla 309 248 315 246 6020 75 6095

Kansas City MondashKans 183 94 160 81 4669 15 4684

Knoxville Tenn 47 72 35 52 882 5 887

Lakeland Fla 103 190 112 199 1811 21 1832

Las VegasndashParadise Nev 245 143 258 145 4616 28 4644

Little RockndashNorth Little Rock Ark 87 135 75 115 1383 14 1397

Los Angeles Calif 1529 118 1684 130 57953 293 58246

Los Angeles Division 1339 135 1435 144 51098 250 51348

Santa Anna Division 190 63 249 83 6855 43 6898

Louisville KyndashInd 123 102 97 79 2286 22 2308

Madison Wis 10 19 29 53 520 4 524

McAllenndashEdinburgndashPharr Tex 57 84 45 64 630 11 641

Memphis TennndashMissndashArk 402 320 346 271 5128 19 5147

Miami Fla 2420 446 2289 419 55807 997 56804

Fort Lauderdale Division 810 455 769 430 16412 262 16674

Miami Division 1243 523 1165 485 29703 512 30215

West Palm Beach Division 367 290 355 279 9692 223 9915

MilwaukeendashWaukeshandashWest Allis Wis 68 45 109 72 2507 18 2525

MinneapolisndashSt PaulndashBloomington MinnndashWis 186 59 184 58 4259 22 4281

Modesto Calif 36 71 22 43 671 6 677

NashvillendashDavidsonndashMurfreesboro Tenn 224 158 172 118 3848 20 3868

New HavenndashMilford Conn 169 200 107 127 4573 73 4646

New OrleansndashMetairiendashKenner La 393 299 271 264 8835 67 8902

32 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

New York NYndashNJndashPa 6215 330 5500 292 195177 2906 198083

Edison Division 191 83 130 56 6709 139 6848

Nassau Division 262 93 246 88 8141 110 8251

New York Division 5266 456 4716 408 160408 2323 162731

Newark Division 496 231 408 190 19919 334 20253

Oklahoma City Okla 125 108 88 75 2255 5 2260

OmahandashCouncil Bluffs NebndashIowa 37 46 80 97 1035 3 1038

Orlando Fla 544 282 517 260 8653 92 8745

OxnardndashThousand OaksndashVentura Calif 49 62 21 26 1008 3 1011

Palm BayndashMelbournendashTitusville Fla 68 129 61 114 1512 11 1523

Philadelphia PandashNJndashDelndashMd 1261 217 1348 231 28221 313 28534

Camden Division 108 87 111 89 3118 42 3160

Philadelphia Division 1022 263 1144 294 22112 250 22362

Wilmington Division 131 191 93 134 2991 21 3012

PhoenixndashMesandashScottsdale Ariz 460 119 376 93 7459 31 7490

Pittsburgh Pa 143 60 135 57 3182 19 3201

PortlandndashSouth Portland Maine 9 18 34 66 562 1 563

PortlandndashVancouverndashBeaverton OrendashWash 170 81 215 101 4825 10 4835

PoughkeepsiendashNewburghndashMiddletown NY 136 204 113 168 3162 24 3186

ProvidencendashNew BedfordndashFall River RIndashMass 132 82 155 96 3900 44 3944

RaleighndashCary NC 138 145 201 202 1987 13 2000

Richmond Va 119 101 122 102 3371 35 3406

RiversidendashSan BernardinondashOntario Calif 361 92 306 76 8568 60 8628

Rochester NY 165 159 124 120 3134 13 3147

SacramentondashArden-ArcadendashRoseville Calif 154 75 169 82 4000 26 4026

St Louis MondashIll 192 69 366 131 5965 40 6005

Salt Lake City Utah 46 44 40 37 1743 10 1753

San Antonio Tex 215 114 247 127 4987 30 5017

San DiegondashCarlsbadndashSan Marcos Calif 491 167 384 131 12934 61 12995

San Francisco Calif 867 209 690 165 40152 96 40248

Oakland Division 312 126 246 99 9546 48 9594

San Francisco Division 555 329 444 261 30606 48 30654

San JosendashSunnyvalendashSanta Clara Calif 88 50 145 81 3747 15 3762

San JuanndashCaguasndashGuaynabo PR 745 289 578 223 21402 277 21679

SarasotandashBradentonndashVenice Fla 82 122 104 152 1978 27 2005

ScrantonndashWilkes-Barre Pa 27 49 47 85 572 6 578

Seattle Wash 353 110 280 86 9172 27 9199

Seattle Division 316 129 255 102 8161 18 8179

Tacoma Division 37 49 25 33 1011 9 1020

Springfield Mass 88 128 45 66 2075 26 2101

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 33

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Stockton Calif 52 78 52 77 1076 15 1091

Syracuse NY 52 80 49 75 1317 8 1325

TampandashSt PetersburgndashClearwater Fla 559 211 605 224 11174 112 11286

Toledo Ohio 25 38 66 101 812 14 826

Tucson Ariz 103 111 100 106 2010 10 2020

Tulsa Okla 83 94 65 72 1494 10 1504

Virginia BeachndashNorfolkndashNewport News VandashNC 183 111 132 80 4711 63 4774

Washington DCndashVandashMdndashWV 1322 252 1684 318 31130 315 31445

Bethesda Division 135 118 173 150 2774 23 2797

Washington Division 1187 289 1511 365 28356 292 28648

Wichita Kans 35 60 38 64 851 2 853

Worcester Mass 76 97 79 101 1783 20 1803

YoungstownndashWarrenndashBoardman OhiondashPa 27 46 26 44 519 0 519

Subtotal for MSAs (population gt500000) 33602 173 31274 159 829633 8171 837804

Metropolitan areas (population of 50000 to 499999) 4477 80 4466 79 94829 847 95676

Nonmetropolitan areas 2666 54 2732 55 52063 445 52508

Totalb 41144 137 38749 128 981708 9494 991202

Note Because of the lack of census information for all US dependent areas includes data for only the 50 states the District of Columbia and Puerto RicoMSA metropolitan statistical areaMSA definitions for this report can be found at httpwwwcensusgovpopulationwwwestimatesmetrodefhtmla Reported case counts for the metropolitan divisions do not sum to the MSA total MSA total includes data from 1 metropolitan division with

population of lt500000b Includes persons whose county of residence is unknown

34 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Alabama (January 1988) 502 6041 48 6089

Alaska (February 1999) 38 285 2 287

Arizona (January 1987) 617 5877 80 5957

Arkansas (July 1989) 206 2349 20 2369

California (April 2006) 6581 7056 92 7148

Colorado (November 1985) 319 6084 31 6115

Connecticut (January 2005)b 826 2500 101 2601

Delaware (February 2006) 788 801 18 819

Florida (July 1997)c 4163 36386 397 36783

Georgia (December 2003) 2245 8197 194 8391

Idaho (June 1986) 35 340 4 344

Illinois (January 2006) 6241 6661 162 6823

Indiana (July 1988) 399 4027 43 4070

Iowa (July 1998) 69 586 5 591

Kansas (July 1999) 142 1225 15 1240

Kentucky (October 2004) 333 1303 13 1316

Louisiana (February 1993) 728 8149 166 8315

Maine (January 2006) 386 393 3 396

Michigan (April 1992) 635 6702 134 6836

Minnesota (October 1985) 309 3356 40 3396

Mississippi (August 1988) 352 4549 59 4608

Missouri (October 1987) 502 5086 55 5141

Nebraska (September 1995) 91 672 14 686

Nevada (February 1992) 339 3532 24 3556

New Hampshire (January 2005) 59 466 9 475

New Jersey (January 1992) 1477 17513 325 17838

New Mexico (January 1998) 114 949 4 953

New York (June 2000) 5326 42345 1820 44165

North Carolina (February 1990) 1615 13879 143 14022

North Dakota (January 1988) 4 82 1 83

Ohio (June 1990) 867 8222 101 8323

Oklahoma (June 1988) 229 2401 30 2431

Oregon (April 2006) 49 95 19 114

Pennsylvania (October 2002)d 4269 9537 179 9716

Rhode Island (July 2006) 14 21 0 21

South Carolina (February 1986) 493 6970 93 7063

South Dakota (January 1988) 18 215 6 221

Tennessee (January 1992) 732 7115 90 7205

Texas (January 1999)e 3370 24282 417 24699

Utah (April 1989) 106 893 14 907

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 35

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Virginia (July 1989) 864 10257 95 10352

Washington (March 2006) 4048 4157 40 4197

West Virginia (January 1989) 66 673 8 681

Wisconsin (November 1985) 261 2500 31 2531

Wyoming (June 1989) 7 93 1 94

Subtotal 50834 274822 5146 279968

US dependent areas

American Samoa (August 2001) 0 1 0 1

Guam (March 2000) 2 66 0 66

Northern Mariana Islands (October 2001) 2 7 0 7

Puerto Rico (January 2003) 1471 5610 91 5701

US Virgin Islands (December 1998) 22 247 6 253

Persons reported from areas with confidential name-based HIV infection reporting but who were residents of other areas 132 685 21 706

Totalf 52878 282640 5314 287954

Note Includes data from 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through 2006b Beginning in 1992 Connecticut had name-based HIV reporting for cases in children only From January 2002 through December 2004

Connecticut had name- or code-based HIV reporting for cases in adolescents and adults As of January 2005 Connecticut has name-based reporting of all cases of HIV infection

c Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterd On October 18 2002 Pennsylvania initiated confidential name-based HIV infection reporting in all areas except Philadelphia Code-based

reporting was implemented in Philadelphia in March 2004 and the switch to name-based reporting was made in October 2005e From February 1994 through December 1998 Texas reported HIV infection in children onlyf Includes 1252 persons reported from areas with confidential name-based HIV infection reporting but whose area of residence is unknown

36 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulativemdashUnited States and dependent areas

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No Adult or adolescentMale-to-male sexual contact 13775 49 429897 54 mdash mdash mdash mdash 13775 35 429897 44Injection drug use 3413 12 163070 21 1826 17 67693 35 5239 13 230763 23Male-to-male sexual contact and

injection drug use 1603 6 65524 8 mdash mdash mdash mdash 1603 4 65524 7Hemophiliacoagulation disorder 43 0 5176 1 11 0 348 0 54 0 5524 1High-risk heterosexual contactc 2997 11 49610 6 4839 46 85186 44 7836 20 134796 14

Sex with injection drug user 330 1 11683 1 706 7 26073 14 1036 3 37756 4Sex with bisexual male mdash mdash mdash mdash 234 2 5162 3 234 1 5162 1Sex with person with hemophilia 1 0 84 0 11 0 502 0 12 0 586 0Sex with HIV-infected transfusion

recipient 22 0 553 0 21 0 793 0 43 0 1346 0Sex with HIV-infected person risk

factor not specified 2644 9 37290 5 3867 37 52656 27 6511 17 89946 9Receipt of blood transfusion blood

d components or tissue 63 0 5213 1 68 1 4176 2 131 0 9389 1Otherrisk factor not reported or

identifiede 6484 23 73136 9 3793 36 34311 18 10278 26 107450 11Subtotal 28378 100 791626 100 10537 100 191714 100 38916 100 983343 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 0 0 222 5 0 0 7 0 0 0 229 2Mother with documented HIV infection or

1 of the following risk factors 24 75 4315 89 50 93 4423 95 74 86 8738 92Injection drug use 4 13 1676 35 4 7 1665 36 8 9 3341 35Sex with injection drug user 4 13 789 16 4 7 750 16 8 9 1539 16Sex with bisexual male 1 3 101 2 2 4 110 2 3 3 211 2Sex with person with hemophilia 0 0 20 0 0 0 16 0 0 0 36 0Sex with HIV-infected transfusion

recipient 0 0 11 0 0 0 15 0 0 0 26 0Sex with HIV-infected person risk

factor not specified 6 19 742 15 17 31 790 17 23 27 1532 16Receipt of blood transfusion blood

components or tissue 0 0 70 1 0 0 82 2 0 0 152 2Has HIV infection risk factor not

specified 9 28 906 19 23 43 995 21 32 37 1901 20Receipt of blood transfusion blood

fcomponents or tissue 1 3 243 5 0 0 144 3 1 1 387 4Otherrisk factor not reported or

identifiedg 7 22 75 2 4 7 93 2 11 13 168 2Subtotal 32 100 4855 100 54 100 4667 100 86 100 9522 100

Total 28410 100 796481 100 10591 100 196381 100 39002 100 992865 100a From the beginning of the epidemic through 2006b From the beginning of the epidemic through 2006 Includes 3 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infectiond AIDS developed in 47 adultsadolescents after they received blood that had tested negative for HIV antibodies AIDS developed in 14 additional adults

after they received tissue organs or artificial insemination from HIV-infected donors Four of the 14 received tissue or organs from a donor who was negative for HIV antibody at the time of donation

e Includes 37 adultsadolescents who were exposed to HIV-infected blood body fluids or concentrated virus in health care laboratory or household settings as supported by seroconversion epidemiologic andor laboratory evidence One person was infected after intentional inoculation with HIV-infected blood Includes an additional 740 persons who acquired HIV infection perinatally but who were more than 12 years of age when AIDS was diagnosed These 740 persons are not counted in the values for the pediatric transmission category

f AIDS developed in 3 children after they received blood that had tested negative for HIV antibodiesg Includes 5 children who were exposed to HIV-infected blood as supported by seroconversion epidemiologic andor laboratory evidence 1 child was

infected after intentional inoculation with HIV-infected blood and 5 children were exposed to HIV-infected blood in a household setting Of the 168 children 26 had sexual contact with an adult with or at high risk for HIV infection

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 37

Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No

Adult or adolescentMale-to-male sexual contact 22912 59 103679 52 mdash mdash mdash mdash 22912 44 103679 37

Injection drug use 3503 9 24255 12 2124 16 13925 17 5627 11 38181 14

Male-to-male sexual contact and injection drug use 1946 5 10704 5 mdash mdash mdash mdash 1946 4 10704 4

Hemophiliacoagulation disorder 43 0 495 0 6 0 73 0 49 0 568 0

High-risk heterosexual contactc 2874 7 16830 8 5939 45 38315 47 8813 17 55145 20

Sex with injection drug user 308 1 2601 1 757 6 6791 8 1065 2 9392 3

Sex with bisexual male mdash mdash mdash mdash 328 2 2265 3 328 1 2265 1

Sex with person with hemophilia 4 0 31 0 16 0 201 0 20 0 232 0

Sex with HIV-infected transfusion recipient 13 0 131 0 28 0 223 0 41 0 354 0

Sex with HIV-infected person risk factor not specified 2549 7 14067 7 4810 36 28835 35 7359 14 42902 15

Receipt of blood transfusion blood components or tissue 61 0 489 0 50 0 536 1 111 0 1025 0

Otherrisk factor not reported or identified 7748 20 44021 22 5106 39 29312 36 12854 25 73338 26

Subtotal 39087 100 200473 100 13225 100 82161 100 52312 100 282640 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 8 3 106 4 0 0 1 0 8 1 107 2

Mother with documented HIV infection or 1 of the following risk factors 197 74 2195 85 254 85 2417 89 451 80 4612 87

Injection drug use 34 13 532 21 53 18 561 21 87 15 1093 21

Sex with injection drug user 12 5 208 8 21 7 213 8 33 6 421 8

Sex with bisexual male 5 2 37 1 4 1 32 1 9 2 69 1

Sex with person with hemophilia 0 0 3 0 1 0 7 0 1 0 10 0

Sex with HIV-infected transfusion recipient 0 0 4 0 0 0 4 0 0 0 8 0

Sex with HIV-infected person risk factor not specified 54 20 534 21 76 25 629 23 130 23 1163 22

Receipt of blood transfusion blood components or tissue 0 0 17 1 2 1 20 1 2 0 37 1

Has HIV infection risk factor not specified 92 35 860 33 97 32 951 35 189 33 1811 34

Receipt of blood transfusion blood components or tissue 6 2 28 1 3 1 24 1 9 2 52 1

Otherrisk factor not reported or identified 55 21 260 10 43 14 283 10 98 17 543 10

Subtotal 266 100 2589 100 300 100 2725 100 566 100 5314 100

Total 39353 100 203062 100 13525 100 84886 100 52878 100 287954 100

Note See Table 16 for the list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006b From the beginning of the epidemic through December 2006 Includes 6 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infection

38 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity

2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 6251 65 253927 73Injection drug use 733 8 31737 9Male-to-male sexual contact and injection drug use 732 8 31434 9Hemophiliacoagulation disorder 26 0 3989 1High-risk heterosexual contactb 416 4 7850 2

Sex with injection drug user 74 1 2310 1

Sex with person with hemophilia 0 0 36 0

Sex with HIV-infected transfusion recipient 2 0 176 0

Sex with HIV-infected person risk factor not specified 340 4 5328 2Receipt of blood transfusion blood components or tissue 20 0 3194 1Otherrisk factor not reported or identified 1400 15 16469 5

Total 9578 100 348600 100

Black not HispanicMale-to-male sexual contact 4309 36 103297 37Injection drug use 1635 14 83369 30Male-to-male sexual contact and injection drug use 526 4 22134 8Hemophiliacoagulation disorder 10 0 604 0High-risk heterosexual contactb 1875 16 29952 11

Sex with injection drug user 167 1 6823 2Sex with person with hemophilia 1 0 36 0Sex with HIV-infected transfusion recipient 15 0 237 0Sex with HIV-infected person risk factor not specified 1692 14 22856 8

Receipt of blood transfusion blood components or tissue 24 0 1218 0Otherrisk factor not reported or identified 3579 30 40268 14

Total 11958 100 280842 100

HispanicMale-to-male sexual contact 2816 47 64893 44Injection drug use 965 16 46337 31Male-to-male sexual contact and injection drug use 287 5 10884 7Hemophiliacoagulation disorder 6 0 466 0High-risk heterosexual contactb 638 11 10950 7

Sex with injection drug user 84 1 2409 2Sex with person with hemophilia 0 0 11 0Sex with HIV-infected transfusion recipient 5 0 125 0Sex with HIV-infected person risk factor not specified 549 9 8405 6

Receipt of blood transfusion blood components or tissue 17 0 657 0Otherrisk factor not reported or identified 1326 22 14832 10

Total 6055 100 149019 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 39

a

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulative

No No

AsianPacific IslanderMale-to-male sexual contact 225 54 4475 68Injection drug use 20 5 317 5Male-to-male sexual contact and injection drug use 17 4 284 4Hemophiliacoagulation disorder 1 0 70 1High-risk heterosexual contactb 34 8 376 6

Sex with injection drug user 1 0 54 1Sex with person with hemophilia 0 0 1 0Sex with HIV-infected transfusion recipient 0 0 8 0Sex with HIV-infected person risk factor not specified 33 8 313 5

Receipt of blood transfusion blood components or tissue 2 0 112 2Otherrisk factor not reported or identified 114 28 949 14

Total 413 100 6583 100

American IndianAlaska NativeMale-to-male sexual contact 61 49 1403 55Injection drug use 15 12 395 15Male-to-male sexual contact and injection drug use 23 19 457 18Hemophiliacoagulation disorder 0 0 27 1High-risk heterosexual contactb 9 7 118 5

Sex with injection drug user 1 1 33 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 8 6 82 3

Receipt of blood transfusion blood components or tissue 0 0 8 0Otherrisk factor not reported or identified 16 13 155 6

Total 124 100 2563 100

Total casesMale-to-male sexual contact 13775 49 429897 54Injection drug use 3413 12 163070 21Male-to-male sexual contact and injection drug use 1603 6 65524 8Hemophiliacoagulation disorder 43 0 5176 1High-risk heterosexual contactb 2997 11 49610 6

Sex with injection drug user 330 1 11683 1Sex with person with hemophilia 1 0 84 0Sex with HIV-infected transfusion recipient 22 0 553 0Sex with HIV-infected person risk factor not specified 2644 9 37290 5

Receipt of blood transfusion blood components or tissue 63 0 5213 1Otherrisk factor not reported or identified 6484 23 73136 9

Total 28378c 100 791626d 100a From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 4019 males of unknown race or multiple races

40 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 11963 73 55725 69Injection drug use 858 5 5512 7Male-to-male sexual contact and injection drug use 1092 7 5578 7Hemophiliacoagulation disorder 29 0 355 0High-risk heterosexual contactb 522 3 2658 3

Sex with injection drug user 65 0 544 1Sex with person with hemophilia 0 0 8 0Sex with HIV-infected transfusion recipient 3 0 33 0Sex with HIV-infected person risk factor not specified 454 3 2073 3

Receipt of blood transfusion blood components or tissue 14 0 197 0Otherrisk factor not reported or identified 1956 12 11147 14

Total 16434 100 81172 100

Black not HispanicMale-to-male sexual contact 6203 44 30148 37Injection drug use 1594 11 11997 15Male-to-male sexual contact and injection drug use 483 3 3489 4Hemophiliacoagulation disorder 10 0 109 0High-risk heterosexual contactb 1714 12 10905 13

Sex with injection drug user 169 1 1554 2Sex with person with hemophilia 4 0 17 0Sex with HIV-infected transfusion recipient 6 0 77 0Sex with HIV-infected person risk factor not specified 1535 11 9257 11

Receipt of blood transfusion blood components or tissue 32 0 223 0Otherrisk factor not reported or identified 4151 29 24632 30

Total 14187 100 81503 100

HispanicMale-to-male sexual contact 4094 55 15623 47Injection drug use 993 13 6407 19Male-to-male sexual contact and injection drug use 316 4 1402 4Hemophiliacoagulation disorder 3 0 26 0High-risk heterosexual contactb 582 8 2963 9

Sex with injection drug user 65 1 455 1Sex with person with hemophilia 0 0 6 0Sex with HIV-infected transfusion recipient 4 0 18 0Sex with HIV-infected person risk factor not specified 513 7 2484 7

Receipt of blood transfusion blood components or tissue 11 0 55 0Otherrisk factor not reported or identified 1475 20 6977 21

Total 7474 100 33453 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 41

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderMale-to-male sexual contact 402 70 1006 63Injection drug use 17 3 55 3Male-to-male sexual contact and injection drug use 15 3 38 2Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 25 4 96 6

Sex with injection drug user 3 1 10 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 22 4 83 5

Receipt of blood transfusion blood components or tissue 4 1 7 0Otherrisk factor not reported or identified 109 19 397 25

Total 572 100 1600 100

American IndianAlaska NativeMale-to-male sexual contact 104 61 516 57Injection drug use 13 8 101 11Male-to-male sexual contact and injection drug use 19 11 110 12Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 10 6 53 6

Sex with injection drug user 2 1 14 2Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 8 5 39 4

Receipt of blood transfusion blood components or tissue 0 0 2 0Otherrisk factor not reported or identified 24 14 125 14

Total 170 100 907 100

Total casesMale-to-male sexual contact 22912 59 103679 52Injection drug use 3503 9 24255 12Male-to-male sexual contact and injection drug use 1946 5 10704 5Hemophiliacoagulation disorder 43 0 495 0High-risk heterosexual contactb 2874 7 16830 8

Sex with injection drug user 308 1 2601 1Sex with person with hemophilia 4 0 31 0Sex with HIV-infected transfusion recipient 13 0 131 0Sex with HIV-infected person risk factor not specified 2549 7 14067 7

Receipt of blood transfusion blood components or tissue 61 0 489 0Otherrisk factor not reported or identified 7748 20 44021 22

Total 39087c 100 200473d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 1838 males of unknown race or multiple races

42 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race

ethnicity 2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 482 28 14981 40Hemophiliacoagulation disorder 4 0 123 0High-risk heterosexual contactb 725 42 15799 42

Sex with injection drug user 153 9 5650 15Sex with bisexual male 63 4 1859 5Sex with person with hemophilia 5 0 329 1Sex with HIV-infected transfusion recipient 5 0 338 1Sex with HIV-infected person risk factor not specified 499 29 7623 20

Receipt of blood transfusion blood components or tissue 15 1 1870 5Otherrisk factor not reported or identified 499 29 4801 13

Total 1725 100 37574 100

Black not HispanicInjection drug use 982 15 38914 34Hemophiliacoagulation disorder 3 0 145 0High-risk heterosexual contactb 3103 46 49876 44

Sex with injection drug user 373 6 13530 12Sex with bisexual male 136 2 2352 2Sex with person with hemophilia 4 0 121 0Sex with HIV-infected transfusion recipient 8 0 277 0Sex with HIV-infected person risk factor not specified 2582 38 33596 29

Receipt of blood transfusion blood components or tissue 39 1 1546 1Otherrisk factor not reported or identified 2612 39 23894 21

Total 6739 100 114375 100

HispanicInjection drug use 322 18 12892 35Hemophiliacoagulation disorder 4 0 67 0High-risk heterosexual contactb 894 49 17995 49

Sex with injection drug user 166 9 6522 18Sex with bisexual male 32 2 818 2Sex with person with hemophilia 1 0 45 0Sex with HIV-infected transfusion recipient 7 0 141 0Sex with HIV-infected person risk factor not specified 688 38 10469 29

Receipt of blood transfusion blood components or tissue 12 1 619 2Otherrisk factor not reported or identified 592 32 5023 14

Total 1824 100 36596 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 43

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 8 8 125 12Hemophiliacoagulation disorder 0 0 7 1High-risk heterosexual contactb 49 47 574 53

Sex with injection drug user 4 4 114 11Sex with bisexual male 2 2 80 7Sex with person with hemophilia 0 0 4 0Sex with HIV-infected transfusion recipient 1 1 25 2Sex with HIV-infected person risk factor not specified 42 40 351 33

Receipt of blood transfusion blood components or tissue 1 1 93 9Otherrisk factor not reported or identified 46 44 279 26

Total 104 100 1078 100

American IndianAlaska NativeInjection drug use 13 32 280 42Hemophiliacoagulation disorder 0 0 3 0High-risk heterosexual contactb 15 37 277 41

Sex with injection drug user 4 10 107 16Sex with bisexual male 1 2 27 4Sex with person with hemophilia 0 0 2 0Sex with HIV-infected transfusion recipient 0 0 6 1Sex with HIV-infected person risk factor not specified 10 24 135 20

Receipt of blood transfusion blood components or tissue 1 2 17 3Otherrisk factor not reported or identified 12 29 95 14

Total 41 100 672 100

Total casesInjection drug use 1826 17 67693 35Hemophiliacoagulation disorder 11 0 348 0High-risk heterosexual contactb 4839 46 85186 44

Sex with injection drug user 706 7 26073 14Sex with bisexual male 234 2 5162 3Sex with person with hemophilia 11 0 502 0Sex with HIV-infected transfusion recipient 21 0 793 0Sex with HIV-infected person risk factor not specified 3867 37 52656 27

Receipt of blood transfusion blood components or tissue 68 1 4176 2Otherrisk factor not reported or identified 3793 36 34311 18

Total 10537c 100 191714d 100a From the beginning of the epidemic through 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 104 females of unknown race or multiple racesd Includes 1419 females of unknown race or multiple races

44 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 690 26 4260 26Hemophiliacoagulation disorder 3 0 24 0

bHigh-risk heterosexual contact 1132 42 7593 46Sex with injection drug user 205 8 1876 11Sex with bisexual male 98 4 659 4Sex with person with hemophilia 10 0 115 1Sex with HIV-infected transfusion recipient 7 0 64 0Sex with HIV-infected person risk factor not specified 812 30 4879 29

Receipt of blood transfusion blood components or tissue 12 0 146 1Otherrisk factor not reported or identified 850 32 4567 28

Total 2687 100 16590 100

Black not HispanicInjection drug use 1034 13 7105 14Hemophiliacoagulation disorder 1 0 35 0

bHigh-risk heterosexual contact 3451 44 23732 46Sex with injection drug user 313 4 3473 7Sex with bisexual male 155 2 1294 3Sex with person with hemophilia 5 0 71 0Sex with HIV-infected transfusion recipient 14 0 120 0Sex with HIV-infected person risk factor not specified 2964 38 18774 36

Receipt of blood transfusion blood components or tissue 26 0 324 1Otherrisk factor not reported or identified 3370 43 20244 39

Total 7882 100 51440 100

HispanicInjection drug use 339 15 2280 18Hemophiliacoagulation disorder 2 0 11 0

bHigh-risk heterosexual contact 1198 52 6264 50Sex with injection drug user 218 9 1324 11Sex with bisexual male 62 3 266 2Sex with person with hemophilia 1 0 11 0Sex with HIV-infected transfusion recipient 7 0 39 0Sex with HIV-infected person risk factor not specified 910 39 4624 37

Receipt of blood transfusion blood components or tissue 12 1 58 0Otherrisk factor not reported or identified 767 33 3843 31

Total 2318 100 12456 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 45

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 3: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Contents

Commentary 5

Section 1 Cases of HIVAIDS and AIDSTable 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003ndash

2006mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting11

Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

12

Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas

13

Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002ndash2006 and cumulativemdash50 states and the District of Columbia

14

Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992ndash2006mdash50 states and the District of Columbia

14

Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006mdash50 states and the District of Columbia

15

Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006mdash33 states with confidential name-based HIV infection reporting

15

Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006mdashUnited States and dependent areas

16

Section 2 DeathsTable 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics

2002ndash2006 and cumulativemdashUnited States and dependent areas17

Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003ndash

2006mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting19

Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission categorymdash33 states with confidential name-based HIV infection reporting

20

Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

21

Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

21

Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002ndash2006mdashUnited States and dependent areas

22

Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission categorymdash50 states and the District of Columbia

23

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age categorymdashUnited States and dependent areas

24

3

Section 4 Survival after AIDS DiagnosisTable 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002

by selected characteristicsmdashUnited States and dependent areas26

Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by year of diagnosismdashUnited States and dependent areas

27

Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by age groupmdashUnited States and dependent areas

27

Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by raceethnicitymdashUnited States and dependent areas

28

Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and

cumulativemdashUnited States and dependent areas29

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico

31

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

35

Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulativemdashUnited States and dependent areas

37

Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

38

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas

39

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

41

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas

43

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

45

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

47

Technical Notes 48

Web Addresses for Reports of State or Local HIV and AIDS Surveillance 55

4 Contents

Commentary

The HIVAIDS epidemic was first recognized in the United States in 1981 Since that time all states and US dependent areas have conducted AIDS sur-veillance by using a standardized confidential name-based reporting system Because successful treatment delays the progression of HIV infection to AIDS AIDS surveillance data alone are insufficient to moni-tor trends in HIV incidence or to meet federal state or local data needs for planning and allocating resources for HIV prevention and care programs An integrated national HIVAIDS surveillance system will enhance the ability to monitor and characterize populations affected by the HIV epidemic and provide information on the entire population of HIV-infected persons who have been tested confidentially In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confi-dential name-based public health disease surveillance systems to report cases of HIV infection California implemented confidential name-based HIV infection case surveillance in April 2006 and this issue marks the first time that HIV case reports from California have been included in the HIVAIDS Surveillance Report For more information about HIV reporting in California visit httpwwwdhscagovAIDSHIVReporting

This report presents estimated numbers of cases of HIVAIDS (cases of HIV infection regardless whether they have progressed to AIDS) from the 38 areas (33 states and 5 US dependent areas) that have had confi-dential name-based HIV infection reporting for a suf-ficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends According to the number of reported AIDS cases these 33 states repre-sent approximately 63 of the epidemic in the 50 states and the District of Columbia From 2003 through 2006 the total number of new cases of HIVAIDS remained stable in the 33 states however HIVAIDS prevalence (ie the number of persons living with HIVAIDS) increased steadily by the end of 2006 an estimated 491727 persons in the 33 states were living with HIVAIDS The map on the cover depicts the estimated rates of diagnoses of HIVAIDS in 2006 by area of residence at the time of diagnosis

for persons residing in the 33 states and 5 US depen-dent areas with confidential name-based HIV infection reporting since at least 2003

Surveillance data on HIV infections compared with data on AIDS provide a more complete picture of the epidemic and the need for prevention and care services However the number of new HIV diagnoses during a given year(s) does not necessarily reflect a trend in HIV incidence (ie new infections) because some per-sons were infected recently and others were infected at some time in the past CDC has developed the serologic testing algorithm for recent HIV seroconversion (STARHS) which can distinguish recent from long-standing HIV infections at a population level This technology has made it possible to develop a surveil-lance system that will provide more accurate and timely estimates of HIV incidence CDC and its part-ners in state and local health departments have been working during the past several years to develop and evaluate this system Five areas were funded in FY 2002 to pilot the methods by FY 2005 34 areas were funded to conduct incidence surveillance HIVAIDS surveillance data are used by CDCrsquos public health part-ners and by professionals in other federal agencies health departments nonprofit organizations and aca-demic institutions Recognizing the changing needs for data CDC is committed to presenting the data that will best meet those needs The first estimates of HIV inci-dence which require the use of complex estimation methods are expected in 2008 The monitoring of HIV incidence will be critical in evaluating progress toward CDCrsquos goal of reducing the number of new HIV infec-tions in the United States and in allocating resources and evaluating prevention program effectiveness

The 2006 HIVAIDS Surveillance Report is orga-nized in 5 sections (1) cases of HIVAIDS and AIDS (2) deaths of persons with AIDS (3) persons living with HIVAIDS AIDS or HIV infection (not AIDS) (4) length of survival after AIDS diagnosis and (5) reports of cases of HIVAIDS AIDS and HIV infec-tion (not AIDS) In Sections 1ndash3 we present point esti-mates of case counts that have been adjusted for reporting delays and for the redistribution of cases in persons initially reported without an identified risk factor CDC routinely adjusts data for the presentation

5

of trends in the epidemic Data to estimate the number of cases of HIVAIDS or AIDS the number of persons living with HIVAIDS AIDS or HIV infection (not AIDS) and the number of deaths among persons with AIDS have been statistically adjusted to correct for delays in the reporting of cases and deaths

To assess trends in cases deaths or prevalence it is preferable to use adjusted data presented by year of diagnosis instead of year of report to eliminate arti-facts of reporting in the surveillance system Therefore for trends the reader is encouraged to use the tables in Sections 1ndash3 that present trends by year of diagnosis year of death or year-end prevalence Section 4 pre-sents estimates of survival for persons whose AIDS diagnosis was made during 2002 (Table 13) and for persons whose diagnosis was made during 1998ndash2005 (Figures 2ndash4) Proportions of persons who survived for various lengths of time after diagnosis are presented by year of diagnosis age group raceethnicity and HIV transmission category

Finally Section 5 presents reports of cases of HIV infection (not AIDS) and cases of AIDS reported through 2006 The areas included in tabulations of reported cases of HIV infection (not AIDS) are based on the date that confidential name-based HIV infection reporting was implemented For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US dependent areas) to describe reports of HIV infection These data which have not been adjusted for delays in reporting are presented by year of report to CDC Tables that present cases by year of report represent the most up-to-date information reported to CDC however cases by year of report do not represent inci-dent cases the most recent diagnoses trends or deaths

HIGHLIGHTS OF ANALYSES

Cases of HIVAIDS and Cases of AIDS

Cases of HIVAIDSFrom 2003 through 2006 the estimated number of

HIVAIDS cases in the 33 states with confidential name-based HIV infection reporting remained stable (Table 1) In 2006 the estimated rate of HIVAIDS cases in the 33 states was 185 per 100000 population (Table 5b)

bull Age group From 2003 through 2006 the estimated number of newly diagnosed HIVAIDS

6 Comm

cases decreased among children (less than 13 years of age) and in the following age groups 13ndash14 30ndash34 and 35ndash39 years (Table 1) The estimated number of HIVAIDS cases remained stable among persons aged 40ndash44 years and increased among persons aged 15ndash19 20ndash24 25ndash29 45ndash49 50ndash54 55ndash59 60ndash64 and 65 years and older In 2006 the largest number of HIVAIDS cases occurred among persons aged 40ndash44 years who accounted for 16 of all HIVAIDS cases diagnosed during that year

bull Raceethnicity From 2003 through 2006 the estimated number of newly diagnosed HIVAIDS cases increased among whites and AsiansPacific Islanders remained stable among blacks and Hispanics and fluctuated among American IndiansAlaska Natives (Table 1) Blacks accounted for 49 of all HIVAIDS cases diagnosed in 2006 In 2006 rates of HIVAIDS cases were 677 per 100000 in the black population 255 per 100000 in the Hispanic population 88 per 100000 in the American IndianAlaska Native population 82 per 100000 in the white population and 67 per 100000 in the AsianPacific Islander population (Table 5b)

bull Sex From 2003 through 2006 the estimated number of HIVAIDS cases increased approximately 5 among males and decreased 6 among females (Table 1) In 2006 males accounted for 74 of all HIVAIDS cases among adults and adolescents In 2006 rates were 338 per 100000 among males and 115 per 100000 among females (Table 5b)

bull Transmission category From 2003 through 2006 the estimated number of HIVAIDS cases increased among men who have sex with men (MSM) and remained stable among adults and adolescents with HIV infection attributed to high-risk heterosexual contact (heterosexual contact with a person known to have or to be at high risk for HIV infection) (Table 1) The estimated number of HIVAIDS cases decreased among injection drug users (IDUs) MSM who were also IDUs and among children MSM (49) and persons exposed through high-risk heterosexual contact (33) accounted for 82 of all HIVAIDS cases diagnosed in 2006

entary

Of all HIV infections diagnosed in 2005 in the 33 states with confidential name-based HIV reporting 38 progressed to AIDS within 12 months after HIV infection was diagnosed AIDS was diagnosed within 12 months after the diagnosis of HIV infection for larger proportions of persons aged 13ndash14 years and 35 years and older for Hispanics for IDUs and for males with HIV infection attributed to high-risk heterosexual contact (Table 2)

Cases of AIDSFrom 2002 through 2006 the estimated number of

newly diagnosed AIDS cases in the 50 states and the District of Columbia remained stable (Table 3) In 2006 the estimated rate of AIDS cases in the United States was 123 per 100000 population (Table 5a)

bull Age group From 2002 through 2006 the estimated number of AIDS cases decreased 64 among children (less than 13 years of age) (Table 3) The estimated number of AIDS cases also decreased among persons in the age groups 30ndash34 and 35ndash39 years (Table 3) The estimated number of AIDS cases remained stable among persons aged 40ndash44 years and increased in the following age groups 13ndash14 15ndash19 20ndash24 25ndash29 45ndash49 50ndash54 55ndash59 60ndash64 and 65 years and older In 2006 the largest number of AIDS cases occurred among persons aged 40ndash44 years who accounted for 20 of all AIDS cases diagnosed during that year in the 50 states and the District of Columbia

bull Raceethnicity From 2002 through 2006 the estimated number of AIDS cases decreased among blacks and American IndiansAlaska Natives remained stable among whites and Hispanics and increased among AsiansPacific Islanders (Table 3) In 2006 rates of AIDS cases were 476 per 100000 in the black population 156 per 100000 in the Hispanic population 62 per 100000 in the American IndianAlaska Native population 54 per 100000 in the white population and 37 per 100000 in the AsianPacific Islander population (Table 5a)

bull Sex From 2002 through 2006 the estimated number of AIDS cases remained stable among both male and female adults and adolescents (Table 3) Males accounted for 73 of all AIDS cases diagnosed in 2006 for adults and adolescents in the 50 states and the District of Columbia (Table

Comm

3) Rates of AIDS cases in 2006 were 224 per 100000 among males and 78 per 100000 among females (Table 5a)

bull Transmission category From 2002 through 2006 among male adults and adolescents the estimated number of AIDS cases decreased among IDUs and MSM who were also IDUs (Table 3) The numbers of males exposed through male-to-male sexual contact and high-risk heterosexual contact remained stable Among female adults and adolescents the estimated number of AIDS cases decreased among IDUs and fluctuated among females exposed through high-risk heterosexual contact

bull Region From 2002 through 2006 the estimated number of AIDS cases decreased 10 in the West and 6 in the Northeast and remained stable in the South and the Midwest

DeathsFrom 2002 through 2006 the estimated number of

deaths of persons with AIDS who resided in the 50 states and the District of Columbia decreased 17 (Table 7)

bull Age group The estimated number of deaths decreased among children (less than 13 years of age) and in the following age groups 13ndash14 25ndash29 30ndash34 35ndash39 40ndash44 and 45ndash49 years The estimated number of deaths remained stable among persons aged 50ndash54 years and increased in the age groups 15ndash19 20ndash24 55ndash59 60ndash64 and 65 years and older

bull Raceethnicity The estimated number of deaths of persons with AIDS decreased among whites blacks and American IndiansAlaska Natives The estimated number of deaths of persons with AIDS remained stable among Hispanics and increased among AsiansPacific Islanders

bull Sex and transmission category The estimated number of deaths of adults and adolescents decreased among MSM and IDUs and remained stable among persons exposed through high-risk heterosexual contact

bull Region The estimated number of deaths decreased in all regions of the United States

entary 7

Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS

Persons living with HIVAIDSFrom 2003 through 2006 the estimated number of

persons living with HIVAIDS increased steadily in the 33 states with confidential name-based HIV infec-tion reporting (Table 8) At the end of 2006 an esti-mated 491727 persons in these states were living with HIVAIDS

bull By age group most (21) were aged 40ndash44 years

bull By raceethnicity 47 were black 34 white 17 Hispanic and less than 1 each were American IndianAlaska Native or AsianPacific Islander

bull By sex 73 of adults and adolescents living with HIVAIDS were male

bull Of the estimated 353825 male adults and adolescents living with HIVAIDS 62 had been exposed through male-to-male sexual contact 17 had been exposed through injection drug use 13 had been exposed through high-risk heterosexual contact and 7 had been exposed through both male-to-male sexual contact and injection drug use Of the estimated 131195 female adults and adolescents living with HIVAIDS 73 had been exposed through high-risk heterosexual contact and 26 had been exposed through injection drug use Of the estimated 6703 children living with HIVAIDS 92 had been exposed perinatally

Prevalence rates of HIV infection (not AIDS)At the end of 2006 in the 38 areas with confidential

name-based HIV infection reporting since at least 2003 the prevalence rate of HIV infection (not AIDS) among adults and adolescents was estimated at 1437 per 100000 (Map 1) The rate for adults and adoles-cents living with HIV infection (not AIDS) ranged from an estimated 49 per 100000 (American Samoa) to an estimated 2617 per 100000 (New York) The prevalence rate of HIV infection (not AIDS) among children residing in the 38 areas was an estimated 65 per 100000 (Map 2) The rate for children living with HIV infection (not AIDS) ranged from an estimated zero per 100000 in Idaho New Mexico American Samoa Guam and the Northern Mariana Islands to an estimated 253 per 100000 in New York

8 Comm

Persons living with AIDSAIDS prevalence also increased steadily from 2002

through 2006 (Table 10) At the end of 2006 an esti-mated 436693 persons in the 50 states and the District of Columbia were living with AIDS

bull By age group most (22) were aged 40ndash44 years

bull By raceethnicity 44 were black 35 white 19 Hispanic 1 AsianPacific Islander and less than 1 were American IndianAlaska Native

bull By sex 77 of adults and adolescents living with AIDS were male

bull Of the estimated 333244 male adults and adolescents living with AIDS 60 had been exposed through male-to-male sexual contact 19 had been exposed through injection drug use 12 had been exposed through high-risk heterosexual contact and 8 had been exposed through both male-to-male sexual contact and injection drug use Of the estimated 99671 female adults and adolescents living with AIDS 66 had been exposed through high-risk heterosexual contact and 32 had been exposed through injection drug use

bull By region 41 resided in the South 29 in the Northeast 20 in the West and 11 in the Midwest

AIDS prevalence ratesAt the end of 2006 the prevalence rate of AIDS

among adults and adolescents in the United States was estimated at 1786 per 100000 (Map 1) The rate for adults and adolescents living with AIDS ranged from an estimated 25 per 100000 (American Samoa) to an estimated 20165 per 100000 (District of Columbia) The prevalence rate of AIDS among children in the United States was estimated at 22 per 100000 at the end of 2006 (Map 2) The rate for children living with AIDS ranged from an estimated zero per 100000 in Idaho Montana Utah American Samoa Guam and the Northern Mariana Islands to an estimated 365 per 100000 in the District of Columbia

Survival after AIDS DiagnosisTable 13 is limited to data on AIDS cases diagnosed

in 2002 in order to describe the survival of persons whose diagnosis was made relatively recently but far enough in the past to permit a meaningful measure of

entary

survival Figures 2 3 and 4 illustrate the proportion of surviving persons among persons whose diagnoses were made over a longer period 1998 through 2005

bull Survival (the estimated proportion of persons surviving a given length of time after diagnosis) increased with the year of diagnosis for diagnoses made during 1998ndash2000 Year-to-year differences were small during 2001ndash2005 (Figure 2)

bull Survival decreased as age at diagnosis increased among persons at least 35 years old at diagnosis and in comparison with persons younger than 35 Survival was similar for the age groups 13ndash24 and 25ndash34 (Figure 3)

bull Survival was greatest among MSM and among children with perinatally acquired HIV infection (Table 13) Survival was intermediate among male and female adults and adolescents who had heterosexual contact with someone known to be HIV infected or at high risk for HIV infection as well as among MSM who also were IDUs Survival was lowest among male and female adults and adolescents who were IDUs

bull Survival particularly at more than 48 months after diagnosis was greater among AsiansPacific Islanders whites and Hispanics than among blacks (Figure 4) Results were unstable or inconsistent for American IndiansAlaska Natives because the numbers of persons in this racialethnic category were small

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Tables 14ndash23 describe reports of cases of HIVAIDS AIDS and HIV infection (not AIDS) Tables 16 18 20 and 22 are based on reports of cases of HIV infection (not AIDS) through 2006 from the 50 areas that had implemented name-based HIV infection reporting Note that not all cases of HIV infection (not AIDS) or AIDS reported in 2006 reflect diagnoses made during 2006 rather the reported cases include cases diagnosed during earlier years

Reports of cases of HIV infection (not AIDS)Through 2006 a total of 287954 persons were

reported as having HIV infection (not AIDS) in the 50 areas with confidential name-based HIV infection reporting (Table 16) (see Technical Notes for discus-sion of surveillance of HIV infection [not AIDS])

Comm

Five states (Florida New Jersey New York North Carolina and Texas) reported 137507 (48) of the 287954 cumulative cases of HIV infection (not AIDS) reported to CDC In 2006 4 states (California Illinois New York and Pennsylvania) reported 22417 (42) of the 52878 cases of HIV infection (not AIDS)

bull In 2006 of the 52312 reported cases among adults and adolescents 75 were in males and 25 were in females (Table 18)

bull In 2006 566 cases in children were reported

Reports of AIDS casesThrough 2006 a total of 992865 persons in the

United States had been reported as having AIDS (Table 14) Three states (California Florida and New York) reported 43 of the cumulative AIDS cases and 37 of AIDS cases reported to CDC in 2006 In the United States the rate of reported AIDS cases in 2006 was 129 per 100000 population When the US dependent areas were included the rate of reported AIDS cases ranged from zero per 100000 (American Samoa Guam and the Northern Mariana Islands) to 1467 per 100000 (District of Columbia)

bull In 2006 males accounted for 73 and females for 27 of 38916 reported AIDS cases among adults and adolescents (Table 17)

bull In 2006 86 AIDS cases in children were reported

ADDITIONAL RESOURCES

The following were prepared by using HIVAIDS surveillance data

bull Selected MMWR articles at httpwwwcdcgovhivresourcesreportsmmwr

bull Public-use slides at httpwwwcdcgovhivtopicssurveillanceresourcesslides

bull Other surveillance reports at httpwwwcdcgovhivtopicssurveillanceresourcesreports

bull Public-use version of the AIDS surveillance data set (AIDS Public Information Data Set [APIDS]) at httpwwwcdcgovhivsoftwareapidshtm

SUGGESTED READINGS

CDC Advancing HIV Prevention New Strategies for a Changing EpidemicmdashUnited States 2003 MMWR 200352(15)329ndash332

entary 9

CDC Dear colleague letter CDC recommends that all states and territories adopt confidential name-based surveillance systems to report HIV infec-tions httpwwwcdcgovhivpubs070505_dearcolleague_gerberdingpdf Pub-lished July 5 2005 Accessed March 11 2008

1981ndash2005 CDC Epidemiology of HIVAIDSmdashUnited States

MMWR 200655(21)589ndash592CDC Guidelines for national HIV case surveil-

lance including monitoring for HIV infection and AIDS MMWR 199948(RR-13)1ndash31

CDC HIV prevention strategic plan extended through 2010 httpwwwcdcgovhivresourcesreportspsp Published October 2007 Accessed March 11 2008

CDC Revised recommendations for HIV testing of adults adolescents and pregnant women in health-care settings MMWR 200655(RR-14)1ndash17

CDC Twenty-five years of HIVAIDSmdashUnited States 1981ndash2006 MMWR 200655(21)585ndash589

Glynn MK Lee LM McKenna MT The status of national HIV case surveillance United States 2006 Public Health Rep 2007122(suppl 1)63ndash71

Janssen RS Satten GA Stramer SL et al New test-ing strategy to detect early HIV-1 infection for use in incidence estimates and for clinical and prevention purposes JAMA 1998280(1)42ndash48

Lee LM McKenna MT Monitoring the incidence of HIV infection in the United States Public Health Rep 2007122(suppl 1)72ndash79

10 Comm

entary

Cases of HIVAIDS and AIDS

Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003ndash2006mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

Year of diagnosis

2003 2004 2005 2006

Data for 33 statesAge at diagnosis (yrs)lt13 211 183 169 13513ndash14 53 36 40 4115ndash19 993 993 1126 133220ndash24 3163 3368 3592 388625ndash29 4023 4057 4236 460330ndash34 5189 4820 4676 446635ndash39 6369 5807 5535 544240ndash44 5786 5429 5529 571845ndash49 4028 3877 4028 420450ndash54 2451 2401 2547 271855ndash59 1279 1363 1455 143860ndash64 655 702 692 714gt65 570 624 613 618

RaceethnicityWhite not Hispanic 10033 10181 10528 10758Black not Hispanic 17668 16718 16629 17356Hispanic 6355 6010 6217 6481AsianPacific Islander 338 339 373 397American IndianAlaska Native 179 171 182 166

Transmission categoryMale adult or adolescentMale-to-male sexual contact 15409 15880 16833 17465Injection drug use 3514 3083 2978 3016Male-to-male sexual contact and injection drug use 1349 1299 1247 1180High-risk heterosexual contacta 4269 3959 3871 4152Otherb 125 110 107 114Subtotal 24666 24331 25036 25928

Female adult or adolescentInjection drug use 2027 1856 1720 1712High-risk heterosexual contacta 7731 7182 7216 7432Otherb 134 107 97 109Subtotal 9892 9145 9033 9252

Child (lt13 yrs at diagnosis)Perinatal 190 157 147 115Otherc 23 27 23 20Subtotal 213 184 170 135

Subtotal for 33 states 34770 33659 34239 35314

Data for US dependent areas 1331 1234 1395 1503

Totald 36102 34894 35634 36817Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

Cases of HIVAIDS and AIDS 11

Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

gt12 Months after diagnosis aof HIV infection

lt12 Months after diagnosis of HIV infectionb Total

No ()c No ()c No

Data for 33 statesAge at diagnosis (yrs)lt13 148 88 21 12 16913ndash14 22 54 18 46 4015ndash19 912 81 215 19 112620ndash24 2874 80 714 20 358925ndash29 3077 73 1157 27 423430ndash34 3016 65 1655 35 467135ndash39 3353 61 2176 39 553040ndash44 3181 58 2338 42 551945ndash49 2145 53 1874 47 401950ndash54 1307 51 1239 49 254655ndash59 725 50 728 50 145360ndash64 316 46 376 54 692gt65 266 44 346 56 612RaceethnicityWhite not Hispanic 6839 65 3677 35 10516Black not Hispanic 10372 62 6242 38 16614Hispanic 3593 58 2614 42 6206AsianPacific Islander 232 62 139 38 371American IndianAlaska Native 110 61 72 39 182Transmission category

Male adult or adolescentMale-to-male sexual contact 10917 65 5902 35 16819Injection drug use 1544 52 1427 48 2971Male-to-male sexual contact and injection drug use 733 59 512 41 1245High-risk heterosexual contactd 2091 54 1773 46 3864Othere 45 42 61 58 107Subtotal 15331 61 9675 39 25006Female adult or adolescentInjection drug use 1056 62 660 38 1716High-risk heterosexual contactd 4761 66 2450 34 7210Othere 47 48 50 52 97Subtotal 5864 65 3160 35 9023Child (lt13 yrs at diagnosis)Perinatal 126 86 21 14 147Otherf 22 94 2 6 23Subtotal 148 87 22 13 170

Subtotal for 33 states 21343 62 12857 38 34200Data for US dependent areas 855 61 541 39 1395

Totalg 22197 62 13398 38 35595h

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003Data exclude 39 persons whose month of diagnosis of HIV infection is unknowna Includes persons in whom AIDS has not developedb Includes persons whose diagnoses of HIV infection and AIDS were made at the same timec Percentages represent proportions of the total number of diagnoses of HIVAIDS made during 2005 for the corresponding group (see row

entries)d Heterosexual contact with a person known to have or to be at high risk for HIV infectione Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedf Includes hemophilia blood transfusion and risk factor not reported or not identifiedg Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the

column totalh Includes 310 persons of unknown race or multiple races

12 Cases of HIVAIDS and AIDS

Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas

Year of diagnosis2002 2003 2004 2005 2006 Cumulativea

Data for 50 states and the District of ColumbiaAge at diagnosis (yrs)lt13 106 70 53 53 38 915613ndash14 62 74 70 66 73 107815ndash19 316 302 334 410 401 562620ndash24 1399 1568 1624 1675 1669 3622525ndash29 3137 3059 3196 3110 3423 11709930ndash34 5701 5521 5144 4668 4349 19753035ndash39 8217 8017 7072 6479 6402 21357340ndash44 7404 7626 7703 7378 7298 17053145ndash49 5358 5617 5498 5727 5628 10720750ndash54 3271 3364 3491 3527 3687 5990755ndash59 1607 1693 1836 1861 2071 3219060ndash64 872 864 913 872 955 17303gt65 682 763 791 727 835 15074

RaceethnicityWhite not Hispanic 11233 10948 11066 10676 10929 394024Black not Hispanic 19246 19512 18909 18081 17960 409982Hispanic 6712 7102 6771 6823 6907 161505AsianPacific Islander 425 450 444 450 519 7951American IndianAlaska Native 177 176 182 170 155 3345

Transmission categoryMale adult or adolescentMale-to-male sexual contact 15709 16078 16054 15711 16001 465965Injection drug use 5483 5275 4818 4603 4410 170171Male-to-male sexual contact and injection drug use 2075 2029 1925 1930 1803 68516High-risk heterosexual contactb 4547 4471 4506 4306 4558 65241Otherc 253 226 228 237 217 13893Subtotal 28067 28079 27532 26787 26989 783786

Female adult or adolescentInjection drug use 2897 2836 2810 2586 2385 74718High-risk heterosexual contactb 6855 7336 7113 6922 7196 108252Otherc 207 217 217 205 220 6596Subtotal 9959 10389 10141 9713 9801 189566

Child (lt13 yrs at diagnosis)Perinatal 104 70 53 52 37 8508Otherd 2 0 0 0 0 636Subtotal 106 70 53 53 38 9144

Region of residenceNortheast 10092 10342 9412 9396 9486 306241Midwest 4125 4226 4089 4371 4164 101479South 17198 17630 18225 16894 17104 374800West 6718 6339 6000 5891 6074 199978Subtotal for 50 states and the District of Columbia 38132 38538 37726 36552 36828 982498

Data for US dependent areas 1058 1060 921 955 833 31217

Totale 39250 39690 38807 37662 37852 1014797Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes persons of unknown race or multiple races and persons of unknown sex Cumulative total includes 5691 persons of unknown race or multiple

races 3 persons of unknown sex 1079 persons of unknown state of residence and 3 persons who were residents of other areas Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Cases of HIVAIDS and AIDS 13

Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002ndash2006 and cumulativemdash50 states and the District of Columbia

Year of diagnosisCumulativea2002 2003 2004 2005 2006

RaceethnicityWhite not Hispanic 14 12 7 4 4 1599Black not Hispanic 70 46 33 38 30 5654Hispanic 18 10 9 8 3 1748AsianPacific Islander 1 0 1 1 1 54American IndianAlaska Native 1 0 1 0 0 31

Transmission categoryHemophiliacoagulation disorder 0 0 0 0 0 226Mother with documented HIV infection or 1 of the following risk factors 104 70 53 52 37 8508

Injection drug use 12 8 5 3 4 3220Sex with injection drug user 4 6 3 2 1 1397Sex with bisexual male 2 0 3 1 1 209Sex with person with hemophilia 0 0 0 0 0 35Sex with HIV-infected transfusion recipient 0 0 0 0 0 22Sex with HIV-infected person risk factor not specified 36 20 20 25 13 1530Receipt of blood transfusion blood components or tissue 2 1 0 0 0 144Has HIV infection risk factor not specified 47 34 21 21 17 1951

Receipt of blood transfusion blood components or tissue 2 0 0 0 0 374Otherrisk factor not reported or identified 0 0 0 0 0 36

Totalb 106 70 53 53 38 9144

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga From the beginning of the epidemic through 2006b Includes children of unknown race or multiple races Cumulative total includes 58 children of unknown race or multiple races Because column totals

were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992ndash2006mdash50 states and the District of Columbia

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reporting

14 Cases of HIVAIDS and AIDS

Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006mdash50 states and the District of Columbia

Raceethnicity

Adults or adolescents

Children (lt13 yrs) TotalaMales Females Totala

No Rate No Rate No Rate No Rate No Rate

White not Hispanic 9267 112 1659 19 10926 64 4 00 10929 54Black not Hispanic 11540 829 6391 404 17930 603 30 04 17960 476Hispanic 5388 313 1516 95 6903 208 3 00 6907 156AsianPacific Islander 423 75 95 16 518 44 1 00 519 37American IndianAlaska Native 118 122 37 36 155 78 0 00 155 62

Totalb 26989 224 9801 78 36790 149 38 01 36828c 123

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reportingData exclude cases in persons whose state or area of residence is unknown as well as cases from US dependent areas for which census information about race and age categories is lackinga Because row totals were calculated independently of the values for the subpopulations the values in each row may not sum to the row totalb Includes person of unknown race or multiple races Because column totals were calculated independently of the values for the subpopulations the

values in each column may not sum to the column totalc Includes 358 persons of unknown race or multiple races

Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006mdash33 states with confidential name-based HIV infection reporting

Raceethnicity

Adults or adolescents

Children (lt13 yrs) TotalaMales Females Totala

No Rate No Rate No Rate No Rate No Rate

White not Hispanic 9078 167 1664 29 10742 96 16 01 10758 82Black not Hispanic 11230 1191 6033 562 17263 856 93 17 17356 677Hispanic 5058 509 1400 151 6458 337 23 04 6481 255AsianPacific Islander 318 135 79 32 397 82 0 00 397 67American IndianAlaska Native 129 177 35 46 164 110 2 06 166 88

Totalb 25928 338 9252 115 35180 224 135 04 35314c 185

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Because row totals were calculated independently of the values for the subpopulations the values in each row may not sum to the row totalb Includes persons of unknown race or multiple races Because column totals were calculated independently of the values for the subpopulations the

values in each column may not sum to the column totalc Includes 156 persons of unknown race or multiple races

Cases of HIVAIDS and AIDS 15

Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006mdashUnited States and dependent areas

Transmission category

Place of birth

United StatesCentralSouth

America Cuba Mexico Puerto Rico Totala

No No No No No No

Male-to-male sexual contact 1172 45 402 49 89 62 790 59 249 18 3337 43Injection drug use 569 22 83 10 13 9 133 10 533 40 1650 21Male-to-male sexual contact

and injection drug use 158 6 25 3 6 4 59 4 63 5 357 5High-risk heterosexual

contactb 661 25 296 36 35 24 342 26 487 36 2282 30Otherc 47 2 8 1 0 0 9 1 14 1 103 1

Totald 2608 100 814 100 145 100 1334 100 1346 100 7728 100Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Includes 222 persons whose place of birth is not among those listed and 1260 persons whose place of birth is unknownb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the

column total

16 Cases of HIVAIDS and AIDS

Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas

Year of death

Cumulativea2002 2003 2004 2005 2006

Data for 50 states and the District of ColumbiaAge at death (yrs)lt13 25 22 15 7 13 4889

13ndash14 10 6 15 12 5 276

15ndash19 39 36 36 38 44 1104

20ndash24 151 157 175 147 162 8716

25ndash29 553 512 482 458 405 43671

30ndash34 1480 1272 1128 1069 785 95351

35ndash39 2967 2763 2425 2096 1682 116746

40ndash44 3595 3516 3393 3317 2636 104133

45ndash49 3294 3234 3251 3275 2886 72831

50ndash54 2318 2373 2502 2645 2343 44255

55ndash59 1209 1322 1425 1543 1480 25123

60ndash64 616 705 741 797 771 14315

gt65 691 773 807 865 805 14393

RaceethnicityWhite not Hispanic 5214 5097 4836 4758 3860 239529

Black not Hispanic 9037 8675 8581 8679 7426 218392

Hispanic 2429 2632 2641 2513 2425 80690

AsianPacific Islander 97 84 111 87 114 3426

American IndianAlaska Native 83 73 80 65 66 1693

Transmission categoryMale adult or adolescentMale-to-male sexual contact 5960 5937 5735 5641 4930 266272

Injection drug use 3738 3547 3315 3314 2641 107173

Male-to-male sexual contact and injection drug use 1278 1299 1237 1289 1064 40993

High-risk heterosexual contactb 1465 1501 1625 1571 1470 26236

Otherc 160 149 125 117 80 9867

Subtotal 12601 12431 12038 11932 10184 450541

Female adult or adolescentInjection drug use 1923 1825 1855 1768 1456 43143

High-risk heterosexual contactb 2281 2292 2373 2458 2258 42620

Otherc 84 87 72 68 70 4131

Subtotal 4289 4204 4300 4295 3784 89895

Child (lt13 yrs at diagnosis)Perinatal 53 49 56 39 42 4848

Otherd 4 5 1 2 7 521

Subtotal 57 54 57 41 48 5369

Deaths 17

Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas (cont)

Year of death

Cumulativea2002 2003 2004 2005 2006

Region of residenceNortheast 5313 5012 4779 4750 4074 180623

Midwest 1726 1666 1482 1378 1325 54468

South 7337 7427 7535 7907 6475 197209

West 2571 2585 2600 2234 2141 113506

Subtotal for 50 states and the District of Columbia 16948 16690 16395 16268 14016 545805

Data for US dependent areas 667 575 572 562 580 19858

Totale 17628 17283 16982 16865 14627 565927f

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column totalf Includes 2082 persons of unknown race or multiple races 261 persons of unknown state of residence and 2 persons who were residents

of other areas

18 Deaths

Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003ndash2006mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

2003 2004 2005 2006Data for 33 states

Age at end of year (yrs)lt13 4154 3700 3294 286713ndash14 1130 1238 1212 113915ndash19 3298 3627 4024 453920ndash24 12389 12826 13411 1430125ndash29 26167 26924 28164 2960030ndash34 49602 47577 45109 4418935ndash39 80703 77871 75842 7363440ndash44 92040 97109 100102 10176445ndash49 71345 77490 83816 9028350ndash54 45133 51033 56640 6319555ndash59 22793 26610 31186 3600860ndash64 10820 12642 14422 16658gt65 8531 9959 11657 13551

RaceethnicityWhite not Hispanic 145081 151694 158375 166000Black not Hispanic 202951 212425 221439 231957Hispanic 72612 76503 80491 84720AsianPacific Islander 2234 2529 2858 3187American IndianAlaska Native 1788 1889 2008 2119

Transmission categoryMale adult or adolescentMale-to-male sexual contact 181771 193245 205423 218676Injection drug use 57651 58149 58369 59077Male-to-male sexual contact and injection drug use 23965 24434 24725 25085High-risk heterosexual contacta 40084 42559 44915 47562Otherb 3218 3278 3325 3424Subtotal 306689 321665 336756 353825

Female adult or adolescentInjection drug use 32346 32735 32973 33470High-risk heterosexual contacta 80324 85348 90185 95403Otherb 2036 2123 2212 2321Subtotal 114705 120206 125370 131195

Child (lt13 yrs at diagnosis)Perinatal 6137 6154 6178 6143Otherc 570 575 571 560Subtotal 6707 6730 6748 6703

Subtotal for 33 states 428107 448605 468879 491727Data for US dependent areas 15809 16399 17150 17955

Totald 443916 465005 486028 509681Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 19

Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission categorymdash33 states with confidential name-based HIV infection reporting

Transmission category

White not Hispanic

Black not Hispanic Hispanic

AsianPacific Islander

American IndianAlaska

Native Totala

No No No No No No

Male adult or adolescentMale-to-male sexual contact 108259 77 70242 49 36043 57 1669 68 938 62 218676 62Injection drug use 12328 9 31339 22 14472 23 264 11 216 14 59077 17Male-to-male sexual contact

and injection drug use 11283 8 9587 7 3720 6 93 4 205 13 25085 7High-risk heterosexual contactb 6667 5 31140 22 8788 14 395 16 143 9 47562 13Otherc 1458 1 1492 1 404 1 30 1 17 1 3424 1Subtotal 139994 100 143799 100 63427 100 2450 100 1519 100 353825 100

Female adult or adolescentInjection drug use 8262 33 19136 23 5528 28 106 15 175 30 33470 26High-risk heterosexual contactb 16338 65 63204 75 14132 71 573 82 392 68 95403 73Otherc 450 2 1469 2 344 2 24 3 12 2 2321 2Subtotal 25050 100 83809 100 20004 100 703 100 578 100 131195 100

Child (lt13 yrs at diagnosis)Perinatal 801 84 4064 93 1183 92 28 82 20 95 6143 92Otherd 154 16 283 7 107 8 6 18 1 5 560 8Subtotal 955 100 4347 100 1290 100 34 100 21 100 6703 100

Totale 166000 231957 84720 3187 2119 491727Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of 33 states that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Includes 3745 persons of unknown race or multiple racesb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes 5 persons of unknown sex Because column totals were calculated independently of the values for the subpopulations the values

in each column may not sum to the column total

20 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Map 1 Estimated rates (per 100000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

Note Rates adjusted for reporting delays Rates of HIV infection include only persons living with HIV infection that has not progressed to AIDSSince 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 Islandsa Includes persons whose area of residence is unknown

Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

Note Rates adjusted for reporting delays Rates of HIV infection include only persons living with HIV infection that has not progressed to AIDSSince 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 Islandsa Includes persons whose area of residence is unknown

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 21

Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002ndash2006mdashUnited States and dependent areas

2002 2003 2004 2005 2006Data for 50 states and the District of Columbia

Age at end of year (yrs)lt13 2308 2006 1684 1394 111513ndash14 685 747 784 762 71115ndash19 1465 1694 1974 2243 248720ndash24 3910 4292 4629 5033 536725ndash29 12725 12743 13045 13505 1435930ndash34 35558 33870 32057 29949 2882435ndash39 70107 68106 65076 62235 5964940ndash44 80377 86294 91335 94021 9517445ndash49 64702 71276 77417 84153 9077550ndash54 41270 46855 53333 59256 6647655ndash59 20113 24145 28356 33522 3901460ndash64 9681 11293 13305 15380 18072gt65 7520 8946 10604 12430 14669

RaceethnicityWhite not Hispanic 129426 135278 141508 147426 154495Black not Hispanic 150488 161326 171654 181056 191590Hispanic 63424 67895 72024 76334 80815AsianPacific Islander 3060 3426 3759 4121 4526American IndianAlaska Native 1254 1356 1458 1562 1651

Transmission categoryMale adult or adolescentMale-to-male sexual contact 158092 168233 178551 188622 199693Injection drug use 56708 58436 59940 61229 62998Male-to-male sexual contact and injection drug use 24726 25457 26144 26785 27523High-risk heterosexual contacta 27329 30300 33181 35916 39004Otherb 3588 3665 3769 3888 4026Subtotal 270444 286091 301585 316440 333244

Female adult or adolescentInjection drug use 27863 28874 29828 30646 31575High-risk heterosexual contacta 46445 51489 56229 60693 65631Otherb 1903 2033 2178 2315 2465Subtotal 76210 82395 88236 93653 99671

Child (lt13 yrs at diagnosis)Perinatal 3633 3654 3651 3664 3660Otherc 129 124 123 122 115Subtotal 3762 3778 3774 3786 3775

Region of residenceNortheast 105599 110929 115562 120208 125620Midwest 36011 38571 41178 44171 47010South 137081 147284 157975 166962 177591West 71729 75483 78883 82540 86473

Subtotal for 50 states and the District of Columbia 350419 372267 393598 413882 436693

Data for US dependent areas 9880 10365 10713 11106 11359

Totald 360617 383024 404849 425646 448871Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

22 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission categorymdash50 states and the District of Columbia

Transmission category

White not Hispanic

Black not Hispanic Hispanic

AsianPacific Islander

American IndianAlaska

Native Totala

No No No No No No

Male adult or adolescentMale-to-male sexual contact 101299 75 57520 45 36087 57 2715 72 704 57 199693 60Injection drug use 13168 10 33911 27 14795 23 325 9 201 16 62998 19Male-to-male sexual contact and

injection drug use 12393 9 10121 8 4352 7 198 5 220 18 27523 8High-risk heterosexual contactb 6081 5 24205 19 7816 12 444 12 105 8 39004 12Otherc 1743 1 1602 1 574 1 69 2 16 1 4026 1Subtotal 134683 100 127359 100 63623 100 3752 100 1246 100 333244 100

Female adult or adolescentInjection drug use 7407 38 18531 30 5025 30 115 15 153 39 31575 32High-risk heterosexual contactb 11350 59 41741 68 11092 67 588 78 227 58 65631 66Otherc 508 3 1456 2 413 2 51 7 13 3 2465 2Subtotal 19264 100 61728 100 16531 100 753 100 393 100 99671 100

Child (lt13 yrs at diagnosis)Perinatal 500 92 2468 99 629 95 20 94 12 100 3660 97Otherd 46 8 34 1 33 5 1 6 0 0 115 3Subtotal 546 100 2503 100 662 100 21 100 12 100 3775 100

Totale 154495 191590 80815 4526 1651 436693

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Includes 3616 persons of unknown race or multiple racesb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes 3 person of unknown sex Because column totals were calculated independently of the values for the subpopulations the values in each column

may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 23

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by

area of residence and age categorymdashUnited States and dependent areas

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

Alabama 5469 17 5486 3744 11 3755Alaska 272 1 273 330 1 331Arizona 5744 49 5793 4922 7 4929Arkansas 2291 7 2298 2139 6 2145California mdash mdash mdash 61451 105 61555Colorado 5855 13 5869 4083 2 4085Connecticut mdash mdash mdash 7406 15 7421Delaware mdash mdash mdash 1753 7 1760District of Columbia mdash mdash mdash 10059 30 10089Floridab 35461 263 35723 46469 194 46663Georgia mdash mdash mdash 17336 47 17383Hawaii mdash mdash mdash 1234 3 1237Idaho 356 0 356 313 0 313Illinois mdash mdash mdash 16139 46 16185Indiana 3849 21 3870 3996 14 4010Iowa 588 2 590 869 3 872Kansas 1230 7 1237 1272 2 1274Kentucky mdash mdash mdash 2589 13 2602Louisiana 7361 101 7462 8052 21 8074Maine mdash mdash mdash 512 2 514Maryland mdash mdash mdash 14540 41 14581Massachusetts mdash mdash mdash 8806 20 8826Michigan 6118 55 6173 6615 12 6627Minnesota 3227 21 3248 2314 9 2323Mississippi 4200 32 4232 3155 13 3168Missouri 4999 33 5033 5479 7 5486Montana mdash mdash mdash 205 0 205Nebraska 688 12 700 771 2 773Nevada 3402 13 3415 2969 3 2972New Hampshire mdash mdash mdash 556 3 559New Jersey 16059 153 16212 17168 57 17226New Mexico 910 0 909 1252 3 1255New York 42220 801 43021 70697 148 70845North Carolina 11700 60 11760 8451 12 8463North Dakota 87 2 89 73 1 74Ohio 8266 57 8323 7054 30 7084Oklahoma 2191 17 2208 2191 3 2194Oregon mdash mdash mdash 2840 4 2844Pennsylvania mdash mdash mdash 18633 71 18703Rhode Island mdash mdash mdash 1296 7 1303South Carolina 6349 45 6394 7035 23 7058South Dakota 195 4 199 139 1 140Tennessee 6579 51 6631 6403 11 6414Texas 24741 262 25003 34010 53 34063Utah 893 10 903 1164 0 1164Vermont mdash mdash mdash 238 2 240Virginia 9937 41 9978 8423 24 8447Washington mdash mdash mdash 5471 5 5476West Virginia 660 5 665 749 5 754Wisconsin 2322 15 2337 2153 12 2165Wyoming 86 2 88 102 1 103

Subtotal 224303 2174 226477 435621 1115 436736

24 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age categorymdashUnited States and dependent areas (cont)

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

US dependent areasAmerican Samoa 2 0 2 1 0 1Guam 63 0 63 36 0 36Northern Mariana Islands 7 0 7 3 0 3Puerto Rico 6269 31 6300 10971 26 10997US Virgin Islands 228 2 230 312 2 314Otherc mdash mdash mdash 1 0 1

Totald 230872 2207 233079 447724 1147 448871

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reporting a See Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at

least 2003b Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterc Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasd Total number of persons living with HIV infection (not AIDS) includes persons reported from areas with confidential name-based HIV

infection reporting who were residents of other states or whose area of residence is unknown Total number of persons living with AIDS includes persons whose area of residence is unknown Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 25

Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristicsmdashUnited States and dependent areas

No of persons

Survival in months

gt12 gt24 gt36Data for 50 states and the District of Columbia

Age at diagnosis (yrs)lt13 101 096 094 09413ndash14 60 098 098 09515ndash19 305 098 096 09520ndash24 1351 096 093 09225ndash29 3034 095 092 09130ndash34 5499 094 091 08935ndash39 7888 093 090 08740ndash44 7085 092 088 08545ndash49 5090 089 085 08250ndash54 3067 086 081 07855ndash59 1505 083 078 07460ndash64 806 080 073 069gt65 614 073 068 065

RaceethnicityWhite not Hispanic 10706 092 089 087Black not Hispanic 18406 090 086 082Hispanic 6398 092 090 088AsianPacific Islander 404 094 092 090American IndianAlaska Native 167 084 081 075

Transmission categoryMale adult or adolescentMale-to-male sexual contact 12830 093 090 088Injection drug use 4048 089 084 081Male-to-male sexual contact and injection drug use 1701 093 089 086High-risk heterosexual contacta 3170 091 088 085Otherb 5019 086 083 080Subtotal 26768 091 088 085

Female adult or adolescentInjection drug use 2101 089 083 078High-risk heterosexual contacta 4686 093 089 086Otherb 2749 090 085 083Subtotal 9536 091 087 083

Child (lt13 yrs at diagnosis)Perinatal 98 096 095 095Otherc 3 100 067 067Subtotal 101 096 094 094

Subtotal for 50 states and the District of Columbia 36405 091 087 085

Data for US dependent areas 891 083 078 075

Total 37352d 091 087 084Note Excludes persons whose date of death was before or in the same month as date of diagnosis Excludes persons whose month of diagnosis or month of death is unknowna Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes 325 persons of unknown race or multiple races

26 Survival after AIDS Diagnosis

Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by year of diagnosismdashUnited States and dependent areas

Months after AIDS diagnosis

Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by age groupmdashUnited States and dependent areas

Months after AIDS diagnosis

Survival after AIDS Diagnosis 27

Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by raceethnicitymdashUnited States and dependent areas

Months after AIDS diagnosis

28 Survival after AIDS Diagnosis

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006

and cumulativemdashUnited States and dependent areas

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Alabama 510 112 462 100 8626 76 8702Alaska 24 36 38 57 648 7 655Arizona 626 105 539 87 10396 46 10442Arkansas 237 85 252 90 3891 36 3927California 4069 113 3960 109 142254 664 142918Colorado 351 75 322 68 8742 31 8773Connecticut 658 188 422 120 14716 183 14899Delaware 177 210 116 136 3547 26 3573District of Columbia 672 1155 853 1467 17372 189 17561Florida 4921 277 4932 273 104084 1530 105614Georgia 2325 255 1605 171 31734 231 31965Hawaii 105 82 93 72 2927 17 2944Idaho 24 17 26 18 604 2 606Illinois 1886 148 1382 108 33620 282 33902Indiana 407 65 346 55 8239 56 8295Iowa 93 31 86 29 1727 13 1740Kansas 105 38 120 43 2781 14 2795Kentucky 249 60 207 49 4600 32 4632Louisiana 936 208 824 192 17612 128 17740Maine 21 16 68 51 1110 8 1118Maryland 1558 279 1626 290 30252 319 30571Massachusetts 666 104 533 83 19181 214 19395Michigan 821 81 672 67 14941 113 15054Minnesota 226 44 212 41 4817 28 4845Mississippi 368 127 365 125 6642 56 6698Missouri 385 66 469 80 11016 61 11077Montana 21 22 7 07 373 3 376Nebraska 53 30 118 67 1479 11 1490Nevada 293 121 294 118 5733 29 5762New Hampshire 33 25 55 42 1074 10 1084New Jersey 1262 145 1065 122 48750 778 49528New Mexico 134 70 93 48 2603 7 2610New York 6201 321 5495 285 174908 2354 177262North Carolina 916 106 1229 139 15954 118 16072North Dakota 10 16 6 09 144 1 145Ohio 753 66 767 67 14957 138 15095Oklahoma 281 79 205 57 4836 26 4862Oregon 217 60 281 76 5995 20 6015Pennsylvania 1486 120 1893 152 33417 365 33782Rhode Island 87 81 111 104 2580 28 2608South Carolina 682 161 705 163 13301 105 13406South Dakota 18 23 18 23 255 5 260Tennessee 818 137 680 113 12457 59 12516Texas 3045 133 2998 128 69735 392 70127Utah 63 25 57 22 2295 20 2315Vermont 5 08 18 29 461 6 467Virginia 638 84 605 79 16802 177 16979Washington 485 77 389 61 11792 34 11826West Virginia 74 41 67 37 1500 11 1511Wisconsin 122 22 217 39 4513 33 4546Wyoming 6 12 8 16 228 2 230

Subtotal 40123 135 37911 127 952221 9094 961315

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 29

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulativemdashUnited States and dependent areas (cont)

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

US dependent areasAmerican Samoa 0 0 0 0 1 0 1Guam 0 0 0 0 68 1 69Northern Mariana Islands 0 0 0 0 3 0 3Puerto Rico 1029 263 850 216 29511 400 29911US Virgin Islands 17 156 32 295 629 18 647Otherb 0 0 0 0 3 0 3

Totalc 41357 138 39002 129 983343 9522 992865d

a From the beginning of the epidemic through 2006b Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasc Includes persons whose state or area of residence is unknownd Includes 916 persons whose state or area of residence is unknown

30 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

MSA (population gt 500000)

Akron Ohio 66 94 32 46 762 1 763

AlbanyndashSchenectadyndashTroy NY 97 114 105 123 2253 24 2277

Albuquerque N Mex 70 88 50 61 1404 2 1406

AllentownndashBethlehemndashEaston PandashNJ 72 91 119 149 1352 17 1369

AtlantandashSandy SpringsndashMarietta Ga 1586 319 1006 196 21896 128 22024

AugustandashRichmond County GandashSC 106 205 32 61 1851 24 1875

AustinndashRound Rock Tex 227 156 186 123 4830 26 4856

Bakersfield Calif 76 100 122 156 1528 8 1536

BaltimorendashTowson Md 1064 401 1001 377 20352 218 20570

Baton Rouge La 222 304 231 301 3732 20 3752

BirminghamndashHoover Ala 151 139 110 100 2614 25 2639

Boise CityndashNampa Idaho 14 26 14 25 281 0 281

Boston MassndashNHa 441 99 355 80 13476 147 13623

Boston Division 269 146 185 101 8451 91 8542

Cambridge Division 108 74 102 70 3126 35 3161

Essex Division 52 71 51 69 1577 20 1597

BridgeportndashStamfordndashNorwalk Conn 181 201 135 150 3733 57 3790

BuffalondashNiagara Falls NY 117 102 96 84 2476 20 2496

Cape CoralndashFort Myers Fla 44 81 91 159 1692 24 1716

CharlestonndashNorth Charleston SC 92 155 91 151 2034 18 2052

CharlottendashGastoniandashConcord NCndashSC 214 141 285 180 3242 22 3264

Chicago IllndashIndndashWis 1716 182 1159 122 30118 261 30379

Chicago Division 1604 203 1073 135 28300 248 28548

Gary Division 61 88 50 71 1038 8 1046

Lake Division 51 59 36 41 780 5 785

CincinnatindashMiddletown OhiondashKyndashInd 111 53 199 95 2735 17 2752

ClevelandndashElyriandashMentor Ohio 228 107 170 80 4226 48 4274

Colorado Springs Colo 19 32 21 35 576 5 581

Columbia SC 177 256 197 280 3274 24 3298

Columbus Ohio 166 97 165 96 3112 15 3127

Dallas Tex 874 150 929 155 20238 63 20301

Dallas Division 681 175 714 178 16038 37 16075

Fort Worth Division 193 100 215 108 4200 26 4226

Dayton Ohio 58 69 54 64 1217 15 1232

DenverndashAurora Colo 274 116 236 98 6899 22 6921

Des Moines Iowa 30 57 23 43 530 4 534

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 31

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Detroit Mich 570 127 445 100 10373 73 10446

Detroit Division 443 223 330 167 8268 57 8325

Warren Division 127 51 115 46 2105 16 2121

El Paso Tex 56 78 40 54 1476 10 1486

Fresno Calif 52 59 64 72 1430 11 1441

Grand RapidsndashWyoming Mich 46 60 51 66 816 6 822

GreensborondashHigh Point NC 52 77 66 96 1265 14 1279

Greenville SC 70 119 67 111 1292 4 1296

HarrisburgndashCarlisle Pa 23 44 67 128 1224 8 1232

HartfordndashWest HartfordndashEast Hartford Conn 256 216 135 114 5126 46 5172

Honolulu Hawaii 54 60 69 76 2121 14 2135

HoustonndashBaytownndashSugar Land Tex 1017 190 1092 197 25821 172 25993

Indianapolis Ind 191 116 150 90 3824 25 3849

Jackson Miss 134 257 117 221 2419 30 2449

Jacksonville Fla 309 248 315 246 6020 75 6095

Kansas City MondashKans 183 94 160 81 4669 15 4684

Knoxville Tenn 47 72 35 52 882 5 887

Lakeland Fla 103 190 112 199 1811 21 1832

Las VegasndashParadise Nev 245 143 258 145 4616 28 4644

Little RockndashNorth Little Rock Ark 87 135 75 115 1383 14 1397

Los Angeles Calif 1529 118 1684 130 57953 293 58246

Los Angeles Division 1339 135 1435 144 51098 250 51348

Santa Anna Division 190 63 249 83 6855 43 6898

Louisville KyndashInd 123 102 97 79 2286 22 2308

Madison Wis 10 19 29 53 520 4 524

McAllenndashEdinburgndashPharr Tex 57 84 45 64 630 11 641

Memphis TennndashMissndashArk 402 320 346 271 5128 19 5147

Miami Fla 2420 446 2289 419 55807 997 56804

Fort Lauderdale Division 810 455 769 430 16412 262 16674

Miami Division 1243 523 1165 485 29703 512 30215

West Palm Beach Division 367 290 355 279 9692 223 9915

MilwaukeendashWaukeshandashWest Allis Wis 68 45 109 72 2507 18 2525

MinneapolisndashSt PaulndashBloomington MinnndashWis 186 59 184 58 4259 22 4281

Modesto Calif 36 71 22 43 671 6 677

NashvillendashDavidsonndashMurfreesboro Tenn 224 158 172 118 3848 20 3868

New HavenndashMilford Conn 169 200 107 127 4573 73 4646

New OrleansndashMetairiendashKenner La 393 299 271 264 8835 67 8902

32 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

New York NYndashNJndashPa 6215 330 5500 292 195177 2906 198083

Edison Division 191 83 130 56 6709 139 6848

Nassau Division 262 93 246 88 8141 110 8251

New York Division 5266 456 4716 408 160408 2323 162731

Newark Division 496 231 408 190 19919 334 20253

Oklahoma City Okla 125 108 88 75 2255 5 2260

OmahandashCouncil Bluffs NebndashIowa 37 46 80 97 1035 3 1038

Orlando Fla 544 282 517 260 8653 92 8745

OxnardndashThousand OaksndashVentura Calif 49 62 21 26 1008 3 1011

Palm BayndashMelbournendashTitusville Fla 68 129 61 114 1512 11 1523

Philadelphia PandashNJndashDelndashMd 1261 217 1348 231 28221 313 28534

Camden Division 108 87 111 89 3118 42 3160

Philadelphia Division 1022 263 1144 294 22112 250 22362

Wilmington Division 131 191 93 134 2991 21 3012

PhoenixndashMesandashScottsdale Ariz 460 119 376 93 7459 31 7490

Pittsburgh Pa 143 60 135 57 3182 19 3201

PortlandndashSouth Portland Maine 9 18 34 66 562 1 563

PortlandndashVancouverndashBeaverton OrendashWash 170 81 215 101 4825 10 4835

PoughkeepsiendashNewburghndashMiddletown NY 136 204 113 168 3162 24 3186

ProvidencendashNew BedfordndashFall River RIndashMass 132 82 155 96 3900 44 3944

RaleighndashCary NC 138 145 201 202 1987 13 2000

Richmond Va 119 101 122 102 3371 35 3406

RiversidendashSan BernardinondashOntario Calif 361 92 306 76 8568 60 8628

Rochester NY 165 159 124 120 3134 13 3147

SacramentondashArden-ArcadendashRoseville Calif 154 75 169 82 4000 26 4026

St Louis MondashIll 192 69 366 131 5965 40 6005

Salt Lake City Utah 46 44 40 37 1743 10 1753

San Antonio Tex 215 114 247 127 4987 30 5017

San DiegondashCarlsbadndashSan Marcos Calif 491 167 384 131 12934 61 12995

San Francisco Calif 867 209 690 165 40152 96 40248

Oakland Division 312 126 246 99 9546 48 9594

San Francisco Division 555 329 444 261 30606 48 30654

San JosendashSunnyvalendashSanta Clara Calif 88 50 145 81 3747 15 3762

San JuanndashCaguasndashGuaynabo PR 745 289 578 223 21402 277 21679

SarasotandashBradentonndashVenice Fla 82 122 104 152 1978 27 2005

ScrantonndashWilkes-Barre Pa 27 49 47 85 572 6 578

Seattle Wash 353 110 280 86 9172 27 9199

Seattle Division 316 129 255 102 8161 18 8179

Tacoma Division 37 49 25 33 1011 9 1020

Springfield Mass 88 128 45 66 2075 26 2101

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 33

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Stockton Calif 52 78 52 77 1076 15 1091

Syracuse NY 52 80 49 75 1317 8 1325

TampandashSt PetersburgndashClearwater Fla 559 211 605 224 11174 112 11286

Toledo Ohio 25 38 66 101 812 14 826

Tucson Ariz 103 111 100 106 2010 10 2020

Tulsa Okla 83 94 65 72 1494 10 1504

Virginia BeachndashNorfolkndashNewport News VandashNC 183 111 132 80 4711 63 4774

Washington DCndashVandashMdndashWV 1322 252 1684 318 31130 315 31445

Bethesda Division 135 118 173 150 2774 23 2797

Washington Division 1187 289 1511 365 28356 292 28648

Wichita Kans 35 60 38 64 851 2 853

Worcester Mass 76 97 79 101 1783 20 1803

YoungstownndashWarrenndashBoardman OhiondashPa 27 46 26 44 519 0 519

Subtotal for MSAs (population gt500000) 33602 173 31274 159 829633 8171 837804

Metropolitan areas (population of 50000 to 499999) 4477 80 4466 79 94829 847 95676

Nonmetropolitan areas 2666 54 2732 55 52063 445 52508

Totalb 41144 137 38749 128 981708 9494 991202

Note Because of the lack of census information for all US dependent areas includes data for only the 50 states the District of Columbia and Puerto RicoMSA metropolitan statistical areaMSA definitions for this report can be found at httpwwwcensusgovpopulationwwwestimatesmetrodefhtmla Reported case counts for the metropolitan divisions do not sum to the MSA total MSA total includes data from 1 metropolitan division with

population of lt500000b Includes persons whose county of residence is unknown

34 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Alabama (January 1988) 502 6041 48 6089

Alaska (February 1999) 38 285 2 287

Arizona (January 1987) 617 5877 80 5957

Arkansas (July 1989) 206 2349 20 2369

California (April 2006) 6581 7056 92 7148

Colorado (November 1985) 319 6084 31 6115

Connecticut (January 2005)b 826 2500 101 2601

Delaware (February 2006) 788 801 18 819

Florida (July 1997)c 4163 36386 397 36783

Georgia (December 2003) 2245 8197 194 8391

Idaho (June 1986) 35 340 4 344

Illinois (January 2006) 6241 6661 162 6823

Indiana (July 1988) 399 4027 43 4070

Iowa (July 1998) 69 586 5 591

Kansas (July 1999) 142 1225 15 1240

Kentucky (October 2004) 333 1303 13 1316

Louisiana (February 1993) 728 8149 166 8315

Maine (January 2006) 386 393 3 396

Michigan (April 1992) 635 6702 134 6836

Minnesota (October 1985) 309 3356 40 3396

Mississippi (August 1988) 352 4549 59 4608

Missouri (October 1987) 502 5086 55 5141

Nebraska (September 1995) 91 672 14 686

Nevada (February 1992) 339 3532 24 3556

New Hampshire (January 2005) 59 466 9 475

New Jersey (January 1992) 1477 17513 325 17838

New Mexico (January 1998) 114 949 4 953

New York (June 2000) 5326 42345 1820 44165

North Carolina (February 1990) 1615 13879 143 14022

North Dakota (January 1988) 4 82 1 83

Ohio (June 1990) 867 8222 101 8323

Oklahoma (June 1988) 229 2401 30 2431

Oregon (April 2006) 49 95 19 114

Pennsylvania (October 2002)d 4269 9537 179 9716

Rhode Island (July 2006) 14 21 0 21

South Carolina (February 1986) 493 6970 93 7063

South Dakota (January 1988) 18 215 6 221

Tennessee (January 1992) 732 7115 90 7205

Texas (January 1999)e 3370 24282 417 24699

Utah (April 1989) 106 893 14 907

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 35

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Virginia (July 1989) 864 10257 95 10352

Washington (March 2006) 4048 4157 40 4197

West Virginia (January 1989) 66 673 8 681

Wisconsin (November 1985) 261 2500 31 2531

Wyoming (June 1989) 7 93 1 94

Subtotal 50834 274822 5146 279968

US dependent areas

American Samoa (August 2001) 0 1 0 1

Guam (March 2000) 2 66 0 66

Northern Mariana Islands (October 2001) 2 7 0 7

Puerto Rico (January 2003) 1471 5610 91 5701

US Virgin Islands (December 1998) 22 247 6 253

Persons reported from areas with confidential name-based HIV infection reporting but who were residents of other areas 132 685 21 706

Totalf 52878 282640 5314 287954

Note Includes data from 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through 2006b Beginning in 1992 Connecticut had name-based HIV reporting for cases in children only From January 2002 through December 2004

Connecticut had name- or code-based HIV reporting for cases in adolescents and adults As of January 2005 Connecticut has name-based reporting of all cases of HIV infection

c Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterd On October 18 2002 Pennsylvania initiated confidential name-based HIV infection reporting in all areas except Philadelphia Code-based

reporting was implemented in Philadelphia in March 2004 and the switch to name-based reporting was made in October 2005e From February 1994 through December 1998 Texas reported HIV infection in children onlyf Includes 1252 persons reported from areas with confidential name-based HIV infection reporting but whose area of residence is unknown

36 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulativemdashUnited States and dependent areas

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No Adult or adolescentMale-to-male sexual contact 13775 49 429897 54 mdash mdash mdash mdash 13775 35 429897 44Injection drug use 3413 12 163070 21 1826 17 67693 35 5239 13 230763 23Male-to-male sexual contact and

injection drug use 1603 6 65524 8 mdash mdash mdash mdash 1603 4 65524 7Hemophiliacoagulation disorder 43 0 5176 1 11 0 348 0 54 0 5524 1High-risk heterosexual contactc 2997 11 49610 6 4839 46 85186 44 7836 20 134796 14

Sex with injection drug user 330 1 11683 1 706 7 26073 14 1036 3 37756 4Sex with bisexual male mdash mdash mdash mdash 234 2 5162 3 234 1 5162 1Sex with person with hemophilia 1 0 84 0 11 0 502 0 12 0 586 0Sex with HIV-infected transfusion

recipient 22 0 553 0 21 0 793 0 43 0 1346 0Sex with HIV-infected person risk

factor not specified 2644 9 37290 5 3867 37 52656 27 6511 17 89946 9Receipt of blood transfusion blood

d components or tissue 63 0 5213 1 68 1 4176 2 131 0 9389 1Otherrisk factor not reported or

identifiede 6484 23 73136 9 3793 36 34311 18 10278 26 107450 11Subtotal 28378 100 791626 100 10537 100 191714 100 38916 100 983343 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 0 0 222 5 0 0 7 0 0 0 229 2Mother with documented HIV infection or

1 of the following risk factors 24 75 4315 89 50 93 4423 95 74 86 8738 92Injection drug use 4 13 1676 35 4 7 1665 36 8 9 3341 35Sex with injection drug user 4 13 789 16 4 7 750 16 8 9 1539 16Sex with bisexual male 1 3 101 2 2 4 110 2 3 3 211 2Sex with person with hemophilia 0 0 20 0 0 0 16 0 0 0 36 0Sex with HIV-infected transfusion

recipient 0 0 11 0 0 0 15 0 0 0 26 0Sex with HIV-infected person risk

factor not specified 6 19 742 15 17 31 790 17 23 27 1532 16Receipt of blood transfusion blood

components or tissue 0 0 70 1 0 0 82 2 0 0 152 2Has HIV infection risk factor not

specified 9 28 906 19 23 43 995 21 32 37 1901 20Receipt of blood transfusion blood

fcomponents or tissue 1 3 243 5 0 0 144 3 1 1 387 4Otherrisk factor not reported or

identifiedg 7 22 75 2 4 7 93 2 11 13 168 2Subtotal 32 100 4855 100 54 100 4667 100 86 100 9522 100

Total 28410 100 796481 100 10591 100 196381 100 39002 100 992865 100a From the beginning of the epidemic through 2006b From the beginning of the epidemic through 2006 Includes 3 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infectiond AIDS developed in 47 adultsadolescents after they received blood that had tested negative for HIV antibodies AIDS developed in 14 additional adults

after they received tissue organs or artificial insemination from HIV-infected donors Four of the 14 received tissue or organs from a donor who was negative for HIV antibody at the time of donation

e Includes 37 adultsadolescents who were exposed to HIV-infected blood body fluids or concentrated virus in health care laboratory or household settings as supported by seroconversion epidemiologic andor laboratory evidence One person was infected after intentional inoculation with HIV-infected blood Includes an additional 740 persons who acquired HIV infection perinatally but who were more than 12 years of age when AIDS was diagnosed These 740 persons are not counted in the values for the pediatric transmission category

f AIDS developed in 3 children after they received blood that had tested negative for HIV antibodiesg Includes 5 children who were exposed to HIV-infected blood as supported by seroconversion epidemiologic andor laboratory evidence 1 child was

infected after intentional inoculation with HIV-infected blood and 5 children were exposed to HIV-infected blood in a household setting Of the 168 children 26 had sexual contact with an adult with or at high risk for HIV infection

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 37

Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No

Adult or adolescentMale-to-male sexual contact 22912 59 103679 52 mdash mdash mdash mdash 22912 44 103679 37

Injection drug use 3503 9 24255 12 2124 16 13925 17 5627 11 38181 14

Male-to-male sexual contact and injection drug use 1946 5 10704 5 mdash mdash mdash mdash 1946 4 10704 4

Hemophiliacoagulation disorder 43 0 495 0 6 0 73 0 49 0 568 0

High-risk heterosexual contactc 2874 7 16830 8 5939 45 38315 47 8813 17 55145 20

Sex with injection drug user 308 1 2601 1 757 6 6791 8 1065 2 9392 3

Sex with bisexual male mdash mdash mdash mdash 328 2 2265 3 328 1 2265 1

Sex with person with hemophilia 4 0 31 0 16 0 201 0 20 0 232 0

Sex with HIV-infected transfusion recipient 13 0 131 0 28 0 223 0 41 0 354 0

Sex with HIV-infected person risk factor not specified 2549 7 14067 7 4810 36 28835 35 7359 14 42902 15

Receipt of blood transfusion blood components or tissue 61 0 489 0 50 0 536 1 111 0 1025 0

Otherrisk factor not reported or identified 7748 20 44021 22 5106 39 29312 36 12854 25 73338 26

Subtotal 39087 100 200473 100 13225 100 82161 100 52312 100 282640 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 8 3 106 4 0 0 1 0 8 1 107 2

Mother with documented HIV infection or 1 of the following risk factors 197 74 2195 85 254 85 2417 89 451 80 4612 87

Injection drug use 34 13 532 21 53 18 561 21 87 15 1093 21

Sex with injection drug user 12 5 208 8 21 7 213 8 33 6 421 8

Sex with bisexual male 5 2 37 1 4 1 32 1 9 2 69 1

Sex with person with hemophilia 0 0 3 0 1 0 7 0 1 0 10 0

Sex with HIV-infected transfusion recipient 0 0 4 0 0 0 4 0 0 0 8 0

Sex with HIV-infected person risk factor not specified 54 20 534 21 76 25 629 23 130 23 1163 22

Receipt of blood transfusion blood components or tissue 0 0 17 1 2 1 20 1 2 0 37 1

Has HIV infection risk factor not specified 92 35 860 33 97 32 951 35 189 33 1811 34

Receipt of blood transfusion blood components or tissue 6 2 28 1 3 1 24 1 9 2 52 1

Otherrisk factor not reported or identified 55 21 260 10 43 14 283 10 98 17 543 10

Subtotal 266 100 2589 100 300 100 2725 100 566 100 5314 100

Total 39353 100 203062 100 13525 100 84886 100 52878 100 287954 100

Note See Table 16 for the list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006b From the beginning of the epidemic through December 2006 Includes 6 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infection

38 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity

2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 6251 65 253927 73Injection drug use 733 8 31737 9Male-to-male sexual contact and injection drug use 732 8 31434 9Hemophiliacoagulation disorder 26 0 3989 1High-risk heterosexual contactb 416 4 7850 2

Sex with injection drug user 74 1 2310 1

Sex with person with hemophilia 0 0 36 0

Sex with HIV-infected transfusion recipient 2 0 176 0

Sex with HIV-infected person risk factor not specified 340 4 5328 2Receipt of blood transfusion blood components or tissue 20 0 3194 1Otherrisk factor not reported or identified 1400 15 16469 5

Total 9578 100 348600 100

Black not HispanicMale-to-male sexual contact 4309 36 103297 37Injection drug use 1635 14 83369 30Male-to-male sexual contact and injection drug use 526 4 22134 8Hemophiliacoagulation disorder 10 0 604 0High-risk heterosexual contactb 1875 16 29952 11

Sex with injection drug user 167 1 6823 2Sex with person with hemophilia 1 0 36 0Sex with HIV-infected transfusion recipient 15 0 237 0Sex with HIV-infected person risk factor not specified 1692 14 22856 8

Receipt of blood transfusion blood components or tissue 24 0 1218 0Otherrisk factor not reported or identified 3579 30 40268 14

Total 11958 100 280842 100

HispanicMale-to-male sexual contact 2816 47 64893 44Injection drug use 965 16 46337 31Male-to-male sexual contact and injection drug use 287 5 10884 7Hemophiliacoagulation disorder 6 0 466 0High-risk heterosexual contactb 638 11 10950 7

Sex with injection drug user 84 1 2409 2Sex with person with hemophilia 0 0 11 0Sex with HIV-infected transfusion recipient 5 0 125 0Sex with HIV-infected person risk factor not specified 549 9 8405 6

Receipt of blood transfusion blood components or tissue 17 0 657 0Otherrisk factor not reported or identified 1326 22 14832 10

Total 6055 100 149019 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 39

a

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulative

No No

AsianPacific IslanderMale-to-male sexual contact 225 54 4475 68Injection drug use 20 5 317 5Male-to-male sexual contact and injection drug use 17 4 284 4Hemophiliacoagulation disorder 1 0 70 1High-risk heterosexual contactb 34 8 376 6

Sex with injection drug user 1 0 54 1Sex with person with hemophilia 0 0 1 0Sex with HIV-infected transfusion recipient 0 0 8 0Sex with HIV-infected person risk factor not specified 33 8 313 5

Receipt of blood transfusion blood components or tissue 2 0 112 2Otherrisk factor not reported or identified 114 28 949 14

Total 413 100 6583 100

American IndianAlaska NativeMale-to-male sexual contact 61 49 1403 55Injection drug use 15 12 395 15Male-to-male sexual contact and injection drug use 23 19 457 18Hemophiliacoagulation disorder 0 0 27 1High-risk heterosexual contactb 9 7 118 5

Sex with injection drug user 1 1 33 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 8 6 82 3

Receipt of blood transfusion blood components or tissue 0 0 8 0Otherrisk factor not reported or identified 16 13 155 6

Total 124 100 2563 100

Total casesMale-to-male sexual contact 13775 49 429897 54Injection drug use 3413 12 163070 21Male-to-male sexual contact and injection drug use 1603 6 65524 8Hemophiliacoagulation disorder 43 0 5176 1High-risk heterosexual contactb 2997 11 49610 6

Sex with injection drug user 330 1 11683 1Sex with person with hemophilia 1 0 84 0Sex with HIV-infected transfusion recipient 22 0 553 0Sex with HIV-infected person risk factor not specified 2644 9 37290 5

Receipt of blood transfusion blood components or tissue 63 0 5213 1Otherrisk factor not reported or identified 6484 23 73136 9

Total 28378c 100 791626d 100a From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 4019 males of unknown race or multiple races

40 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 11963 73 55725 69Injection drug use 858 5 5512 7Male-to-male sexual contact and injection drug use 1092 7 5578 7Hemophiliacoagulation disorder 29 0 355 0High-risk heterosexual contactb 522 3 2658 3

Sex with injection drug user 65 0 544 1Sex with person with hemophilia 0 0 8 0Sex with HIV-infected transfusion recipient 3 0 33 0Sex with HIV-infected person risk factor not specified 454 3 2073 3

Receipt of blood transfusion blood components or tissue 14 0 197 0Otherrisk factor not reported or identified 1956 12 11147 14

Total 16434 100 81172 100

Black not HispanicMale-to-male sexual contact 6203 44 30148 37Injection drug use 1594 11 11997 15Male-to-male sexual contact and injection drug use 483 3 3489 4Hemophiliacoagulation disorder 10 0 109 0High-risk heterosexual contactb 1714 12 10905 13

Sex with injection drug user 169 1 1554 2Sex with person with hemophilia 4 0 17 0Sex with HIV-infected transfusion recipient 6 0 77 0Sex with HIV-infected person risk factor not specified 1535 11 9257 11

Receipt of blood transfusion blood components or tissue 32 0 223 0Otherrisk factor not reported or identified 4151 29 24632 30

Total 14187 100 81503 100

HispanicMale-to-male sexual contact 4094 55 15623 47Injection drug use 993 13 6407 19Male-to-male sexual contact and injection drug use 316 4 1402 4Hemophiliacoagulation disorder 3 0 26 0High-risk heterosexual contactb 582 8 2963 9

Sex with injection drug user 65 1 455 1Sex with person with hemophilia 0 0 6 0Sex with HIV-infected transfusion recipient 4 0 18 0Sex with HIV-infected person risk factor not specified 513 7 2484 7

Receipt of blood transfusion blood components or tissue 11 0 55 0Otherrisk factor not reported or identified 1475 20 6977 21

Total 7474 100 33453 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 41

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderMale-to-male sexual contact 402 70 1006 63Injection drug use 17 3 55 3Male-to-male sexual contact and injection drug use 15 3 38 2Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 25 4 96 6

Sex with injection drug user 3 1 10 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 22 4 83 5

Receipt of blood transfusion blood components or tissue 4 1 7 0Otherrisk factor not reported or identified 109 19 397 25

Total 572 100 1600 100

American IndianAlaska NativeMale-to-male sexual contact 104 61 516 57Injection drug use 13 8 101 11Male-to-male sexual contact and injection drug use 19 11 110 12Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 10 6 53 6

Sex with injection drug user 2 1 14 2Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 8 5 39 4

Receipt of blood transfusion blood components or tissue 0 0 2 0Otherrisk factor not reported or identified 24 14 125 14

Total 170 100 907 100

Total casesMale-to-male sexual contact 22912 59 103679 52Injection drug use 3503 9 24255 12Male-to-male sexual contact and injection drug use 1946 5 10704 5Hemophiliacoagulation disorder 43 0 495 0High-risk heterosexual contactb 2874 7 16830 8

Sex with injection drug user 308 1 2601 1Sex with person with hemophilia 4 0 31 0Sex with HIV-infected transfusion recipient 13 0 131 0Sex with HIV-infected person risk factor not specified 2549 7 14067 7

Receipt of blood transfusion blood components or tissue 61 0 489 0Otherrisk factor not reported or identified 7748 20 44021 22

Total 39087c 100 200473d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 1838 males of unknown race or multiple races

42 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race

ethnicity 2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 482 28 14981 40Hemophiliacoagulation disorder 4 0 123 0High-risk heterosexual contactb 725 42 15799 42

Sex with injection drug user 153 9 5650 15Sex with bisexual male 63 4 1859 5Sex with person with hemophilia 5 0 329 1Sex with HIV-infected transfusion recipient 5 0 338 1Sex with HIV-infected person risk factor not specified 499 29 7623 20

Receipt of blood transfusion blood components or tissue 15 1 1870 5Otherrisk factor not reported or identified 499 29 4801 13

Total 1725 100 37574 100

Black not HispanicInjection drug use 982 15 38914 34Hemophiliacoagulation disorder 3 0 145 0High-risk heterosexual contactb 3103 46 49876 44

Sex with injection drug user 373 6 13530 12Sex with bisexual male 136 2 2352 2Sex with person with hemophilia 4 0 121 0Sex with HIV-infected transfusion recipient 8 0 277 0Sex with HIV-infected person risk factor not specified 2582 38 33596 29

Receipt of blood transfusion blood components or tissue 39 1 1546 1Otherrisk factor not reported or identified 2612 39 23894 21

Total 6739 100 114375 100

HispanicInjection drug use 322 18 12892 35Hemophiliacoagulation disorder 4 0 67 0High-risk heterosexual contactb 894 49 17995 49

Sex with injection drug user 166 9 6522 18Sex with bisexual male 32 2 818 2Sex with person with hemophilia 1 0 45 0Sex with HIV-infected transfusion recipient 7 0 141 0Sex with HIV-infected person risk factor not specified 688 38 10469 29

Receipt of blood transfusion blood components or tissue 12 1 619 2Otherrisk factor not reported or identified 592 32 5023 14

Total 1824 100 36596 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 43

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 8 8 125 12Hemophiliacoagulation disorder 0 0 7 1High-risk heterosexual contactb 49 47 574 53

Sex with injection drug user 4 4 114 11Sex with bisexual male 2 2 80 7Sex with person with hemophilia 0 0 4 0Sex with HIV-infected transfusion recipient 1 1 25 2Sex with HIV-infected person risk factor not specified 42 40 351 33

Receipt of blood transfusion blood components or tissue 1 1 93 9Otherrisk factor not reported or identified 46 44 279 26

Total 104 100 1078 100

American IndianAlaska NativeInjection drug use 13 32 280 42Hemophiliacoagulation disorder 0 0 3 0High-risk heterosexual contactb 15 37 277 41

Sex with injection drug user 4 10 107 16Sex with bisexual male 1 2 27 4Sex with person with hemophilia 0 0 2 0Sex with HIV-infected transfusion recipient 0 0 6 1Sex with HIV-infected person risk factor not specified 10 24 135 20

Receipt of blood transfusion blood components or tissue 1 2 17 3Otherrisk factor not reported or identified 12 29 95 14

Total 41 100 672 100

Total casesInjection drug use 1826 17 67693 35Hemophiliacoagulation disorder 11 0 348 0High-risk heterosexual contactb 4839 46 85186 44

Sex with injection drug user 706 7 26073 14Sex with bisexual male 234 2 5162 3Sex with person with hemophilia 11 0 502 0Sex with HIV-infected transfusion recipient 21 0 793 0Sex with HIV-infected person risk factor not specified 3867 37 52656 27

Receipt of blood transfusion blood components or tissue 68 1 4176 2Otherrisk factor not reported or identified 3793 36 34311 18

Total 10537c 100 191714d 100a From the beginning of the epidemic through 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 104 females of unknown race or multiple racesd Includes 1419 females of unknown race or multiple races

44 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 690 26 4260 26Hemophiliacoagulation disorder 3 0 24 0

bHigh-risk heterosexual contact 1132 42 7593 46Sex with injection drug user 205 8 1876 11Sex with bisexual male 98 4 659 4Sex with person with hemophilia 10 0 115 1Sex with HIV-infected transfusion recipient 7 0 64 0Sex with HIV-infected person risk factor not specified 812 30 4879 29

Receipt of blood transfusion blood components or tissue 12 0 146 1Otherrisk factor not reported or identified 850 32 4567 28

Total 2687 100 16590 100

Black not HispanicInjection drug use 1034 13 7105 14Hemophiliacoagulation disorder 1 0 35 0

bHigh-risk heterosexual contact 3451 44 23732 46Sex with injection drug user 313 4 3473 7Sex with bisexual male 155 2 1294 3Sex with person with hemophilia 5 0 71 0Sex with HIV-infected transfusion recipient 14 0 120 0Sex with HIV-infected person risk factor not specified 2964 38 18774 36

Receipt of blood transfusion blood components or tissue 26 0 324 1Otherrisk factor not reported or identified 3370 43 20244 39

Total 7882 100 51440 100

HispanicInjection drug use 339 15 2280 18Hemophiliacoagulation disorder 2 0 11 0

bHigh-risk heterosexual contact 1198 52 6264 50Sex with injection drug user 218 9 1324 11Sex with bisexual male 62 3 266 2Sex with person with hemophilia 1 0 11 0Sex with HIV-infected transfusion recipient 7 0 39 0Sex with HIV-infected person risk factor not specified 910 39 4624 37

Receipt of blood transfusion blood components or tissue 12 1 58 0Otherrisk factor not reported or identified 767 33 3843 31

Total 2318 100 12456 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 45

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 4: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Section 4 Survival after AIDS DiagnosisTable 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002

by selected characteristicsmdashUnited States and dependent areas26

Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by year of diagnosismdashUnited States and dependent areas

27

Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by age groupmdashUnited States and dependent areas

27

Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by raceethnicitymdashUnited States and dependent areas

28

Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and

cumulativemdashUnited States and dependent areas29

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico

31

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

35

Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulativemdashUnited States and dependent areas

37

Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

38

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas

39

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

41

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas

43

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

45

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

47

Technical Notes 48

Web Addresses for Reports of State or Local HIV and AIDS Surveillance 55

4 Contents

Commentary

The HIVAIDS epidemic was first recognized in the United States in 1981 Since that time all states and US dependent areas have conducted AIDS sur-veillance by using a standardized confidential name-based reporting system Because successful treatment delays the progression of HIV infection to AIDS AIDS surveillance data alone are insufficient to moni-tor trends in HIV incidence or to meet federal state or local data needs for planning and allocating resources for HIV prevention and care programs An integrated national HIVAIDS surveillance system will enhance the ability to monitor and characterize populations affected by the HIV epidemic and provide information on the entire population of HIV-infected persons who have been tested confidentially In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confi-dential name-based public health disease surveillance systems to report cases of HIV infection California implemented confidential name-based HIV infection case surveillance in April 2006 and this issue marks the first time that HIV case reports from California have been included in the HIVAIDS Surveillance Report For more information about HIV reporting in California visit httpwwwdhscagovAIDSHIVReporting

This report presents estimated numbers of cases of HIVAIDS (cases of HIV infection regardless whether they have progressed to AIDS) from the 38 areas (33 states and 5 US dependent areas) that have had confi-dential name-based HIV infection reporting for a suf-ficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends According to the number of reported AIDS cases these 33 states repre-sent approximately 63 of the epidemic in the 50 states and the District of Columbia From 2003 through 2006 the total number of new cases of HIVAIDS remained stable in the 33 states however HIVAIDS prevalence (ie the number of persons living with HIVAIDS) increased steadily by the end of 2006 an estimated 491727 persons in the 33 states were living with HIVAIDS The map on the cover depicts the estimated rates of diagnoses of HIVAIDS in 2006 by area of residence at the time of diagnosis

for persons residing in the 33 states and 5 US depen-dent areas with confidential name-based HIV infection reporting since at least 2003

Surveillance data on HIV infections compared with data on AIDS provide a more complete picture of the epidemic and the need for prevention and care services However the number of new HIV diagnoses during a given year(s) does not necessarily reflect a trend in HIV incidence (ie new infections) because some per-sons were infected recently and others were infected at some time in the past CDC has developed the serologic testing algorithm for recent HIV seroconversion (STARHS) which can distinguish recent from long-standing HIV infections at a population level This technology has made it possible to develop a surveil-lance system that will provide more accurate and timely estimates of HIV incidence CDC and its part-ners in state and local health departments have been working during the past several years to develop and evaluate this system Five areas were funded in FY 2002 to pilot the methods by FY 2005 34 areas were funded to conduct incidence surveillance HIVAIDS surveillance data are used by CDCrsquos public health part-ners and by professionals in other federal agencies health departments nonprofit organizations and aca-demic institutions Recognizing the changing needs for data CDC is committed to presenting the data that will best meet those needs The first estimates of HIV inci-dence which require the use of complex estimation methods are expected in 2008 The monitoring of HIV incidence will be critical in evaluating progress toward CDCrsquos goal of reducing the number of new HIV infec-tions in the United States and in allocating resources and evaluating prevention program effectiveness

The 2006 HIVAIDS Surveillance Report is orga-nized in 5 sections (1) cases of HIVAIDS and AIDS (2) deaths of persons with AIDS (3) persons living with HIVAIDS AIDS or HIV infection (not AIDS) (4) length of survival after AIDS diagnosis and (5) reports of cases of HIVAIDS AIDS and HIV infec-tion (not AIDS) In Sections 1ndash3 we present point esti-mates of case counts that have been adjusted for reporting delays and for the redistribution of cases in persons initially reported without an identified risk factor CDC routinely adjusts data for the presentation

5

of trends in the epidemic Data to estimate the number of cases of HIVAIDS or AIDS the number of persons living with HIVAIDS AIDS or HIV infection (not AIDS) and the number of deaths among persons with AIDS have been statistically adjusted to correct for delays in the reporting of cases and deaths

To assess trends in cases deaths or prevalence it is preferable to use adjusted data presented by year of diagnosis instead of year of report to eliminate arti-facts of reporting in the surveillance system Therefore for trends the reader is encouraged to use the tables in Sections 1ndash3 that present trends by year of diagnosis year of death or year-end prevalence Section 4 pre-sents estimates of survival for persons whose AIDS diagnosis was made during 2002 (Table 13) and for persons whose diagnosis was made during 1998ndash2005 (Figures 2ndash4) Proportions of persons who survived for various lengths of time after diagnosis are presented by year of diagnosis age group raceethnicity and HIV transmission category

Finally Section 5 presents reports of cases of HIV infection (not AIDS) and cases of AIDS reported through 2006 The areas included in tabulations of reported cases of HIV infection (not AIDS) are based on the date that confidential name-based HIV infection reporting was implemented For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US dependent areas) to describe reports of HIV infection These data which have not been adjusted for delays in reporting are presented by year of report to CDC Tables that present cases by year of report represent the most up-to-date information reported to CDC however cases by year of report do not represent inci-dent cases the most recent diagnoses trends or deaths

HIGHLIGHTS OF ANALYSES

Cases of HIVAIDS and Cases of AIDS

Cases of HIVAIDSFrom 2003 through 2006 the estimated number of

HIVAIDS cases in the 33 states with confidential name-based HIV infection reporting remained stable (Table 1) In 2006 the estimated rate of HIVAIDS cases in the 33 states was 185 per 100000 population (Table 5b)

bull Age group From 2003 through 2006 the estimated number of newly diagnosed HIVAIDS

6 Comm

cases decreased among children (less than 13 years of age) and in the following age groups 13ndash14 30ndash34 and 35ndash39 years (Table 1) The estimated number of HIVAIDS cases remained stable among persons aged 40ndash44 years and increased among persons aged 15ndash19 20ndash24 25ndash29 45ndash49 50ndash54 55ndash59 60ndash64 and 65 years and older In 2006 the largest number of HIVAIDS cases occurred among persons aged 40ndash44 years who accounted for 16 of all HIVAIDS cases diagnosed during that year

bull Raceethnicity From 2003 through 2006 the estimated number of newly diagnosed HIVAIDS cases increased among whites and AsiansPacific Islanders remained stable among blacks and Hispanics and fluctuated among American IndiansAlaska Natives (Table 1) Blacks accounted for 49 of all HIVAIDS cases diagnosed in 2006 In 2006 rates of HIVAIDS cases were 677 per 100000 in the black population 255 per 100000 in the Hispanic population 88 per 100000 in the American IndianAlaska Native population 82 per 100000 in the white population and 67 per 100000 in the AsianPacific Islander population (Table 5b)

bull Sex From 2003 through 2006 the estimated number of HIVAIDS cases increased approximately 5 among males and decreased 6 among females (Table 1) In 2006 males accounted for 74 of all HIVAIDS cases among adults and adolescents In 2006 rates were 338 per 100000 among males and 115 per 100000 among females (Table 5b)

bull Transmission category From 2003 through 2006 the estimated number of HIVAIDS cases increased among men who have sex with men (MSM) and remained stable among adults and adolescents with HIV infection attributed to high-risk heterosexual contact (heterosexual contact with a person known to have or to be at high risk for HIV infection) (Table 1) The estimated number of HIVAIDS cases decreased among injection drug users (IDUs) MSM who were also IDUs and among children MSM (49) and persons exposed through high-risk heterosexual contact (33) accounted for 82 of all HIVAIDS cases diagnosed in 2006

entary

Of all HIV infections diagnosed in 2005 in the 33 states with confidential name-based HIV reporting 38 progressed to AIDS within 12 months after HIV infection was diagnosed AIDS was diagnosed within 12 months after the diagnosis of HIV infection for larger proportions of persons aged 13ndash14 years and 35 years and older for Hispanics for IDUs and for males with HIV infection attributed to high-risk heterosexual contact (Table 2)

Cases of AIDSFrom 2002 through 2006 the estimated number of

newly diagnosed AIDS cases in the 50 states and the District of Columbia remained stable (Table 3) In 2006 the estimated rate of AIDS cases in the United States was 123 per 100000 population (Table 5a)

bull Age group From 2002 through 2006 the estimated number of AIDS cases decreased 64 among children (less than 13 years of age) (Table 3) The estimated number of AIDS cases also decreased among persons in the age groups 30ndash34 and 35ndash39 years (Table 3) The estimated number of AIDS cases remained stable among persons aged 40ndash44 years and increased in the following age groups 13ndash14 15ndash19 20ndash24 25ndash29 45ndash49 50ndash54 55ndash59 60ndash64 and 65 years and older In 2006 the largest number of AIDS cases occurred among persons aged 40ndash44 years who accounted for 20 of all AIDS cases diagnosed during that year in the 50 states and the District of Columbia

bull Raceethnicity From 2002 through 2006 the estimated number of AIDS cases decreased among blacks and American IndiansAlaska Natives remained stable among whites and Hispanics and increased among AsiansPacific Islanders (Table 3) In 2006 rates of AIDS cases were 476 per 100000 in the black population 156 per 100000 in the Hispanic population 62 per 100000 in the American IndianAlaska Native population 54 per 100000 in the white population and 37 per 100000 in the AsianPacific Islander population (Table 5a)

bull Sex From 2002 through 2006 the estimated number of AIDS cases remained stable among both male and female adults and adolescents (Table 3) Males accounted for 73 of all AIDS cases diagnosed in 2006 for adults and adolescents in the 50 states and the District of Columbia (Table

Comm

3) Rates of AIDS cases in 2006 were 224 per 100000 among males and 78 per 100000 among females (Table 5a)

bull Transmission category From 2002 through 2006 among male adults and adolescents the estimated number of AIDS cases decreased among IDUs and MSM who were also IDUs (Table 3) The numbers of males exposed through male-to-male sexual contact and high-risk heterosexual contact remained stable Among female adults and adolescents the estimated number of AIDS cases decreased among IDUs and fluctuated among females exposed through high-risk heterosexual contact

bull Region From 2002 through 2006 the estimated number of AIDS cases decreased 10 in the West and 6 in the Northeast and remained stable in the South and the Midwest

DeathsFrom 2002 through 2006 the estimated number of

deaths of persons with AIDS who resided in the 50 states and the District of Columbia decreased 17 (Table 7)

bull Age group The estimated number of deaths decreased among children (less than 13 years of age) and in the following age groups 13ndash14 25ndash29 30ndash34 35ndash39 40ndash44 and 45ndash49 years The estimated number of deaths remained stable among persons aged 50ndash54 years and increased in the age groups 15ndash19 20ndash24 55ndash59 60ndash64 and 65 years and older

bull Raceethnicity The estimated number of deaths of persons with AIDS decreased among whites blacks and American IndiansAlaska Natives The estimated number of deaths of persons with AIDS remained stable among Hispanics and increased among AsiansPacific Islanders

bull Sex and transmission category The estimated number of deaths of adults and adolescents decreased among MSM and IDUs and remained stable among persons exposed through high-risk heterosexual contact

bull Region The estimated number of deaths decreased in all regions of the United States

entary 7

Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS

Persons living with HIVAIDSFrom 2003 through 2006 the estimated number of

persons living with HIVAIDS increased steadily in the 33 states with confidential name-based HIV infec-tion reporting (Table 8) At the end of 2006 an esti-mated 491727 persons in these states were living with HIVAIDS

bull By age group most (21) were aged 40ndash44 years

bull By raceethnicity 47 were black 34 white 17 Hispanic and less than 1 each were American IndianAlaska Native or AsianPacific Islander

bull By sex 73 of adults and adolescents living with HIVAIDS were male

bull Of the estimated 353825 male adults and adolescents living with HIVAIDS 62 had been exposed through male-to-male sexual contact 17 had been exposed through injection drug use 13 had been exposed through high-risk heterosexual contact and 7 had been exposed through both male-to-male sexual contact and injection drug use Of the estimated 131195 female adults and adolescents living with HIVAIDS 73 had been exposed through high-risk heterosexual contact and 26 had been exposed through injection drug use Of the estimated 6703 children living with HIVAIDS 92 had been exposed perinatally

Prevalence rates of HIV infection (not AIDS)At the end of 2006 in the 38 areas with confidential

name-based HIV infection reporting since at least 2003 the prevalence rate of HIV infection (not AIDS) among adults and adolescents was estimated at 1437 per 100000 (Map 1) The rate for adults and adoles-cents living with HIV infection (not AIDS) ranged from an estimated 49 per 100000 (American Samoa) to an estimated 2617 per 100000 (New York) The prevalence rate of HIV infection (not AIDS) among children residing in the 38 areas was an estimated 65 per 100000 (Map 2) The rate for children living with HIV infection (not AIDS) ranged from an estimated zero per 100000 in Idaho New Mexico American Samoa Guam and the Northern Mariana Islands to an estimated 253 per 100000 in New York

8 Comm

Persons living with AIDSAIDS prevalence also increased steadily from 2002

through 2006 (Table 10) At the end of 2006 an esti-mated 436693 persons in the 50 states and the District of Columbia were living with AIDS

bull By age group most (22) were aged 40ndash44 years

bull By raceethnicity 44 were black 35 white 19 Hispanic 1 AsianPacific Islander and less than 1 were American IndianAlaska Native

bull By sex 77 of adults and adolescents living with AIDS were male

bull Of the estimated 333244 male adults and adolescents living with AIDS 60 had been exposed through male-to-male sexual contact 19 had been exposed through injection drug use 12 had been exposed through high-risk heterosexual contact and 8 had been exposed through both male-to-male sexual contact and injection drug use Of the estimated 99671 female adults and adolescents living with AIDS 66 had been exposed through high-risk heterosexual contact and 32 had been exposed through injection drug use

bull By region 41 resided in the South 29 in the Northeast 20 in the West and 11 in the Midwest

AIDS prevalence ratesAt the end of 2006 the prevalence rate of AIDS

among adults and adolescents in the United States was estimated at 1786 per 100000 (Map 1) The rate for adults and adolescents living with AIDS ranged from an estimated 25 per 100000 (American Samoa) to an estimated 20165 per 100000 (District of Columbia) The prevalence rate of AIDS among children in the United States was estimated at 22 per 100000 at the end of 2006 (Map 2) The rate for children living with AIDS ranged from an estimated zero per 100000 in Idaho Montana Utah American Samoa Guam and the Northern Mariana Islands to an estimated 365 per 100000 in the District of Columbia

Survival after AIDS DiagnosisTable 13 is limited to data on AIDS cases diagnosed

in 2002 in order to describe the survival of persons whose diagnosis was made relatively recently but far enough in the past to permit a meaningful measure of

entary

survival Figures 2 3 and 4 illustrate the proportion of surviving persons among persons whose diagnoses were made over a longer period 1998 through 2005

bull Survival (the estimated proportion of persons surviving a given length of time after diagnosis) increased with the year of diagnosis for diagnoses made during 1998ndash2000 Year-to-year differences were small during 2001ndash2005 (Figure 2)

bull Survival decreased as age at diagnosis increased among persons at least 35 years old at diagnosis and in comparison with persons younger than 35 Survival was similar for the age groups 13ndash24 and 25ndash34 (Figure 3)

bull Survival was greatest among MSM and among children with perinatally acquired HIV infection (Table 13) Survival was intermediate among male and female adults and adolescents who had heterosexual contact with someone known to be HIV infected or at high risk for HIV infection as well as among MSM who also were IDUs Survival was lowest among male and female adults and adolescents who were IDUs

bull Survival particularly at more than 48 months after diagnosis was greater among AsiansPacific Islanders whites and Hispanics than among blacks (Figure 4) Results were unstable or inconsistent for American IndiansAlaska Natives because the numbers of persons in this racialethnic category were small

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Tables 14ndash23 describe reports of cases of HIVAIDS AIDS and HIV infection (not AIDS) Tables 16 18 20 and 22 are based on reports of cases of HIV infection (not AIDS) through 2006 from the 50 areas that had implemented name-based HIV infection reporting Note that not all cases of HIV infection (not AIDS) or AIDS reported in 2006 reflect diagnoses made during 2006 rather the reported cases include cases diagnosed during earlier years

Reports of cases of HIV infection (not AIDS)Through 2006 a total of 287954 persons were

reported as having HIV infection (not AIDS) in the 50 areas with confidential name-based HIV infection reporting (Table 16) (see Technical Notes for discus-sion of surveillance of HIV infection [not AIDS])

Comm

Five states (Florida New Jersey New York North Carolina and Texas) reported 137507 (48) of the 287954 cumulative cases of HIV infection (not AIDS) reported to CDC In 2006 4 states (California Illinois New York and Pennsylvania) reported 22417 (42) of the 52878 cases of HIV infection (not AIDS)

bull In 2006 of the 52312 reported cases among adults and adolescents 75 were in males and 25 were in females (Table 18)

bull In 2006 566 cases in children were reported

Reports of AIDS casesThrough 2006 a total of 992865 persons in the

United States had been reported as having AIDS (Table 14) Three states (California Florida and New York) reported 43 of the cumulative AIDS cases and 37 of AIDS cases reported to CDC in 2006 In the United States the rate of reported AIDS cases in 2006 was 129 per 100000 population When the US dependent areas were included the rate of reported AIDS cases ranged from zero per 100000 (American Samoa Guam and the Northern Mariana Islands) to 1467 per 100000 (District of Columbia)

bull In 2006 males accounted for 73 and females for 27 of 38916 reported AIDS cases among adults and adolescents (Table 17)

bull In 2006 86 AIDS cases in children were reported

ADDITIONAL RESOURCES

The following were prepared by using HIVAIDS surveillance data

bull Selected MMWR articles at httpwwwcdcgovhivresourcesreportsmmwr

bull Public-use slides at httpwwwcdcgovhivtopicssurveillanceresourcesslides

bull Other surveillance reports at httpwwwcdcgovhivtopicssurveillanceresourcesreports

bull Public-use version of the AIDS surveillance data set (AIDS Public Information Data Set [APIDS]) at httpwwwcdcgovhivsoftwareapidshtm

SUGGESTED READINGS

CDC Advancing HIV Prevention New Strategies for a Changing EpidemicmdashUnited States 2003 MMWR 200352(15)329ndash332

entary 9

CDC Dear colleague letter CDC recommends that all states and territories adopt confidential name-based surveillance systems to report HIV infec-tions httpwwwcdcgovhivpubs070505_dearcolleague_gerberdingpdf Pub-lished July 5 2005 Accessed March 11 2008

1981ndash2005 CDC Epidemiology of HIVAIDSmdashUnited States

MMWR 200655(21)589ndash592CDC Guidelines for national HIV case surveil-

lance including monitoring for HIV infection and AIDS MMWR 199948(RR-13)1ndash31

CDC HIV prevention strategic plan extended through 2010 httpwwwcdcgovhivresourcesreportspsp Published October 2007 Accessed March 11 2008

CDC Revised recommendations for HIV testing of adults adolescents and pregnant women in health-care settings MMWR 200655(RR-14)1ndash17

CDC Twenty-five years of HIVAIDSmdashUnited States 1981ndash2006 MMWR 200655(21)585ndash589

Glynn MK Lee LM McKenna MT The status of national HIV case surveillance United States 2006 Public Health Rep 2007122(suppl 1)63ndash71

Janssen RS Satten GA Stramer SL et al New test-ing strategy to detect early HIV-1 infection for use in incidence estimates and for clinical and prevention purposes JAMA 1998280(1)42ndash48

Lee LM McKenna MT Monitoring the incidence of HIV infection in the United States Public Health Rep 2007122(suppl 1)72ndash79

10 Comm

entary

Cases of HIVAIDS and AIDS

Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003ndash2006mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

Year of diagnosis

2003 2004 2005 2006

Data for 33 statesAge at diagnosis (yrs)lt13 211 183 169 13513ndash14 53 36 40 4115ndash19 993 993 1126 133220ndash24 3163 3368 3592 388625ndash29 4023 4057 4236 460330ndash34 5189 4820 4676 446635ndash39 6369 5807 5535 544240ndash44 5786 5429 5529 571845ndash49 4028 3877 4028 420450ndash54 2451 2401 2547 271855ndash59 1279 1363 1455 143860ndash64 655 702 692 714gt65 570 624 613 618

RaceethnicityWhite not Hispanic 10033 10181 10528 10758Black not Hispanic 17668 16718 16629 17356Hispanic 6355 6010 6217 6481AsianPacific Islander 338 339 373 397American IndianAlaska Native 179 171 182 166

Transmission categoryMale adult or adolescentMale-to-male sexual contact 15409 15880 16833 17465Injection drug use 3514 3083 2978 3016Male-to-male sexual contact and injection drug use 1349 1299 1247 1180High-risk heterosexual contacta 4269 3959 3871 4152Otherb 125 110 107 114Subtotal 24666 24331 25036 25928

Female adult or adolescentInjection drug use 2027 1856 1720 1712High-risk heterosexual contacta 7731 7182 7216 7432Otherb 134 107 97 109Subtotal 9892 9145 9033 9252

Child (lt13 yrs at diagnosis)Perinatal 190 157 147 115Otherc 23 27 23 20Subtotal 213 184 170 135

Subtotal for 33 states 34770 33659 34239 35314

Data for US dependent areas 1331 1234 1395 1503

Totald 36102 34894 35634 36817Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

Cases of HIVAIDS and AIDS 11

Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

gt12 Months after diagnosis aof HIV infection

lt12 Months after diagnosis of HIV infectionb Total

No ()c No ()c No

Data for 33 statesAge at diagnosis (yrs)lt13 148 88 21 12 16913ndash14 22 54 18 46 4015ndash19 912 81 215 19 112620ndash24 2874 80 714 20 358925ndash29 3077 73 1157 27 423430ndash34 3016 65 1655 35 467135ndash39 3353 61 2176 39 553040ndash44 3181 58 2338 42 551945ndash49 2145 53 1874 47 401950ndash54 1307 51 1239 49 254655ndash59 725 50 728 50 145360ndash64 316 46 376 54 692gt65 266 44 346 56 612RaceethnicityWhite not Hispanic 6839 65 3677 35 10516Black not Hispanic 10372 62 6242 38 16614Hispanic 3593 58 2614 42 6206AsianPacific Islander 232 62 139 38 371American IndianAlaska Native 110 61 72 39 182Transmission category

Male adult or adolescentMale-to-male sexual contact 10917 65 5902 35 16819Injection drug use 1544 52 1427 48 2971Male-to-male sexual contact and injection drug use 733 59 512 41 1245High-risk heterosexual contactd 2091 54 1773 46 3864Othere 45 42 61 58 107Subtotal 15331 61 9675 39 25006Female adult or adolescentInjection drug use 1056 62 660 38 1716High-risk heterosexual contactd 4761 66 2450 34 7210Othere 47 48 50 52 97Subtotal 5864 65 3160 35 9023Child (lt13 yrs at diagnosis)Perinatal 126 86 21 14 147Otherf 22 94 2 6 23Subtotal 148 87 22 13 170

Subtotal for 33 states 21343 62 12857 38 34200Data for US dependent areas 855 61 541 39 1395

Totalg 22197 62 13398 38 35595h

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003Data exclude 39 persons whose month of diagnosis of HIV infection is unknowna Includes persons in whom AIDS has not developedb Includes persons whose diagnoses of HIV infection and AIDS were made at the same timec Percentages represent proportions of the total number of diagnoses of HIVAIDS made during 2005 for the corresponding group (see row

entries)d Heterosexual contact with a person known to have or to be at high risk for HIV infectione Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedf Includes hemophilia blood transfusion and risk factor not reported or not identifiedg Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the

column totalh Includes 310 persons of unknown race or multiple races

12 Cases of HIVAIDS and AIDS

Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas

Year of diagnosis2002 2003 2004 2005 2006 Cumulativea

Data for 50 states and the District of ColumbiaAge at diagnosis (yrs)lt13 106 70 53 53 38 915613ndash14 62 74 70 66 73 107815ndash19 316 302 334 410 401 562620ndash24 1399 1568 1624 1675 1669 3622525ndash29 3137 3059 3196 3110 3423 11709930ndash34 5701 5521 5144 4668 4349 19753035ndash39 8217 8017 7072 6479 6402 21357340ndash44 7404 7626 7703 7378 7298 17053145ndash49 5358 5617 5498 5727 5628 10720750ndash54 3271 3364 3491 3527 3687 5990755ndash59 1607 1693 1836 1861 2071 3219060ndash64 872 864 913 872 955 17303gt65 682 763 791 727 835 15074

RaceethnicityWhite not Hispanic 11233 10948 11066 10676 10929 394024Black not Hispanic 19246 19512 18909 18081 17960 409982Hispanic 6712 7102 6771 6823 6907 161505AsianPacific Islander 425 450 444 450 519 7951American IndianAlaska Native 177 176 182 170 155 3345

Transmission categoryMale adult or adolescentMale-to-male sexual contact 15709 16078 16054 15711 16001 465965Injection drug use 5483 5275 4818 4603 4410 170171Male-to-male sexual contact and injection drug use 2075 2029 1925 1930 1803 68516High-risk heterosexual contactb 4547 4471 4506 4306 4558 65241Otherc 253 226 228 237 217 13893Subtotal 28067 28079 27532 26787 26989 783786

Female adult or adolescentInjection drug use 2897 2836 2810 2586 2385 74718High-risk heterosexual contactb 6855 7336 7113 6922 7196 108252Otherc 207 217 217 205 220 6596Subtotal 9959 10389 10141 9713 9801 189566

Child (lt13 yrs at diagnosis)Perinatal 104 70 53 52 37 8508Otherd 2 0 0 0 0 636Subtotal 106 70 53 53 38 9144

Region of residenceNortheast 10092 10342 9412 9396 9486 306241Midwest 4125 4226 4089 4371 4164 101479South 17198 17630 18225 16894 17104 374800West 6718 6339 6000 5891 6074 199978Subtotal for 50 states and the District of Columbia 38132 38538 37726 36552 36828 982498

Data for US dependent areas 1058 1060 921 955 833 31217

Totale 39250 39690 38807 37662 37852 1014797Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes persons of unknown race or multiple races and persons of unknown sex Cumulative total includes 5691 persons of unknown race or multiple

races 3 persons of unknown sex 1079 persons of unknown state of residence and 3 persons who were residents of other areas Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Cases of HIVAIDS and AIDS 13

Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002ndash2006 and cumulativemdash50 states and the District of Columbia

Year of diagnosisCumulativea2002 2003 2004 2005 2006

RaceethnicityWhite not Hispanic 14 12 7 4 4 1599Black not Hispanic 70 46 33 38 30 5654Hispanic 18 10 9 8 3 1748AsianPacific Islander 1 0 1 1 1 54American IndianAlaska Native 1 0 1 0 0 31

Transmission categoryHemophiliacoagulation disorder 0 0 0 0 0 226Mother with documented HIV infection or 1 of the following risk factors 104 70 53 52 37 8508

Injection drug use 12 8 5 3 4 3220Sex with injection drug user 4 6 3 2 1 1397Sex with bisexual male 2 0 3 1 1 209Sex with person with hemophilia 0 0 0 0 0 35Sex with HIV-infected transfusion recipient 0 0 0 0 0 22Sex with HIV-infected person risk factor not specified 36 20 20 25 13 1530Receipt of blood transfusion blood components or tissue 2 1 0 0 0 144Has HIV infection risk factor not specified 47 34 21 21 17 1951

Receipt of blood transfusion blood components or tissue 2 0 0 0 0 374Otherrisk factor not reported or identified 0 0 0 0 0 36

Totalb 106 70 53 53 38 9144

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga From the beginning of the epidemic through 2006b Includes children of unknown race or multiple races Cumulative total includes 58 children of unknown race or multiple races Because column totals

were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992ndash2006mdash50 states and the District of Columbia

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reporting

14 Cases of HIVAIDS and AIDS

Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006mdash50 states and the District of Columbia

Raceethnicity

Adults or adolescents

Children (lt13 yrs) TotalaMales Females Totala

No Rate No Rate No Rate No Rate No Rate

White not Hispanic 9267 112 1659 19 10926 64 4 00 10929 54Black not Hispanic 11540 829 6391 404 17930 603 30 04 17960 476Hispanic 5388 313 1516 95 6903 208 3 00 6907 156AsianPacific Islander 423 75 95 16 518 44 1 00 519 37American IndianAlaska Native 118 122 37 36 155 78 0 00 155 62

Totalb 26989 224 9801 78 36790 149 38 01 36828c 123

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reportingData exclude cases in persons whose state or area of residence is unknown as well as cases from US dependent areas for which census information about race and age categories is lackinga Because row totals were calculated independently of the values for the subpopulations the values in each row may not sum to the row totalb Includes person of unknown race or multiple races Because column totals were calculated independently of the values for the subpopulations the

values in each column may not sum to the column totalc Includes 358 persons of unknown race or multiple races

Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006mdash33 states with confidential name-based HIV infection reporting

Raceethnicity

Adults or adolescents

Children (lt13 yrs) TotalaMales Females Totala

No Rate No Rate No Rate No Rate No Rate

White not Hispanic 9078 167 1664 29 10742 96 16 01 10758 82Black not Hispanic 11230 1191 6033 562 17263 856 93 17 17356 677Hispanic 5058 509 1400 151 6458 337 23 04 6481 255AsianPacific Islander 318 135 79 32 397 82 0 00 397 67American IndianAlaska Native 129 177 35 46 164 110 2 06 166 88

Totalb 25928 338 9252 115 35180 224 135 04 35314c 185

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Because row totals were calculated independently of the values for the subpopulations the values in each row may not sum to the row totalb Includes persons of unknown race or multiple races Because column totals were calculated independently of the values for the subpopulations the

values in each column may not sum to the column totalc Includes 156 persons of unknown race or multiple races

Cases of HIVAIDS and AIDS 15

Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006mdashUnited States and dependent areas

Transmission category

Place of birth

United StatesCentralSouth

America Cuba Mexico Puerto Rico Totala

No No No No No No

Male-to-male sexual contact 1172 45 402 49 89 62 790 59 249 18 3337 43Injection drug use 569 22 83 10 13 9 133 10 533 40 1650 21Male-to-male sexual contact

and injection drug use 158 6 25 3 6 4 59 4 63 5 357 5High-risk heterosexual

contactb 661 25 296 36 35 24 342 26 487 36 2282 30Otherc 47 2 8 1 0 0 9 1 14 1 103 1

Totald 2608 100 814 100 145 100 1334 100 1346 100 7728 100Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Includes 222 persons whose place of birth is not among those listed and 1260 persons whose place of birth is unknownb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the

column total

16 Cases of HIVAIDS and AIDS

Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas

Year of death

Cumulativea2002 2003 2004 2005 2006

Data for 50 states and the District of ColumbiaAge at death (yrs)lt13 25 22 15 7 13 4889

13ndash14 10 6 15 12 5 276

15ndash19 39 36 36 38 44 1104

20ndash24 151 157 175 147 162 8716

25ndash29 553 512 482 458 405 43671

30ndash34 1480 1272 1128 1069 785 95351

35ndash39 2967 2763 2425 2096 1682 116746

40ndash44 3595 3516 3393 3317 2636 104133

45ndash49 3294 3234 3251 3275 2886 72831

50ndash54 2318 2373 2502 2645 2343 44255

55ndash59 1209 1322 1425 1543 1480 25123

60ndash64 616 705 741 797 771 14315

gt65 691 773 807 865 805 14393

RaceethnicityWhite not Hispanic 5214 5097 4836 4758 3860 239529

Black not Hispanic 9037 8675 8581 8679 7426 218392

Hispanic 2429 2632 2641 2513 2425 80690

AsianPacific Islander 97 84 111 87 114 3426

American IndianAlaska Native 83 73 80 65 66 1693

Transmission categoryMale adult or adolescentMale-to-male sexual contact 5960 5937 5735 5641 4930 266272

Injection drug use 3738 3547 3315 3314 2641 107173

Male-to-male sexual contact and injection drug use 1278 1299 1237 1289 1064 40993

High-risk heterosexual contactb 1465 1501 1625 1571 1470 26236

Otherc 160 149 125 117 80 9867

Subtotal 12601 12431 12038 11932 10184 450541

Female adult or adolescentInjection drug use 1923 1825 1855 1768 1456 43143

High-risk heterosexual contactb 2281 2292 2373 2458 2258 42620

Otherc 84 87 72 68 70 4131

Subtotal 4289 4204 4300 4295 3784 89895

Child (lt13 yrs at diagnosis)Perinatal 53 49 56 39 42 4848

Otherd 4 5 1 2 7 521

Subtotal 57 54 57 41 48 5369

Deaths 17

Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas (cont)

Year of death

Cumulativea2002 2003 2004 2005 2006

Region of residenceNortheast 5313 5012 4779 4750 4074 180623

Midwest 1726 1666 1482 1378 1325 54468

South 7337 7427 7535 7907 6475 197209

West 2571 2585 2600 2234 2141 113506

Subtotal for 50 states and the District of Columbia 16948 16690 16395 16268 14016 545805

Data for US dependent areas 667 575 572 562 580 19858

Totale 17628 17283 16982 16865 14627 565927f

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column totalf Includes 2082 persons of unknown race or multiple races 261 persons of unknown state of residence and 2 persons who were residents

of other areas

18 Deaths

Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003ndash2006mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

2003 2004 2005 2006Data for 33 states

Age at end of year (yrs)lt13 4154 3700 3294 286713ndash14 1130 1238 1212 113915ndash19 3298 3627 4024 453920ndash24 12389 12826 13411 1430125ndash29 26167 26924 28164 2960030ndash34 49602 47577 45109 4418935ndash39 80703 77871 75842 7363440ndash44 92040 97109 100102 10176445ndash49 71345 77490 83816 9028350ndash54 45133 51033 56640 6319555ndash59 22793 26610 31186 3600860ndash64 10820 12642 14422 16658gt65 8531 9959 11657 13551

RaceethnicityWhite not Hispanic 145081 151694 158375 166000Black not Hispanic 202951 212425 221439 231957Hispanic 72612 76503 80491 84720AsianPacific Islander 2234 2529 2858 3187American IndianAlaska Native 1788 1889 2008 2119

Transmission categoryMale adult or adolescentMale-to-male sexual contact 181771 193245 205423 218676Injection drug use 57651 58149 58369 59077Male-to-male sexual contact and injection drug use 23965 24434 24725 25085High-risk heterosexual contacta 40084 42559 44915 47562Otherb 3218 3278 3325 3424Subtotal 306689 321665 336756 353825

Female adult or adolescentInjection drug use 32346 32735 32973 33470High-risk heterosexual contacta 80324 85348 90185 95403Otherb 2036 2123 2212 2321Subtotal 114705 120206 125370 131195

Child (lt13 yrs at diagnosis)Perinatal 6137 6154 6178 6143Otherc 570 575 571 560Subtotal 6707 6730 6748 6703

Subtotal for 33 states 428107 448605 468879 491727Data for US dependent areas 15809 16399 17150 17955

Totald 443916 465005 486028 509681Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 19

Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission categorymdash33 states with confidential name-based HIV infection reporting

Transmission category

White not Hispanic

Black not Hispanic Hispanic

AsianPacific Islander

American IndianAlaska

Native Totala

No No No No No No

Male adult or adolescentMale-to-male sexual contact 108259 77 70242 49 36043 57 1669 68 938 62 218676 62Injection drug use 12328 9 31339 22 14472 23 264 11 216 14 59077 17Male-to-male sexual contact

and injection drug use 11283 8 9587 7 3720 6 93 4 205 13 25085 7High-risk heterosexual contactb 6667 5 31140 22 8788 14 395 16 143 9 47562 13Otherc 1458 1 1492 1 404 1 30 1 17 1 3424 1Subtotal 139994 100 143799 100 63427 100 2450 100 1519 100 353825 100

Female adult or adolescentInjection drug use 8262 33 19136 23 5528 28 106 15 175 30 33470 26High-risk heterosexual contactb 16338 65 63204 75 14132 71 573 82 392 68 95403 73Otherc 450 2 1469 2 344 2 24 3 12 2 2321 2Subtotal 25050 100 83809 100 20004 100 703 100 578 100 131195 100

Child (lt13 yrs at diagnosis)Perinatal 801 84 4064 93 1183 92 28 82 20 95 6143 92Otherd 154 16 283 7 107 8 6 18 1 5 560 8Subtotal 955 100 4347 100 1290 100 34 100 21 100 6703 100

Totale 166000 231957 84720 3187 2119 491727Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of 33 states that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Includes 3745 persons of unknown race or multiple racesb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes 5 persons of unknown sex Because column totals were calculated independently of the values for the subpopulations the values

in each column may not sum to the column total

20 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Map 1 Estimated rates (per 100000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

Note Rates adjusted for reporting delays Rates of HIV infection include only persons living with HIV infection that has not progressed to AIDSSince 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 Islandsa Includes persons whose area of residence is unknown

Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

Note Rates adjusted for reporting delays Rates of HIV infection include only persons living with HIV infection that has not progressed to AIDSSince 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 Islandsa Includes persons whose area of residence is unknown

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 21

Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002ndash2006mdashUnited States and dependent areas

2002 2003 2004 2005 2006Data for 50 states and the District of Columbia

Age at end of year (yrs)lt13 2308 2006 1684 1394 111513ndash14 685 747 784 762 71115ndash19 1465 1694 1974 2243 248720ndash24 3910 4292 4629 5033 536725ndash29 12725 12743 13045 13505 1435930ndash34 35558 33870 32057 29949 2882435ndash39 70107 68106 65076 62235 5964940ndash44 80377 86294 91335 94021 9517445ndash49 64702 71276 77417 84153 9077550ndash54 41270 46855 53333 59256 6647655ndash59 20113 24145 28356 33522 3901460ndash64 9681 11293 13305 15380 18072gt65 7520 8946 10604 12430 14669

RaceethnicityWhite not Hispanic 129426 135278 141508 147426 154495Black not Hispanic 150488 161326 171654 181056 191590Hispanic 63424 67895 72024 76334 80815AsianPacific Islander 3060 3426 3759 4121 4526American IndianAlaska Native 1254 1356 1458 1562 1651

Transmission categoryMale adult or adolescentMale-to-male sexual contact 158092 168233 178551 188622 199693Injection drug use 56708 58436 59940 61229 62998Male-to-male sexual contact and injection drug use 24726 25457 26144 26785 27523High-risk heterosexual contacta 27329 30300 33181 35916 39004Otherb 3588 3665 3769 3888 4026Subtotal 270444 286091 301585 316440 333244

Female adult or adolescentInjection drug use 27863 28874 29828 30646 31575High-risk heterosexual contacta 46445 51489 56229 60693 65631Otherb 1903 2033 2178 2315 2465Subtotal 76210 82395 88236 93653 99671

Child (lt13 yrs at diagnosis)Perinatal 3633 3654 3651 3664 3660Otherc 129 124 123 122 115Subtotal 3762 3778 3774 3786 3775

Region of residenceNortheast 105599 110929 115562 120208 125620Midwest 36011 38571 41178 44171 47010South 137081 147284 157975 166962 177591West 71729 75483 78883 82540 86473

Subtotal for 50 states and the District of Columbia 350419 372267 393598 413882 436693

Data for US dependent areas 9880 10365 10713 11106 11359

Totald 360617 383024 404849 425646 448871Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

22 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission categorymdash50 states and the District of Columbia

Transmission category

White not Hispanic

Black not Hispanic Hispanic

AsianPacific Islander

American IndianAlaska

Native Totala

No No No No No No

Male adult or adolescentMale-to-male sexual contact 101299 75 57520 45 36087 57 2715 72 704 57 199693 60Injection drug use 13168 10 33911 27 14795 23 325 9 201 16 62998 19Male-to-male sexual contact and

injection drug use 12393 9 10121 8 4352 7 198 5 220 18 27523 8High-risk heterosexual contactb 6081 5 24205 19 7816 12 444 12 105 8 39004 12Otherc 1743 1 1602 1 574 1 69 2 16 1 4026 1Subtotal 134683 100 127359 100 63623 100 3752 100 1246 100 333244 100

Female adult or adolescentInjection drug use 7407 38 18531 30 5025 30 115 15 153 39 31575 32High-risk heterosexual contactb 11350 59 41741 68 11092 67 588 78 227 58 65631 66Otherc 508 3 1456 2 413 2 51 7 13 3 2465 2Subtotal 19264 100 61728 100 16531 100 753 100 393 100 99671 100

Child (lt13 yrs at diagnosis)Perinatal 500 92 2468 99 629 95 20 94 12 100 3660 97Otherd 46 8 34 1 33 5 1 6 0 0 115 3Subtotal 546 100 2503 100 662 100 21 100 12 100 3775 100

Totale 154495 191590 80815 4526 1651 436693

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Includes 3616 persons of unknown race or multiple racesb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes 3 person of unknown sex Because column totals were calculated independently of the values for the subpopulations the values in each column

may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 23

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by

area of residence and age categorymdashUnited States and dependent areas

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

Alabama 5469 17 5486 3744 11 3755Alaska 272 1 273 330 1 331Arizona 5744 49 5793 4922 7 4929Arkansas 2291 7 2298 2139 6 2145California mdash mdash mdash 61451 105 61555Colorado 5855 13 5869 4083 2 4085Connecticut mdash mdash mdash 7406 15 7421Delaware mdash mdash mdash 1753 7 1760District of Columbia mdash mdash mdash 10059 30 10089Floridab 35461 263 35723 46469 194 46663Georgia mdash mdash mdash 17336 47 17383Hawaii mdash mdash mdash 1234 3 1237Idaho 356 0 356 313 0 313Illinois mdash mdash mdash 16139 46 16185Indiana 3849 21 3870 3996 14 4010Iowa 588 2 590 869 3 872Kansas 1230 7 1237 1272 2 1274Kentucky mdash mdash mdash 2589 13 2602Louisiana 7361 101 7462 8052 21 8074Maine mdash mdash mdash 512 2 514Maryland mdash mdash mdash 14540 41 14581Massachusetts mdash mdash mdash 8806 20 8826Michigan 6118 55 6173 6615 12 6627Minnesota 3227 21 3248 2314 9 2323Mississippi 4200 32 4232 3155 13 3168Missouri 4999 33 5033 5479 7 5486Montana mdash mdash mdash 205 0 205Nebraska 688 12 700 771 2 773Nevada 3402 13 3415 2969 3 2972New Hampshire mdash mdash mdash 556 3 559New Jersey 16059 153 16212 17168 57 17226New Mexico 910 0 909 1252 3 1255New York 42220 801 43021 70697 148 70845North Carolina 11700 60 11760 8451 12 8463North Dakota 87 2 89 73 1 74Ohio 8266 57 8323 7054 30 7084Oklahoma 2191 17 2208 2191 3 2194Oregon mdash mdash mdash 2840 4 2844Pennsylvania mdash mdash mdash 18633 71 18703Rhode Island mdash mdash mdash 1296 7 1303South Carolina 6349 45 6394 7035 23 7058South Dakota 195 4 199 139 1 140Tennessee 6579 51 6631 6403 11 6414Texas 24741 262 25003 34010 53 34063Utah 893 10 903 1164 0 1164Vermont mdash mdash mdash 238 2 240Virginia 9937 41 9978 8423 24 8447Washington mdash mdash mdash 5471 5 5476West Virginia 660 5 665 749 5 754Wisconsin 2322 15 2337 2153 12 2165Wyoming 86 2 88 102 1 103

Subtotal 224303 2174 226477 435621 1115 436736

24 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age categorymdashUnited States and dependent areas (cont)

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

US dependent areasAmerican Samoa 2 0 2 1 0 1Guam 63 0 63 36 0 36Northern Mariana Islands 7 0 7 3 0 3Puerto Rico 6269 31 6300 10971 26 10997US Virgin Islands 228 2 230 312 2 314Otherc mdash mdash mdash 1 0 1

Totald 230872 2207 233079 447724 1147 448871

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reporting a See Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at

least 2003b Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterc Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasd Total number of persons living with HIV infection (not AIDS) includes persons reported from areas with confidential name-based HIV

infection reporting who were residents of other states or whose area of residence is unknown Total number of persons living with AIDS includes persons whose area of residence is unknown Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 25

Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristicsmdashUnited States and dependent areas

No of persons

Survival in months

gt12 gt24 gt36Data for 50 states and the District of Columbia

Age at diagnosis (yrs)lt13 101 096 094 09413ndash14 60 098 098 09515ndash19 305 098 096 09520ndash24 1351 096 093 09225ndash29 3034 095 092 09130ndash34 5499 094 091 08935ndash39 7888 093 090 08740ndash44 7085 092 088 08545ndash49 5090 089 085 08250ndash54 3067 086 081 07855ndash59 1505 083 078 07460ndash64 806 080 073 069gt65 614 073 068 065

RaceethnicityWhite not Hispanic 10706 092 089 087Black not Hispanic 18406 090 086 082Hispanic 6398 092 090 088AsianPacific Islander 404 094 092 090American IndianAlaska Native 167 084 081 075

Transmission categoryMale adult or adolescentMale-to-male sexual contact 12830 093 090 088Injection drug use 4048 089 084 081Male-to-male sexual contact and injection drug use 1701 093 089 086High-risk heterosexual contacta 3170 091 088 085Otherb 5019 086 083 080Subtotal 26768 091 088 085

Female adult or adolescentInjection drug use 2101 089 083 078High-risk heterosexual contacta 4686 093 089 086Otherb 2749 090 085 083Subtotal 9536 091 087 083

Child (lt13 yrs at diagnosis)Perinatal 98 096 095 095Otherc 3 100 067 067Subtotal 101 096 094 094

Subtotal for 50 states and the District of Columbia 36405 091 087 085

Data for US dependent areas 891 083 078 075

Total 37352d 091 087 084Note Excludes persons whose date of death was before or in the same month as date of diagnosis Excludes persons whose month of diagnosis or month of death is unknowna Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes 325 persons of unknown race or multiple races

26 Survival after AIDS Diagnosis

Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by year of diagnosismdashUnited States and dependent areas

Months after AIDS diagnosis

Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by age groupmdashUnited States and dependent areas

Months after AIDS diagnosis

Survival after AIDS Diagnosis 27

Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by raceethnicitymdashUnited States and dependent areas

Months after AIDS diagnosis

28 Survival after AIDS Diagnosis

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006

and cumulativemdashUnited States and dependent areas

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Alabama 510 112 462 100 8626 76 8702Alaska 24 36 38 57 648 7 655Arizona 626 105 539 87 10396 46 10442Arkansas 237 85 252 90 3891 36 3927California 4069 113 3960 109 142254 664 142918Colorado 351 75 322 68 8742 31 8773Connecticut 658 188 422 120 14716 183 14899Delaware 177 210 116 136 3547 26 3573District of Columbia 672 1155 853 1467 17372 189 17561Florida 4921 277 4932 273 104084 1530 105614Georgia 2325 255 1605 171 31734 231 31965Hawaii 105 82 93 72 2927 17 2944Idaho 24 17 26 18 604 2 606Illinois 1886 148 1382 108 33620 282 33902Indiana 407 65 346 55 8239 56 8295Iowa 93 31 86 29 1727 13 1740Kansas 105 38 120 43 2781 14 2795Kentucky 249 60 207 49 4600 32 4632Louisiana 936 208 824 192 17612 128 17740Maine 21 16 68 51 1110 8 1118Maryland 1558 279 1626 290 30252 319 30571Massachusetts 666 104 533 83 19181 214 19395Michigan 821 81 672 67 14941 113 15054Minnesota 226 44 212 41 4817 28 4845Mississippi 368 127 365 125 6642 56 6698Missouri 385 66 469 80 11016 61 11077Montana 21 22 7 07 373 3 376Nebraska 53 30 118 67 1479 11 1490Nevada 293 121 294 118 5733 29 5762New Hampshire 33 25 55 42 1074 10 1084New Jersey 1262 145 1065 122 48750 778 49528New Mexico 134 70 93 48 2603 7 2610New York 6201 321 5495 285 174908 2354 177262North Carolina 916 106 1229 139 15954 118 16072North Dakota 10 16 6 09 144 1 145Ohio 753 66 767 67 14957 138 15095Oklahoma 281 79 205 57 4836 26 4862Oregon 217 60 281 76 5995 20 6015Pennsylvania 1486 120 1893 152 33417 365 33782Rhode Island 87 81 111 104 2580 28 2608South Carolina 682 161 705 163 13301 105 13406South Dakota 18 23 18 23 255 5 260Tennessee 818 137 680 113 12457 59 12516Texas 3045 133 2998 128 69735 392 70127Utah 63 25 57 22 2295 20 2315Vermont 5 08 18 29 461 6 467Virginia 638 84 605 79 16802 177 16979Washington 485 77 389 61 11792 34 11826West Virginia 74 41 67 37 1500 11 1511Wisconsin 122 22 217 39 4513 33 4546Wyoming 6 12 8 16 228 2 230

Subtotal 40123 135 37911 127 952221 9094 961315

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 29

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulativemdashUnited States and dependent areas (cont)

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

US dependent areasAmerican Samoa 0 0 0 0 1 0 1Guam 0 0 0 0 68 1 69Northern Mariana Islands 0 0 0 0 3 0 3Puerto Rico 1029 263 850 216 29511 400 29911US Virgin Islands 17 156 32 295 629 18 647Otherb 0 0 0 0 3 0 3

Totalc 41357 138 39002 129 983343 9522 992865d

a From the beginning of the epidemic through 2006b Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasc Includes persons whose state or area of residence is unknownd Includes 916 persons whose state or area of residence is unknown

30 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

MSA (population gt 500000)

Akron Ohio 66 94 32 46 762 1 763

AlbanyndashSchenectadyndashTroy NY 97 114 105 123 2253 24 2277

Albuquerque N Mex 70 88 50 61 1404 2 1406

AllentownndashBethlehemndashEaston PandashNJ 72 91 119 149 1352 17 1369

AtlantandashSandy SpringsndashMarietta Ga 1586 319 1006 196 21896 128 22024

AugustandashRichmond County GandashSC 106 205 32 61 1851 24 1875

AustinndashRound Rock Tex 227 156 186 123 4830 26 4856

Bakersfield Calif 76 100 122 156 1528 8 1536

BaltimorendashTowson Md 1064 401 1001 377 20352 218 20570

Baton Rouge La 222 304 231 301 3732 20 3752

BirminghamndashHoover Ala 151 139 110 100 2614 25 2639

Boise CityndashNampa Idaho 14 26 14 25 281 0 281

Boston MassndashNHa 441 99 355 80 13476 147 13623

Boston Division 269 146 185 101 8451 91 8542

Cambridge Division 108 74 102 70 3126 35 3161

Essex Division 52 71 51 69 1577 20 1597

BridgeportndashStamfordndashNorwalk Conn 181 201 135 150 3733 57 3790

BuffalondashNiagara Falls NY 117 102 96 84 2476 20 2496

Cape CoralndashFort Myers Fla 44 81 91 159 1692 24 1716

CharlestonndashNorth Charleston SC 92 155 91 151 2034 18 2052

CharlottendashGastoniandashConcord NCndashSC 214 141 285 180 3242 22 3264

Chicago IllndashIndndashWis 1716 182 1159 122 30118 261 30379

Chicago Division 1604 203 1073 135 28300 248 28548

Gary Division 61 88 50 71 1038 8 1046

Lake Division 51 59 36 41 780 5 785

CincinnatindashMiddletown OhiondashKyndashInd 111 53 199 95 2735 17 2752

ClevelandndashElyriandashMentor Ohio 228 107 170 80 4226 48 4274

Colorado Springs Colo 19 32 21 35 576 5 581

Columbia SC 177 256 197 280 3274 24 3298

Columbus Ohio 166 97 165 96 3112 15 3127

Dallas Tex 874 150 929 155 20238 63 20301

Dallas Division 681 175 714 178 16038 37 16075

Fort Worth Division 193 100 215 108 4200 26 4226

Dayton Ohio 58 69 54 64 1217 15 1232

DenverndashAurora Colo 274 116 236 98 6899 22 6921

Des Moines Iowa 30 57 23 43 530 4 534

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 31

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Detroit Mich 570 127 445 100 10373 73 10446

Detroit Division 443 223 330 167 8268 57 8325

Warren Division 127 51 115 46 2105 16 2121

El Paso Tex 56 78 40 54 1476 10 1486

Fresno Calif 52 59 64 72 1430 11 1441

Grand RapidsndashWyoming Mich 46 60 51 66 816 6 822

GreensborondashHigh Point NC 52 77 66 96 1265 14 1279

Greenville SC 70 119 67 111 1292 4 1296

HarrisburgndashCarlisle Pa 23 44 67 128 1224 8 1232

HartfordndashWest HartfordndashEast Hartford Conn 256 216 135 114 5126 46 5172

Honolulu Hawaii 54 60 69 76 2121 14 2135

HoustonndashBaytownndashSugar Land Tex 1017 190 1092 197 25821 172 25993

Indianapolis Ind 191 116 150 90 3824 25 3849

Jackson Miss 134 257 117 221 2419 30 2449

Jacksonville Fla 309 248 315 246 6020 75 6095

Kansas City MondashKans 183 94 160 81 4669 15 4684

Knoxville Tenn 47 72 35 52 882 5 887

Lakeland Fla 103 190 112 199 1811 21 1832

Las VegasndashParadise Nev 245 143 258 145 4616 28 4644

Little RockndashNorth Little Rock Ark 87 135 75 115 1383 14 1397

Los Angeles Calif 1529 118 1684 130 57953 293 58246

Los Angeles Division 1339 135 1435 144 51098 250 51348

Santa Anna Division 190 63 249 83 6855 43 6898

Louisville KyndashInd 123 102 97 79 2286 22 2308

Madison Wis 10 19 29 53 520 4 524

McAllenndashEdinburgndashPharr Tex 57 84 45 64 630 11 641

Memphis TennndashMissndashArk 402 320 346 271 5128 19 5147

Miami Fla 2420 446 2289 419 55807 997 56804

Fort Lauderdale Division 810 455 769 430 16412 262 16674

Miami Division 1243 523 1165 485 29703 512 30215

West Palm Beach Division 367 290 355 279 9692 223 9915

MilwaukeendashWaukeshandashWest Allis Wis 68 45 109 72 2507 18 2525

MinneapolisndashSt PaulndashBloomington MinnndashWis 186 59 184 58 4259 22 4281

Modesto Calif 36 71 22 43 671 6 677

NashvillendashDavidsonndashMurfreesboro Tenn 224 158 172 118 3848 20 3868

New HavenndashMilford Conn 169 200 107 127 4573 73 4646

New OrleansndashMetairiendashKenner La 393 299 271 264 8835 67 8902

32 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

New York NYndashNJndashPa 6215 330 5500 292 195177 2906 198083

Edison Division 191 83 130 56 6709 139 6848

Nassau Division 262 93 246 88 8141 110 8251

New York Division 5266 456 4716 408 160408 2323 162731

Newark Division 496 231 408 190 19919 334 20253

Oklahoma City Okla 125 108 88 75 2255 5 2260

OmahandashCouncil Bluffs NebndashIowa 37 46 80 97 1035 3 1038

Orlando Fla 544 282 517 260 8653 92 8745

OxnardndashThousand OaksndashVentura Calif 49 62 21 26 1008 3 1011

Palm BayndashMelbournendashTitusville Fla 68 129 61 114 1512 11 1523

Philadelphia PandashNJndashDelndashMd 1261 217 1348 231 28221 313 28534

Camden Division 108 87 111 89 3118 42 3160

Philadelphia Division 1022 263 1144 294 22112 250 22362

Wilmington Division 131 191 93 134 2991 21 3012

PhoenixndashMesandashScottsdale Ariz 460 119 376 93 7459 31 7490

Pittsburgh Pa 143 60 135 57 3182 19 3201

PortlandndashSouth Portland Maine 9 18 34 66 562 1 563

PortlandndashVancouverndashBeaverton OrendashWash 170 81 215 101 4825 10 4835

PoughkeepsiendashNewburghndashMiddletown NY 136 204 113 168 3162 24 3186

ProvidencendashNew BedfordndashFall River RIndashMass 132 82 155 96 3900 44 3944

RaleighndashCary NC 138 145 201 202 1987 13 2000

Richmond Va 119 101 122 102 3371 35 3406

RiversidendashSan BernardinondashOntario Calif 361 92 306 76 8568 60 8628

Rochester NY 165 159 124 120 3134 13 3147

SacramentondashArden-ArcadendashRoseville Calif 154 75 169 82 4000 26 4026

St Louis MondashIll 192 69 366 131 5965 40 6005

Salt Lake City Utah 46 44 40 37 1743 10 1753

San Antonio Tex 215 114 247 127 4987 30 5017

San DiegondashCarlsbadndashSan Marcos Calif 491 167 384 131 12934 61 12995

San Francisco Calif 867 209 690 165 40152 96 40248

Oakland Division 312 126 246 99 9546 48 9594

San Francisco Division 555 329 444 261 30606 48 30654

San JosendashSunnyvalendashSanta Clara Calif 88 50 145 81 3747 15 3762

San JuanndashCaguasndashGuaynabo PR 745 289 578 223 21402 277 21679

SarasotandashBradentonndashVenice Fla 82 122 104 152 1978 27 2005

ScrantonndashWilkes-Barre Pa 27 49 47 85 572 6 578

Seattle Wash 353 110 280 86 9172 27 9199

Seattle Division 316 129 255 102 8161 18 8179

Tacoma Division 37 49 25 33 1011 9 1020

Springfield Mass 88 128 45 66 2075 26 2101

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 33

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Stockton Calif 52 78 52 77 1076 15 1091

Syracuse NY 52 80 49 75 1317 8 1325

TampandashSt PetersburgndashClearwater Fla 559 211 605 224 11174 112 11286

Toledo Ohio 25 38 66 101 812 14 826

Tucson Ariz 103 111 100 106 2010 10 2020

Tulsa Okla 83 94 65 72 1494 10 1504

Virginia BeachndashNorfolkndashNewport News VandashNC 183 111 132 80 4711 63 4774

Washington DCndashVandashMdndashWV 1322 252 1684 318 31130 315 31445

Bethesda Division 135 118 173 150 2774 23 2797

Washington Division 1187 289 1511 365 28356 292 28648

Wichita Kans 35 60 38 64 851 2 853

Worcester Mass 76 97 79 101 1783 20 1803

YoungstownndashWarrenndashBoardman OhiondashPa 27 46 26 44 519 0 519

Subtotal for MSAs (population gt500000) 33602 173 31274 159 829633 8171 837804

Metropolitan areas (population of 50000 to 499999) 4477 80 4466 79 94829 847 95676

Nonmetropolitan areas 2666 54 2732 55 52063 445 52508

Totalb 41144 137 38749 128 981708 9494 991202

Note Because of the lack of census information for all US dependent areas includes data for only the 50 states the District of Columbia and Puerto RicoMSA metropolitan statistical areaMSA definitions for this report can be found at httpwwwcensusgovpopulationwwwestimatesmetrodefhtmla Reported case counts for the metropolitan divisions do not sum to the MSA total MSA total includes data from 1 metropolitan division with

population of lt500000b Includes persons whose county of residence is unknown

34 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Alabama (January 1988) 502 6041 48 6089

Alaska (February 1999) 38 285 2 287

Arizona (January 1987) 617 5877 80 5957

Arkansas (July 1989) 206 2349 20 2369

California (April 2006) 6581 7056 92 7148

Colorado (November 1985) 319 6084 31 6115

Connecticut (January 2005)b 826 2500 101 2601

Delaware (February 2006) 788 801 18 819

Florida (July 1997)c 4163 36386 397 36783

Georgia (December 2003) 2245 8197 194 8391

Idaho (June 1986) 35 340 4 344

Illinois (January 2006) 6241 6661 162 6823

Indiana (July 1988) 399 4027 43 4070

Iowa (July 1998) 69 586 5 591

Kansas (July 1999) 142 1225 15 1240

Kentucky (October 2004) 333 1303 13 1316

Louisiana (February 1993) 728 8149 166 8315

Maine (January 2006) 386 393 3 396

Michigan (April 1992) 635 6702 134 6836

Minnesota (October 1985) 309 3356 40 3396

Mississippi (August 1988) 352 4549 59 4608

Missouri (October 1987) 502 5086 55 5141

Nebraska (September 1995) 91 672 14 686

Nevada (February 1992) 339 3532 24 3556

New Hampshire (January 2005) 59 466 9 475

New Jersey (January 1992) 1477 17513 325 17838

New Mexico (January 1998) 114 949 4 953

New York (June 2000) 5326 42345 1820 44165

North Carolina (February 1990) 1615 13879 143 14022

North Dakota (January 1988) 4 82 1 83

Ohio (June 1990) 867 8222 101 8323

Oklahoma (June 1988) 229 2401 30 2431

Oregon (April 2006) 49 95 19 114

Pennsylvania (October 2002)d 4269 9537 179 9716

Rhode Island (July 2006) 14 21 0 21

South Carolina (February 1986) 493 6970 93 7063

South Dakota (January 1988) 18 215 6 221

Tennessee (January 1992) 732 7115 90 7205

Texas (January 1999)e 3370 24282 417 24699

Utah (April 1989) 106 893 14 907

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 35

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Virginia (July 1989) 864 10257 95 10352

Washington (March 2006) 4048 4157 40 4197

West Virginia (January 1989) 66 673 8 681

Wisconsin (November 1985) 261 2500 31 2531

Wyoming (June 1989) 7 93 1 94

Subtotal 50834 274822 5146 279968

US dependent areas

American Samoa (August 2001) 0 1 0 1

Guam (March 2000) 2 66 0 66

Northern Mariana Islands (October 2001) 2 7 0 7

Puerto Rico (January 2003) 1471 5610 91 5701

US Virgin Islands (December 1998) 22 247 6 253

Persons reported from areas with confidential name-based HIV infection reporting but who were residents of other areas 132 685 21 706

Totalf 52878 282640 5314 287954

Note Includes data from 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through 2006b Beginning in 1992 Connecticut had name-based HIV reporting for cases in children only From January 2002 through December 2004

Connecticut had name- or code-based HIV reporting for cases in adolescents and adults As of January 2005 Connecticut has name-based reporting of all cases of HIV infection

c Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterd On October 18 2002 Pennsylvania initiated confidential name-based HIV infection reporting in all areas except Philadelphia Code-based

reporting was implemented in Philadelphia in March 2004 and the switch to name-based reporting was made in October 2005e From February 1994 through December 1998 Texas reported HIV infection in children onlyf Includes 1252 persons reported from areas with confidential name-based HIV infection reporting but whose area of residence is unknown

36 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulativemdashUnited States and dependent areas

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No Adult or adolescentMale-to-male sexual contact 13775 49 429897 54 mdash mdash mdash mdash 13775 35 429897 44Injection drug use 3413 12 163070 21 1826 17 67693 35 5239 13 230763 23Male-to-male sexual contact and

injection drug use 1603 6 65524 8 mdash mdash mdash mdash 1603 4 65524 7Hemophiliacoagulation disorder 43 0 5176 1 11 0 348 0 54 0 5524 1High-risk heterosexual contactc 2997 11 49610 6 4839 46 85186 44 7836 20 134796 14

Sex with injection drug user 330 1 11683 1 706 7 26073 14 1036 3 37756 4Sex with bisexual male mdash mdash mdash mdash 234 2 5162 3 234 1 5162 1Sex with person with hemophilia 1 0 84 0 11 0 502 0 12 0 586 0Sex with HIV-infected transfusion

recipient 22 0 553 0 21 0 793 0 43 0 1346 0Sex with HIV-infected person risk

factor not specified 2644 9 37290 5 3867 37 52656 27 6511 17 89946 9Receipt of blood transfusion blood

d components or tissue 63 0 5213 1 68 1 4176 2 131 0 9389 1Otherrisk factor not reported or

identifiede 6484 23 73136 9 3793 36 34311 18 10278 26 107450 11Subtotal 28378 100 791626 100 10537 100 191714 100 38916 100 983343 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 0 0 222 5 0 0 7 0 0 0 229 2Mother with documented HIV infection or

1 of the following risk factors 24 75 4315 89 50 93 4423 95 74 86 8738 92Injection drug use 4 13 1676 35 4 7 1665 36 8 9 3341 35Sex with injection drug user 4 13 789 16 4 7 750 16 8 9 1539 16Sex with bisexual male 1 3 101 2 2 4 110 2 3 3 211 2Sex with person with hemophilia 0 0 20 0 0 0 16 0 0 0 36 0Sex with HIV-infected transfusion

recipient 0 0 11 0 0 0 15 0 0 0 26 0Sex with HIV-infected person risk

factor not specified 6 19 742 15 17 31 790 17 23 27 1532 16Receipt of blood transfusion blood

components or tissue 0 0 70 1 0 0 82 2 0 0 152 2Has HIV infection risk factor not

specified 9 28 906 19 23 43 995 21 32 37 1901 20Receipt of blood transfusion blood

fcomponents or tissue 1 3 243 5 0 0 144 3 1 1 387 4Otherrisk factor not reported or

identifiedg 7 22 75 2 4 7 93 2 11 13 168 2Subtotal 32 100 4855 100 54 100 4667 100 86 100 9522 100

Total 28410 100 796481 100 10591 100 196381 100 39002 100 992865 100a From the beginning of the epidemic through 2006b From the beginning of the epidemic through 2006 Includes 3 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infectiond AIDS developed in 47 adultsadolescents after they received blood that had tested negative for HIV antibodies AIDS developed in 14 additional adults

after they received tissue organs or artificial insemination from HIV-infected donors Four of the 14 received tissue or organs from a donor who was negative for HIV antibody at the time of donation

e Includes 37 adultsadolescents who were exposed to HIV-infected blood body fluids or concentrated virus in health care laboratory or household settings as supported by seroconversion epidemiologic andor laboratory evidence One person was infected after intentional inoculation with HIV-infected blood Includes an additional 740 persons who acquired HIV infection perinatally but who were more than 12 years of age when AIDS was diagnosed These 740 persons are not counted in the values for the pediatric transmission category

f AIDS developed in 3 children after they received blood that had tested negative for HIV antibodiesg Includes 5 children who were exposed to HIV-infected blood as supported by seroconversion epidemiologic andor laboratory evidence 1 child was

infected after intentional inoculation with HIV-infected blood and 5 children were exposed to HIV-infected blood in a household setting Of the 168 children 26 had sexual contact with an adult with or at high risk for HIV infection

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 37

Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No

Adult or adolescentMale-to-male sexual contact 22912 59 103679 52 mdash mdash mdash mdash 22912 44 103679 37

Injection drug use 3503 9 24255 12 2124 16 13925 17 5627 11 38181 14

Male-to-male sexual contact and injection drug use 1946 5 10704 5 mdash mdash mdash mdash 1946 4 10704 4

Hemophiliacoagulation disorder 43 0 495 0 6 0 73 0 49 0 568 0

High-risk heterosexual contactc 2874 7 16830 8 5939 45 38315 47 8813 17 55145 20

Sex with injection drug user 308 1 2601 1 757 6 6791 8 1065 2 9392 3

Sex with bisexual male mdash mdash mdash mdash 328 2 2265 3 328 1 2265 1

Sex with person with hemophilia 4 0 31 0 16 0 201 0 20 0 232 0

Sex with HIV-infected transfusion recipient 13 0 131 0 28 0 223 0 41 0 354 0

Sex with HIV-infected person risk factor not specified 2549 7 14067 7 4810 36 28835 35 7359 14 42902 15

Receipt of blood transfusion blood components or tissue 61 0 489 0 50 0 536 1 111 0 1025 0

Otherrisk factor not reported or identified 7748 20 44021 22 5106 39 29312 36 12854 25 73338 26

Subtotal 39087 100 200473 100 13225 100 82161 100 52312 100 282640 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 8 3 106 4 0 0 1 0 8 1 107 2

Mother with documented HIV infection or 1 of the following risk factors 197 74 2195 85 254 85 2417 89 451 80 4612 87

Injection drug use 34 13 532 21 53 18 561 21 87 15 1093 21

Sex with injection drug user 12 5 208 8 21 7 213 8 33 6 421 8

Sex with bisexual male 5 2 37 1 4 1 32 1 9 2 69 1

Sex with person with hemophilia 0 0 3 0 1 0 7 0 1 0 10 0

Sex with HIV-infected transfusion recipient 0 0 4 0 0 0 4 0 0 0 8 0

Sex with HIV-infected person risk factor not specified 54 20 534 21 76 25 629 23 130 23 1163 22

Receipt of blood transfusion blood components or tissue 0 0 17 1 2 1 20 1 2 0 37 1

Has HIV infection risk factor not specified 92 35 860 33 97 32 951 35 189 33 1811 34

Receipt of blood transfusion blood components or tissue 6 2 28 1 3 1 24 1 9 2 52 1

Otherrisk factor not reported or identified 55 21 260 10 43 14 283 10 98 17 543 10

Subtotal 266 100 2589 100 300 100 2725 100 566 100 5314 100

Total 39353 100 203062 100 13525 100 84886 100 52878 100 287954 100

Note See Table 16 for the list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006b From the beginning of the epidemic through December 2006 Includes 6 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infection

38 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity

2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 6251 65 253927 73Injection drug use 733 8 31737 9Male-to-male sexual contact and injection drug use 732 8 31434 9Hemophiliacoagulation disorder 26 0 3989 1High-risk heterosexual contactb 416 4 7850 2

Sex with injection drug user 74 1 2310 1

Sex with person with hemophilia 0 0 36 0

Sex with HIV-infected transfusion recipient 2 0 176 0

Sex with HIV-infected person risk factor not specified 340 4 5328 2Receipt of blood transfusion blood components or tissue 20 0 3194 1Otherrisk factor not reported or identified 1400 15 16469 5

Total 9578 100 348600 100

Black not HispanicMale-to-male sexual contact 4309 36 103297 37Injection drug use 1635 14 83369 30Male-to-male sexual contact and injection drug use 526 4 22134 8Hemophiliacoagulation disorder 10 0 604 0High-risk heterosexual contactb 1875 16 29952 11

Sex with injection drug user 167 1 6823 2Sex with person with hemophilia 1 0 36 0Sex with HIV-infected transfusion recipient 15 0 237 0Sex with HIV-infected person risk factor not specified 1692 14 22856 8

Receipt of blood transfusion blood components or tissue 24 0 1218 0Otherrisk factor not reported or identified 3579 30 40268 14

Total 11958 100 280842 100

HispanicMale-to-male sexual contact 2816 47 64893 44Injection drug use 965 16 46337 31Male-to-male sexual contact and injection drug use 287 5 10884 7Hemophiliacoagulation disorder 6 0 466 0High-risk heterosexual contactb 638 11 10950 7

Sex with injection drug user 84 1 2409 2Sex with person with hemophilia 0 0 11 0Sex with HIV-infected transfusion recipient 5 0 125 0Sex with HIV-infected person risk factor not specified 549 9 8405 6

Receipt of blood transfusion blood components or tissue 17 0 657 0Otherrisk factor not reported or identified 1326 22 14832 10

Total 6055 100 149019 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 39

a

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulative

No No

AsianPacific IslanderMale-to-male sexual contact 225 54 4475 68Injection drug use 20 5 317 5Male-to-male sexual contact and injection drug use 17 4 284 4Hemophiliacoagulation disorder 1 0 70 1High-risk heterosexual contactb 34 8 376 6

Sex with injection drug user 1 0 54 1Sex with person with hemophilia 0 0 1 0Sex with HIV-infected transfusion recipient 0 0 8 0Sex with HIV-infected person risk factor not specified 33 8 313 5

Receipt of blood transfusion blood components or tissue 2 0 112 2Otherrisk factor not reported or identified 114 28 949 14

Total 413 100 6583 100

American IndianAlaska NativeMale-to-male sexual contact 61 49 1403 55Injection drug use 15 12 395 15Male-to-male sexual contact and injection drug use 23 19 457 18Hemophiliacoagulation disorder 0 0 27 1High-risk heterosexual contactb 9 7 118 5

Sex with injection drug user 1 1 33 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 8 6 82 3

Receipt of blood transfusion blood components or tissue 0 0 8 0Otherrisk factor not reported or identified 16 13 155 6

Total 124 100 2563 100

Total casesMale-to-male sexual contact 13775 49 429897 54Injection drug use 3413 12 163070 21Male-to-male sexual contact and injection drug use 1603 6 65524 8Hemophiliacoagulation disorder 43 0 5176 1High-risk heterosexual contactb 2997 11 49610 6

Sex with injection drug user 330 1 11683 1Sex with person with hemophilia 1 0 84 0Sex with HIV-infected transfusion recipient 22 0 553 0Sex with HIV-infected person risk factor not specified 2644 9 37290 5

Receipt of blood transfusion blood components or tissue 63 0 5213 1Otherrisk factor not reported or identified 6484 23 73136 9

Total 28378c 100 791626d 100a From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 4019 males of unknown race or multiple races

40 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 11963 73 55725 69Injection drug use 858 5 5512 7Male-to-male sexual contact and injection drug use 1092 7 5578 7Hemophiliacoagulation disorder 29 0 355 0High-risk heterosexual contactb 522 3 2658 3

Sex with injection drug user 65 0 544 1Sex with person with hemophilia 0 0 8 0Sex with HIV-infected transfusion recipient 3 0 33 0Sex with HIV-infected person risk factor not specified 454 3 2073 3

Receipt of blood transfusion blood components or tissue 14 0 197 0Otherrisk factor not reported or identified 1956 12 11147 14

Total 16434 100 81172 100

Black not HispanicMale-to-male sexual contact 6203 44 30148 37Injection drug use 1594 11 11997 15Male-to-male sexual contact and injection drug use 483 3 3489 4Hemophiliacoagulation disorder 10 0 109 0High-risk heterosexual contactb 1714 12 10905 13

Sex with injection drug user 169 1 1554 2Sex with person with hemophilia 4 0 17 0Sex with HIV-infected transfusion recipient 6 0 77 0Sex with HIV-infected person risk factor not specified 1535 11 9257 11

Receipt of blood transfusion blood components or tissue 32 0 223 0Otherrisk factor not reported or identified 4151 29 24632 30

Total 14187 100 81503 100

HispanicMale-to-male sexual contact 4094 55 15623 47Injection drug use 993 13 6407 19Male-to-male sexual contact and injection drug use 316 4 1402 4Hemophiliacoagulation disorder 3 0 26 0High-risk heterosexual contactb 582 8 2963 9

Sex with injection drug user 65 1 455 1Sex with person with hemophilia 0 0 6 0Sex with HIV-infected transfusion recipient 4 0 18 0Sex with HIV-infected person risk factor not specified 513 7 2484 7

Receipt of blood transfusion blood components or tissue 11 0 55 0Otherrisk factor not reported or identified 1475 20 6977 21

Total 7474 100 33453 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 41

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderMale-to-male sexual contact 402 70 1006 63Injection drug use 17 3 55 3Male-to-male sexual contact and injection drug use 15 3 38 2Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 25 4 96 6

Sex with injection drug user 3 1 10 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 22 4 83 5

Receipt of blood transfusion blood components or tissue 4 1 7 0Otherrisk factor not reported or identified 109 19 397 25

Total 572 100 1600 100

American IndianAlaska NativeMale-to-male sexual contact 104 61 516 57Injection drug use 13 8 101 11Male-to-male sexual contact and injection drug use 19 11 110 12Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 10 6 53 6

Sex with injection drug user 2 1 14 2Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 8 5 39 4

Receipt of blood transfusion blood components or tissue 0 0 2 0Otherrisk factor not reported or identified 24 14 125 14

Total 170 100 907 100

Total casesMale-to-male sexual contact 22912 59 103679 52Injection drug use 3503 9 24255 12Male-to-male sexual contact and injection drug use 1946 5 10704 5Hemophiliacoagulation disorder 43 0 495 0High-risk heterosexual contactb 2874 7 16830 8

Sex with injection drug user 308 1 2601 1Sex with person with hemophilia 4 0 31 0Sex with HIV-infected transfusion recipient 13 0 131 0Sex with HIV-infected person risk factor not specified 2549 7 14067 7

Receipt of blood transfusion blood components or tissue 61 0 489 0Otherrisk factor not reported or identified 7748 20 44021 22

Total 39087c 100 200473d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 1838 males of unknown race or multiple races

42 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race

ethnicity 2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 482 28 14981 40Hemophiliacoagulation disorder 4 0 123 0High-risk heterosexual contactb 725 42 15799 42

Sex with injection drug user 153 9 5650 15Sex with bisexual male 63 4 1859 5Sex with person with hemophilia 5 0 329 1Sex with HIV-infected transfusion recipient 5 0 338 1Sex with HIV-infected person risk factor not specified 499 29 7623 20

Receipt of blood transfusion blood components or tissue 15 1 1870 5Otherrisk factor not reported or identified 499 29 4801 13

Total 1725 100 37574 100

Black not HispanicInjection drug use 982 15 38914 34Hemophiliacoagulation disorder 3 0 145 0High-risk heterosexual contactb 3103 46 49876 44

Sex with injection drug user 373 6 13530 12Sex with bisexual male 136 2 2352 2Sex with person with hemophilia 4 0 121 0Sex with HIV-infected transfusion recipient 8 0 277 0Sex with HIV-infected person risk factor not specified 2582 38 33596 29

Receipt of blood transfusion blood components or tissue 39 1 1546 1Otherrisk factor not reported or identified 2612 39 23894 21

Total 6739 100 114375 100

HispanicInjection drug use 322 18 12892 35Hemophiliacoagulation disorder 4 0 67 0High-risk heterosexual contactb 894 49 17995 49

Sex with injection drug user 166 9 6522 18Sex with bisexual male 32 2 818 2Sex with person with hemophilia 1 0 45 0Sex with HIV-infected transfusion recipient 7 0 141 0Sex with HIV-infected person risk factor not specified 688 38 10469 29

Receipt of blood transfusion blood components or tissue 12 1 619 2Otherrisk factor not reported or identified 592 32 5023 14

Total 1824 100 36596 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 43

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 8 8 125 12Hemophiliacoagulation disorder 0 0 7 1High-risk heterosexual contactb 49 47 574 53

Sex with injection drug user 4 4 114 11Sex with bisexual male 2 2 80 7Sex with person with hemophilia 0 0 4 0Sex with HIV-infected transfusion recipient 1 1 25 2Sex with HIV-infected person risk factor not specified 42 40 351 33

Receipt of blood transfusion blood components or tissue 1 1 93 9Otherrisk factor not reported or identified 46 44 279 26

Total 104 100 1078 100

American IndianAlaska NativeInjection drug use 13 32 280 42Hemophiliacoagulation disorder 0 0 3 0High-risk heterosexual contactb 15 37 277 41

Sex with injection drug user 4 10 107 16Sex with bisexual male 1 2 27 4Sex with person with hemophilia 0 0 2 0Sex with HIV-infected transfusion recipient 0 0 6 1Sex with HIV-infected person risk factor not specified 10 24 135 20

Receipt of blood transfusion blood components or tissue 1 2 17 3Otherrisk factor not reported or identified 12 29 95 14

Total 41 100 672 100

Total casesInjection drug use 1826 17 67693 35Hemophiliacoagulation disorder 11 0 348 0High-risk heterosexual contactb 4839 46 85186 44

Sex with injection drug user 706 7 26073 14Sex with bisexual male 234 2 5162 3Sex with person with hemophilia 11 0 502 0Sex with HIV-infected transfusion recipient 21 0 793 0Sex with HIV-infected person risk factor not specified 3867 37 52656 27

Receipt of blood transfusion blood components or tissue 68 1 4176 2Otherrisk factor not reported or identified 3793 36 34311 18

Total 10537c 100 191714d 100a From the beginning of the epidemic through 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 104 females of unknown race or multiple racesd Includes 1419 females of unknown race or multiple races

44 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 690 26 4260 26Hemophiliacoagulation disorder 3 0 24 0

bHigh-risk heterosexual contact 1132 42 7593 46Sex with injection drug user 205 8 1876 11Sex with bisexual male 98 4 659 4Sex with person with hemophilia 10 0 115 1Sex with HIV-infected transfusion recipient 7 0 64 0Sex with HIV-infected person risk factor not specified 812 30 4879 29

Receipt of blood transfusion blood components or tissue 12 0 146 1Otherrisk factor not reported or identified 850 32 4567 28

Total 2687 100 16590 100

Black not HispanicInjection drug use 1034 13 7105 14Hemophiliacoagulation disorder 1 0 35 0

bHigh-risk heterosexual contact 3451 44 23732 46Sex with injection drug user 313 4 3473 7Sex with bisexual male 155 2 1294 3Sex with person with hemophilia 5 0 71 0Sex with HIV-infected transfusion recipient 14 0 120 0Sex with HIV-infected person risk factor not specified 2964 38 18774 36

Receipt of blood transfusion blood components or tissue 26 0 324 1Otherrisk factor not reported or identified 3370 43 20244 39

Total 7882 100 51440 100

HispanicInjection drug use 339 15 2280 18Hemophiliacoagulation disorder 2 0 11 0

bHigh-risk heterosexual contact 1198 52 6264 50Sex with injection drug user 218 9 1324 11Sex with bisexual male 62 3 266 2Sex with person with hemophilia 1 0 11 0Sex with HIV-infected transfusion recipient 7 0 39 0Sex with HIV-infected person risk factor not specified 910 39 4624 37

Receipt of blood transfusion blood components or tissue 12 1 58 0Otherrisk factor not reported or identified 767 33 3843 31

Total 2318 100 12456 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 45

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 5: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Commentary

The HIVAIDS epidemic was first recognized in the United States in 1981 Since that time all states and US dependent areas have conducted AIDS sur-veillance by using a standardized confidential name-based reporting system Because successful treatment delays the progression of HIV infection to AIDS AIDS surveillance data alone are insufficient to moni-tor trends in HIV incidence or to meet federal state or local data needs for planning and allocating resources for HIV prevention and care programs An integrated national HIVAIDS surveillance system will enhance the ability to monitor and characterize populations affected by the HIV epidemic and provide information on the entire population of HIV-infected persons who have been tested confidentially In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confi-dential name-based public health disease surveillance systems to report cases of HIV infection California implemented confidential name-based HIV infection case surveillance in April 2006 and this issue marks the first time that HIV case reports from California have been included in the HIVAIDS Surveillance Report For more information about HIV reporting in California visit httpwwwdhscagovAIDSHIVReporting

This report presents estimated numbers of cases of HIVAIDS (cases of HIV infection regardless whether they have progressed to AIDS) from the 38 areas (33 states and 5 US dependent areas) that have had confi-dential name-based HIV infection reporting for a suf-ficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends According to the number of reported AIDS cases these 33 states repre-sent approximately 63 of the epidemic in the 50 states and the District of Columbia From 2003 through 2006 the total number of new cases of HIVAIDS remained stable in the 33 states however HIVAIDS prevalence (ie the number of persons living with HIVAIDS) increased steadily by the end of 2006 an estimated 491727 persons in the 33 states were living with HIVAIDS The map on the cover depicts the estimated rates of diagnoses of HIVAIDS in 2006 by area of residence at the time of diagnosis

for persons residing in the 33 states and 5 US depen-dent areas with confidential name-based HIV infection reporting since at least 2003

Surveillance data on HIV infections compared with data on AIDS provide a more complete picture of the epidemic and the need for prevention and care services However the number of new HIV diagnoses during a given year(s) does not necessarily reflect a trend in HIV incidence (ie new infections) because some per-sons were infected recently and others were infected at some time in the past CDC has developed the serologic testing algorithm for recent HIV seroconversion (STARHS) which can distinguish recent from long-standing HIV infections at a population level This technology has made it possible to develop a surveil-lance system that will provide more accurate and timely estimates of HIV incidence CDC and its part-ners in state and local health departments have been working during the past several years to develop and evaluate this system Five areas were funded in FY 2002 to pilot the methods by FY 2005 34 areas were funded to conduct incidence surveillance HIVAIDS surveillance data are used by CDCrsquos public health part-ners and by professionals in other federal agencies health departments nonprofit organizations and aca-demic institutions Recognizing the changing needs for data CDC is committed to presenting the data that will best meet those needs The first estimates of HIV inci-dence which require the use of complex estimation methods are expected in 2008 The monitoring of HIV incidence will be critical in evaluating progress toward CDCrsquos goal of reducing the number of new HIV infec-tions in the United States and in allocating resources and evaluating prevention program effectiveness

The 2006 HIVAIDS Surveillance Report is orga-nized in 5 sections (1) cases of HIVAIDS and AIDS (2) deaths of persons with AIDS (3) persons living with HIVAIDS AIDS or HIV infection (not AIDS) (4) length of survival after AIDS diagnosis and (5) reports of cases of HIVAIDS AIDS and HIV infec-tion (not AIDS) In Sections 1ndash3 we present point esti-mates of case counts that have been adjusted for reporting delays and for the redistribution of cases in persons initially reported without an identified risk factor CDC routinely adjusts data for the presentation

5

of trends in the epidemic Data to estimate the number of cases of HIVAIDS or AIDS the number of persons living with HIVAIDS AIDS or HIV infection (not AIDS) and the number of deaths among persons with AIDS have been statistically adjusted to correct for delays in the reporting of cases and deaths

To assess trends in cases deaths or prevalence it is preferable to use adjusted data presented by year of diagnosis instead of year of report to eliminate arti-facts of reporting in the surveillance system Therefore for trends the reader is encouraged to use the tables in Sections 1ndash3 that present trends by year of diagnosis year of death or year-end prevalence Section 4 pre-sents estimates of survival for persons whose AIDS diagnosis was made during 2002 (Table 13) and for persons whose diagnosis was made during 1998ndash2005 (Figures 2ndash4) Proportions of persons who survived for various lengths of time after diagnosis are presented by year of diagnosis age group raceethnicity and HIV transmission category

Finally Section 5 presents reports of cases of HIV infection (not AIDS) and cases of AIDS reported through 2006 The areas included in tabulations of reported cases of HIV infection (not AIDS) are based on the date that confidential name-based HIV infection reporting was implemented For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US dependent areas) to describe reports of HIV infection These data which have not been adjusted for delays in reporting are presented by year of report to CDC Tables that present cases by year of report represent the most up-to-date information reported to CDC however cases by year of report do not represent inci-dent cases the most recent diagnoses trends or deaths

HIGHLIGHTS OF ANALYSES

Cases of HIVAIDS and Cases of AIDS

Cases of HIVAIDSFrom 2003 through 2006 the estimated number of

HIVAIDS cases in the 33 states with confidential name-based HIV infection reporting remained stable (Table 1) In 2006 the estimated rate of HIVAIDS cases in the 33 states was 185 per 100000 population (Table 5b)

bull Age group From 2003 through 2006 the estimated number of newly diagnosed HIVAIDS

6 Comm

cases decreased among children (less than 13 years of age) and in the following age groups 13ndash14 30ndash34 and 35ndash39 years (Table 1) The estimated number of HIVAIDS cases remained stable among persons aged 40ndash44 years and increased among persons aged 15ndash19 20ndash24 25ndash29 45ndash49 50ndash54 55ndash59 60ndash64 and 65 years and older In 2006 the largest number of HIVAIDS cases occurred among persons aged 40ndash44 years who accounted for 16 of all HIVAIDS cases diagnosed during that year

bull Raceethnicity From 2003 through 2006 the estimated number of newly diagnosed HIVAIDS cases increased among whites and AsiansPacific Islanders remained stable among blacks and Hispanics and fluctuated among American IndiansAlaska Natives (Table 1) Blacks accounted for 49 of all HIVAIDS cases diagnosed in 2006 In 2006 rates of HIVAIDS cases were 677 per 100000 in the black population 255 per 100000 in the Hispanic population 88 per 100000 in the American IndianAlaska Native population 82 per 100000 in the white population and 67 per 100000 in the AsianPacific Islander population (Table 5b)

bull Sex From 2003 through 2006 the estimated number of HIVAIDS cases increased approximately 5 among males and decreased 6 among females (Table 1) In 2006 males accounted for 74 of all HIVAIDS cases among adults and adolescents In 2006 rates were 338 per 100000 among males and 115 per 100000 among females (Table 5b)

bull Transmission category From 2003 through 2006 the estimated number of HIVAIDS cases increased among men who have sex with men (MSM) and remained stable among adults and adolescents with HIV infection attributed to high-risk heterosexual contact (heterosexual contact with a person known to have or to be at high risk for HIV infection) (Table 1) The estimated number of HIVAIDS cases decreased among injection drug users (IDUs) MSM who were also IDUs and among children MSM (49) and persons exposed through high-risk heterosexual contact (33) accounted for 82 of all HIVAIDS cases diagnosed in 2006

entary

Of all HIV infections diagnosed in 2005 in the 33 states with confidential name-based HIV reporting 38 progressed to AIDS within 12 months after HIV infection was diagnosed AIDS was diagnosed within 12 months after the diagnosis of HIV infection for larger proportions of persons aged 13ndash14 years and 35 years and older for Hispanics for IDUs and for males with HIV infection attributed to high-risk heterosexual contact (Table 2)

Cases of AIDSFrom 2002 through 2006 the estimated number of

newly diagnosed AIDS cases in the 50 states and the District of Columbia remained stable (Table 3) In 2006 the estimated rate of AIDS cases in the United States was 123 per 100000 population (Table 5a)

bull Age group From 2002 through 2006 the estimated number of AIDS cases decreased 64 among children (less than 13 years of age) (Table 3) The estimated number of AIDS cases also decreased among persons in the age groups 30ndash34 and 35ndash39 years (Table 3) The estimated number of AIDS cases remained stable among persons aged 40ndash44 years and increased in the following age groups 13ndash14 15ndash19 20ndash24 25ndash29 45ndash49 50ndash54 55ndash59 60ndash64 and 65 years and older In 2006 the largest number of AIDS cases occurred among persons aged 40ndash44 years who accounted for 20 of all AIDS cases diagnosed during that year in the 50 states and the District of Columbia

bull Raceethnicity From 2002 through 2006 the estimated number of AIDS cases decreased among blacks and American IndiansAlaska Natives remained stable among whites and Hispanics and increased among AsiansPacific Islanders (Table 3) In 2006 rates of AIDS cases were 476 per 100000 in the black population 156 per 100000 in the Hispanic population 62 per 100000 in the American IndianAlaska Native population 54 per 100000 in the white population and 37 per 100000 in the AsianPacific Islander population (Table 5a)

bull Sex From 2002 through 2006 the estimated number of AIDS cases remained stable among both male and female adults and adolescents (Table 3) Males accounted for 73 of all AIDS cases diagnosed in 2006 for adults and adolescents in the 50 states and the District of Columbia (Table

Comm

3) Rates of AIDS cases in 2006 were 224 per 100000 among males and 78 per 100000 among females (Table 5a)

bull Transmission category From 2002 through 2006 among male adults and adolescents the estimated number of AIDS cases decreased among IDUs and MSM who were also IDUs (Table 3) The numbers of males exposed through male-to-male sexual contact and high-risk heterosexual contact remained stable Among female adults and adolescents the estimated number of AIDS cases decreased among IDUs and fluctuated among females exposed through high-risk heterosexual contact

bull Region From 2002 through 2006 the estimated number of AIDS cases decreased 10 in the West and 6 in the Northeast and remained stable in the South and the Midwest

DeathsFrom 2002 through 2006 the estimated number of

deaths of persons with AIDS who resided in the 50 states and the District of Columbia decreased 17 (Table 7)

bull Age group The estimated number of deaths decreased among children (less than 13 years of age) and in the following age groups 13ndash14 25ndash29 30ndash34 35ndash39 40ndash44 and 45ndash49 years The estimated number of deaths remained stable among persons aged 50ndash54 years and increased in the age groups 15ndash19 20ndash24 55ndash59 60ndash64 and 65 years and older

bull Raceethnicity The estimated number of deaths of persons with AIDS decreased among whites blacks and American IndiansAlaska Natives The estimated number of deaths of persons with AIDS remained stable among Hispanics and increased among AsiansPacific Islanders

bull Sex and transmission category The estimated number of deaths of adults and adolescents decreased among MSM and IDUs and remained stable among persons exposed through high-risk heterosexual contact

bull Region The estimated number of deaths decreased in all regions of the United States

entary 7

Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS

Persons living with HIVAIDSFrom 2003 through 2006 the estimated number of

persons living with HIVAIDS increased steadily in the 33 states with confidential name-based HIV infec-tion reporting (Table 8) At the end of 2006 an esti-mated 491727 persons in these states were living with HIVAIDS

bull By age group most (21) were aged 40ndash44 years

bull By raceethnicity 47 were black 34 white 17 Hispanic and less than 1 each were American IndianAlaska Native or AsianPacific Islander

bull By sex 73 of adults and adolescents living with HIVAIDS were male

bull Of the estimated 353825 male adults and adolescents living with HIVAIDS 62 had been exposed through male-to-male sexual contact 17 had been exposed through injection drug use 13 had been exposed through high-risk heterosexual contact and 7 had been exposed through both male-to-male sexual contact and injection drug use Of the estimated 131195 female adults and adolescents living with HIVAIDS 73 had been exposed through high-risk heterosexual contact and 26 had been exposed through injection drug use Of the estimated 6703 children living with HIVAIDS 92 had been exposed perinatally

Prevalence rates of HIV infection (not AIDS)At the end of 2006 in the 38 areas with confidential

name-based HIV infection reporting since at least 2003 the prevalence rate of HIV infection (not AIDS) among adults and adolescents was estimated at 1437 per 100000 (Map 1) The rate for adults and adoles-cents living with HIV infection (not AIDS) ranged from an estimated 49 per 100000 (American Samoa) to an estimated 2617 per 100000 (New York) The prevalence rate of HIV infection (not AIDS) among children residing in the 38 areas was an estimated 65 per 100000 (Map 2) The rate for children living with HIV infection (not AIDS) ranged from an estimated zero per 100000 in Idaho New Mexico American Samoa Guam and the Northern Mariana Islands to an estimated 253 per 100000 in New York

8 Comm

Persons living with AIDSAIDS prevalence also increased steadily from 2002

through 2006 (Table 10) At the end of 2006 an esti-mated 436693 persons in the 50 states and the District of Columbia were living with AIDS

bull By age group most (22) were aged 40ndash44 years

bull By raceethnicity 44 were black 35 white 19 Hispanic 1 AsianPacific Islander and less than 1 were American IndianAlaska Native

bull By sex 77 of adults and adolescents living with AIDS were male

bull Of the estimated 333244 male adults and adolescents living with AIDS 60 had been exposed through male-to-male sexual contact 19 had been exposed through injection drug use 12 had been exposed through high-risk heterosexual contact and 8 had been exposed through both male-to-male sexual contact and injection drug use Of the estimated 99671 female adults and adolescents living with AIDS 66 had been exposed through high-risk heterosexual contact and 32 had been exposed through injection drug use

bull By region 41 resided in the South 29 in the Northeast 20 in the West and 11 in the Midwest

AIDS prevalence ratesAt the end of 2006 the prevalence rate of AIDS

among adults and adolescents in the United States was estimated at 1786 per 100000 (Map 1) The rate for adults and adolescents living with AIDS ranged from an estimated 25 per 100000 (American Samoa) to an estimated 20165 per 100000 (District of Columbia) The prevalence rate of AIDS among children in the United States was estimated at 22 per 100000 at the end of 2006 (Map 2) The rate for children living with AIDS ranged from an estimated zero per 100000 in Idaho Montana Utah American Samoa Guam and the Northern Mariana Islands to an estimated 365 per 100000 in the District of Columbia

Survival after AIDS DiagnosisTable 13 is limited to data on AIDS cases diagnosed

in 2002 in order to describe the survival of persons whose diagnosis was made relatively recently but far enough in the past to permit a meaningful measure of

entary

survival Figures 2 3 and 4 illustrate the proportion of surviving persons among persons whose diagnoses were made over a longer period 1998 through 2005

bull Survival (the estimated proportion of persons surviving a given length of time after diagnosis) increased with the year of diagnosis for diagnoses made during 1998ndash2000 Year-to-year differences were small during 2001ndash2005 (Figure 2)

bull Survival decreased as age at diagnosis increased among persons at least 35 years old at diagnosis and in comparison with persons younger than 35 Survival was similar for the age groups 13ndash24 and 25ndash34 (Figure 3)

bull Survival was greatest among MSM and among children with perinatally acquired HIV infection (Table 13) Survival was intermediate among male and female adults and adolescents who had heterosexual contact with someone known to be HIV infected or at high risk for HIV infection as well as among MSM who also were IDUs Survival was lowest among male and female adults and adolescents who were IDUs

bull Survival particularly at more than 48 months after diagnosis was greater among AsiansPacific Islanders whites and Hispanics than among blacks (Figure 4) Results were unstable or inconsistent for American IndiansAlaska Natives because the numbers of persons in this racialethnic category were small

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Tables 14ndash23 describe reports of cases of HIVAIDS AIDS and HIV infection (not AIDS) Tables 16 18 20 and 22 are based on reports of cases of HIV infection (not AIDS) through 2006 from the 50 areas that had implemented name-based HIV infection reporting Note that not all cases of HIV infection (not AIDS) or AIDS reported in 2006 reflect diagnoses made during 2006 rather the reported cases include cases diagnosed during earlier years

Reports of cases of HIV infection (not AIDS)Through 2006 a total of 287954 persons were

reported as having HIV infection (not AIDS) in the 50 areas with confidential name-based HIV infection reporting (Table 16) (see Technical Notes for discus-sion of surveillance of HIV infection [not AIDS])

Comm

Five states (Florida New Jersey New York North Carolina and Texas) reported 137507 (48) of the 287954 cumulative cases of HIV infection (not AIDS) reported to CDC In 2006 4 states (California Illinois New York and Pennsylvania) reported 22417 (42) of the 52878 cases of HIV infection (not AIDS)

bull In 2006 of the 52312 reported cases among adults and adolescents 75 were in males and 25 were in females (Table 18)

bull In 2006 566 cases in children were reported

Reports of AIDS casesThrough 2006 a total of 992865 persons in the

United States had been reported as having AIDS (Table 14) Three states (California Florida and New York) reported 43 of the cumulative AIDS cases and 37 of AIDS cases reported to CDC in 2006 In the United States the rate of reported AIDS cases in 2006 was 129 per 100000 population When the US dependent areas were included the rate of reported AIDS cases ranged from zero per 100000 (American Samoa Guam and the Northern Mariana Islands) to 1467 per 100000 (District of Columbia)

bull In 2006 males accounted for 73 and females for 27 of 38916 reported AIDS cases among adults and adolescents (Table 17)

bull In 2006 86 AIDS cases in children were reported

ADDITIONAL RESOURCES

The following were prepared by using HIVAIDS surveillance data

bull Selected MMWR articles at httpwwwcdcgovhivresourcesreportsmmwr

bull Public-use slides at httpwwwcdcgovhivtopicssurveillanceresourcesslides

bull Other surveillance reports at httpwwwcdcgovhivtopicssurveillanceresourcesreports

bull Public-use version of the AIDS surveillance data set (AIDS Public Information Data Set [APIDS]) at httpwwwcdcgovhivsoftwareapidshtm

SUGGESTED READINGS

CDC Advancing HIV Prevention New Strategies for a Changing EpidemicmdashUnited States 2003 MMWR 200352(15)329ndash332

entary 9

CDC Dear colleague letter CDC recommends that all states and territories adopt confidential name-based surveillance systems to report HIV infec-tions httpwwwcdcgovhivpubs070505_dearcolleague_gerberdingpdf Pub-lished July 5 2005 Accessed March 11 2008

1981ndash2005 CDC Epidemiology of HIVAIDSmdashUnited States

MMWR 200655(21)589ndash592CDC Guidelines for national HIV case surveil-

lance including monitoring for HIV infection and AIDS MMWR 199948(RR-13)1ndash31

CDC HIV prevention strategic plan extended through 2010 httpwwwcdcgovhivresourcesreportspsp Published October 2007 Accessed March 11 2008

CDC Revised recommendations for HIV testing of adults adolescents and pregnant women in health-care settings MMWR 200655(RR-14)1ndash17

CDC Twenty-five years of HIVAIDSmdashUnited States 1981ndash2006 MMWR 200655(21)585ndash589

Glynn MK Lee LM McKenna MT The status of national HIV case surveillance United States 2006 Public Health Rep 2007122(suppl 1)63ndash71

Janssen RS Satten GA Stramer SL et al New test-ing strategy to detect early HIV-1 infection for use in incidence estimates and for clinical and prevention purposes JAMA 1998280(1)42ndash48

Lee LM McKenna MT Monitoring the incidence of HIV infection in the United States Public Health Rep 2007122(suppl 1)72ndash79

10 Comm

entary

Cases of HIVAIDS and AIDS

Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003ndash2006mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

Year of diagnosis

2003 2004 2005 2006

Data for 33 statesAge at diagnosis (yrs)lt13 211 183 169 13513ndash14 53 36 40 4115ndash19 993 993 1126 133220ndash24 3163 3368 3592 388625ndash29 4023 4057 4236 460330ndash34 5189 4820 4676 446635ndash39 6369 5807 5535 544240ndash44 5786 5429 5529 571845ndash49 4028 3877 4028 420450ndash54 2451 2401 2547 271855ndash59 1279 1363 1455 143860ndash64 655 702 692 714gt65 570 624 613 618

RaceethnicityWhite not Hispanic 10033 10181 10528 10758Black not Hispanic 17668 16718 16629 17356Hispanic 6355 6010 6217 6481AsianPacific Islander 338 339 373 397American IndianAlaska Native 179 171 182 166

Transmission categoryMale adult or adolescentMale-to-male sexual contact 15409 15880 16833 17465Injection drug use 3514 3083 2978 3016Male-to-male sexual contact and injection drug use 1349 1299 1247 1180High-risk heterosexual contacta 4269 3959 3871 4152Otherb 125 110 107 114Subtotal 24666 24331 25036 25928

Female adult or adolescentInjection drug use 2027 1856 1720 1712High-risk heterosexual contacta 7731 7182 7216 7432Otherb 134 107 97 109Subtotal 9892 9145 9033 9252

Child (lt13 yrs at diagnosis)Perinatal 190 157 147 115Otherc 23 27 23 20Subtotal 213 184 170 135

Subtotal for 33 states 34770 33659 34239 35314

Data for US dependent areas 1331 1234 1395 1503

Totald 36102 34894 35634 36817Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

Cases of HIVAIDS and AIDS 11

Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

gt12 Months after diagnosis aof HIV infection

lt12 Months after diagnosis of HIV infectionb Total

No ()c No ()c No

Data for 33 statesAge at diagnosis (yrs)lt13 148 88 21 12 16913ndash14 22 54 18 46 4015ndash19 912 81 215 19 112620ndash24 2874 80 714 20 358925ndash29 3077 73 1157 27 423430ndash34 3016 65 1655 35 467135ndash39 3353 61 2176 39 553040ndash44 3181 58 2338 42 551945ndash49 2145 53 1874 47 401950ndash54 1307 51 1239 49 254655ndash59 725 50 728 50 145360ndash64 316 46 376 54 692gt65 266 44 346 56 612RaceethnicityWhite not Hispanic 6839 65 3677 35 10516Black not Hispanic 10372 62 6242 38 16614Hispanic 3593 58 2614 42 6206AsianPacific Islander 232 62 139 38 371American IndianAlaska Native 110 61 72 39 182Transmission category

Male adult or adolescentMale-to-male sexual contact 10917 65 5902 35 16819Injection drug use 1544 52 1427 48 2971Male-to-male sexual contact and injection drug use 733 59 512 41 1245High-risk heterosexual contactd 2091 54 1773 46 3864Othere 45 42 61 58 107Subtotal 15331 61 9675 39 25006Female adult or adolescentInjection drug use 1056 62 660 38 1716High-risk heterosexual contactd 4761 66 2450 34 7210Othere 47 48 50 52 97Subtotal 5864 65 3160 35 9023Child (lt13 yrs at diagnosis)Perinatal 126 86 21 14 147Otherf 22 94 2 6 23Subtotal 148 87 22 13 170

Subtotal for 33 states 21343 62 12857 38 34200Data for US dependent areas 855 61 541 39 1395

Totalg 22197 62 13398 38 35595h

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003Data exclude 39 persons whose month of diagnosis of HIV infection is unknowna Includes persons in whom AIDS has not developedb Includes persons whose diagnoses of HIV infection and AIDS were made at the same timec Percentages represent proportions of the total number of diagnoses of HIVAIDS made during 2005 for the corresponding group (see row

entries)d Heterosexual contact with a person known to have or to be at high risk for HIV infectione Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedf Includes hemophilia blood transfusion and risk factor not reported or not identifiedg Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the

column totalh Includes 310 persons of unknown race or multiple races

12 Cases of HIVAIDS and AIDS

Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas

Year of diagnosis2002 2003 2004 2005 2006 Cumulativea

Data for 50 states and the District of ColumbiaAge at diagnosis (yrs)lt13 106 70 53 53 38 915613ndash14 62 74 70 66 73 107815ndash19 316 302 334 410 401 562620ndash24 1399 1568 1624 1675 1669 3622525ndash29 3137 3059 3196 3110 3423 11709930ndash34 5701 5521 5144 4668 4349 19753035ndash39 8217 8017 7072 6479 6402 21357340ndash44 7404 7626 7703 7378 7298 17053145ndash49 5358 5617 5498 5727 5628 10720750ndash54 3271 3364 3491 3527 3687 5990755ndash59 1607 1693 1836 1861 2071 3219060ndash64 872 864 913 872 955 17303gt65 682 763 791 727 835 15074

RaceethnicityWhite not Hispanic 11233 10948 11066 10676 10929 394024Black not Hispanic 19246 19512 18909 18081 17960 409982Hispanic 6712 7102 6771 6823 6907 161505AsianPacific Islander 425 450 444 450 519 7951American IndianAlaska Native 177 176 182 170 155 3345

Transmission categoryMale adult or adolescentMale-to-male sexual contact 15709 16078 16054 15711 16001 465965Injection drug use 5483 5275 4818 4603 4410 170171Male-to-male sexual contact and injection drug use 2075 2029 1925 1930 1803 68516High-risk heterosexual contactb 4547 4471 4506 4306 4558 65241Otherc 253 226 228 237 217 13893Subtotal 28067 28079 27532 26787 26989 783786

Female adult or adolescentInjection drug use 2897 2836 2810 2586 2385 74718High-risk heterosexual contactb 6855 7336 7113 6922 7196 108252Otherc 207 217 217 205 220 6596Subtotal 9959 10389 10141 9713 9801 189566

Child (lt13 yrs at diagnosis)Perinatal 104 70 53 52 37 8508Otherd 2 0 0 0 0 636Subtotal 106 70 53 53 38 9144

Region of residenceNortheast 10092 10342 9412 9396 9486 306241Midwest 4125 4226 4089 4371 4164 101479South 17198 17630 18225 16894 17104 374800West 6718 6339 6000 5891 6074 199978Subtotal for 50 states and the District of Columbia 38132 38538 37726 36552 36828 982498

Data for US dependent areas 1058 1060 921 955 833 31217

Totale 39250 39690 38807 37662 37852 1014797Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes persons of unknown race or multiple races and persons of unknown sex Cumulative total includes 5691 persons of unknown race or multiple

races 3 persons of unknown sex 1079 persons of unknown state of residence and 3 persons who were residents of other areas Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Cases of HIVAIDS and AIDS 13

Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002ndash2006 and cumulativemdash50 states and the District of Columbia

Year of diagnosisCumulativea2002 2003 2004 2005 2006

RaceethnicityWhite not Hispanic 14 12 7 4 4 1599Black not Hispanic 70 46 33 38 30 5654Hispanic 18 10 9 8 3 1748AsianPacific Islander 1 0 1 1 1 54American IndianAlaska Native 1 0 1 0 0 31

Transmission categoryHemophiliacoagulation disorder 0 0 0 0 0 226Mother with documented HIV infection or 1 of the following risk factors 104 70 53 52 37 8508

Injection drug use 12 8 5 3 4 3220Sex with injection drug user 4 6 3 2 1 1397Sex with bisexual male 2 0 3 1 1 209Sex with person with hemophilia 0 0 0 0 0 35Sex with HIV-infected transfusion recipient 0 0 0 0 0 22Sex with HIV-infected person risk factor not specified 36 20 20 25 13 1530Receipt of blood transfusion blood components or tissue 2 1 0 0 0 144Has HIV infection risk factor not specified 47 34 21 21 17 1951

Receipt of blood transfusion blood components or tissue 2 0 0 0 0 374Otherrisk factor not reported or identified 0 0 0 0 0 36

Totalb 106 70 53 53 38 9144

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga From the beginning of the epidemic through 2006b Includes children of unknown race or multiple races Cumulative total includes 58 children of unknown race or multiple races Because column totals

were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992ndash2006mdash50 states and the District of Columbia

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reporting

14 Cases of HIVAIDS and AIDS

Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006mdash50 states and the District of Columbia

Raceethnicity

Adults or adolescents

Children (lt13 yrs) TotalaMales Females Totala

No Rate No Rate No Rate No Rate No Rate

White not Hispanic 9267 112 1659 19 10926 64 4 00 10929 54Black not Hispanic 11540 829 6391 404 17930 603 30 04 17960 476Hispanic 5388 313 1516 95 6903 208 3 00 6907 156AsianPacific Islander 423 75 95 16 518 44 1 00 519 37American IndianAlaska Native 118 122 37 36 155 78 0 00 155 62

Totalb 26989 224 9801 78 36790 149 38 01 36828c 123

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reportingData exclude cases in persons whose state or area of residence is unknown as well as cases from US dependent areas for which census information about race and age categories is lackinga Because row totals were calculated independently of the values for the subpopulations the values in each row may not sum to the row totalb Includes person of unknown race or multiple races Because column totals were calculated independently of the values for the subpopulations the

values in each column may not sum to the column totalc Includes 358 persons of unknown race or multiple races

Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006mdash33 states with confidential name-based HIV infection reporting

Raceethnicity

Adults or adolescents

Children (lt13 yrs) TotalaMales Females Totala

No Rate No Rate No Rate No Rate No Rate

White not Hispanic 9078 167 1664 29 10742 96 16 01 10758 82Black not Hispanic 11230 1191 6033 562 17263 856 93 17 17356 677Hispanic 5058 509 1400 151 6458 337 23 04 6481 255AsianPacific Islander 318 135 79 32 397 82 0 00 397 67American IndianAlaska Native 129 177 35 46 164 110 2 06 166 88

Totalb 25928 338 9252 115 35180 224 135 04 35314c 185

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Because row totals were calculated independently of the values for the subpopulations the values in each row may not sum to the row totalb Includes persons of unknown race or multiple races Because column totals were calculated independently of the values for the subpopulations the

values in each column may not sum to the column totalc Includes 156 persons of unknown race or multiple races

Cases of HIVAIDS and AIDS 15

Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006mdashUnited States and dependent areas

Transmission category

Place of birth

United StatesCentralSouth

America Cuba Mexico Puerto Rico Totala

No No No No No No

Male-to-male sexual contact 1172 45 402 49 89 62 790 59 249 18 3337 43Injection drug use 569 22 83 10 13 9 133 10 533 40 1650 21Male-to-male sexual contact

and injection drug use 158 6 25 3 6 4 59 4 63 5 357 5High-risk heterosexual

contactb 661 25 296 36 35 24 342 26 487 36 2282 30Otherc 47 2 8 1 0 0 9 1 14 1 103 1

Totald 2608 100 814 100 145 100 1334 100 1346 100 7728 100Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Includes 222 persons whose place of birth is not among those listed and 1260 persons whose place of birth is unknownb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the

column total

16 Cases of HIVAIDS and AIDS

Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas

Year of death

Cumulativea2002 2003 2004 2005 2006

Data for 50 states and the District of ColumbiaAge at death (yrs)lt13 25 22 15 7 13 4889

13ndash14 10 6 15 12 5 276

15ndash19 39 36 36 38 44 1104

20ndash24 151 157 175 147 162 8716

25ndash29 553 512 482 458 405 43671

30ndash34 1480 1272 1128 1069 785 95351

35ndash39 2967 2763 2425 2096 1682 116746

40ndash44 3595 3516 3393 3317 2636 104133

45ndash49 3294 3234 3251 3275 2886 72831

50ndash54 2318 2373 2502 2645 2343 44255

55ndash59 1209 1322 1425 1543 1480 25123

60ndash64 616 705 741 797 771 14315

gt65 691 773 807 865 805 14393

RaceethnicityWhite not Hispanic 5214 5097 4836 4758 3860 239529

Black not Hispanic 9037 8675 8581 8679 7426 218392

Hispanic 2429 2632 2641 2513 2425 80690

AsianPacific Islander 97 84 111 87 114 3426

American IndianAlaska Native 83 73 80 65 66 1693

Transmission categoryMale adult or adolescentMale-to-male sexual contact 5960 5937 5735 5641 4930 266272

Injection drug use 3738 3547 3315 3314 2641 107173

Male-to-male sexual contact and injection drug use 1278 1299 1237 1289 1064 40993

High-risk heterosexual contactb 1465 1501 1625 1571 1470 26236

Otherc 160 149 125 117 80 9867

Subtotal 12601 12431 12038 11932 10184 450541

Female adult or adolescentInjection drug use 1923 1825 1855 1768 1456 43143

High-risk heterosexual contactb 2281 2292 2373 2458 2258 42620

Otherc 84 87 72 68 70 4131

Subtotal 4289 4204 4300 4295 3784 89895

Child (lt13 yrs at diagnosis)Perinatal 53 49 56 39 42 4848

Otherd 4 5 1 2 7 521

Subtotal 57 54 57 41 48 5369

Deaths 17

Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas (cont)

Year of death

Cumulativea2002 2003 2004 2005 2006

Region of residenceNortheast 5313 5012 4779 4750 4074 180623

Midwest 1726 1666 1482 1378 1325 54468

South 7337 7427 7535 7907 6475 197209

West 2571 2585 2600 2234 2141 113506

Subtotal for 50 states and the District of Columbia 16948 16690 16395 16268 14016 545805

Data for US dependent areas 667 575 572 562 580 19858

Totale 17628 17283 16982 16865 14627 565927f

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column totalf Includes 2082 persons of unknown race or multiple races 261 persons of unknown state of residence and 2 persons who were residents

of other areas

18 Deaths

Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003ndash2006mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

2003 2004 2005 2006Data for 33 states

Age at end of year (yrs)lt13 4154 3700 3294 286713ndash14 1130 1238 1212 113915ndash19 3298 3627 4024 453920ndash24 12389 12826 13411 1430125ndash29 26167 26924 28164 2960030ndash34 49602 47577 45109 4418935ndash39 80703 77871 75842 7363440ndash44 92040 97109 100102 10176445ndash49 71345 77490 83816 9028350ndash54 45133 51033 56640 6319555ndash59 22793 26610 31186 3600860ndash64 10820 12642 14422 16658gt65 8531 9959 11657 13551

RaceethnicityWhite not Hispanic 145081 151694 158375 166000Black not Hispanic 202951 212425 221439 231957Hispanic 72612 76503 80491 84720AsianPacific Islander 2234 2529 2858 3187American IndianAlaska Native 1788 1889 2008 2119

Transmission categoryMale adult or adolescentMale-to-male sexual contact 181771 193245 205423 218676Injection drug use 57651 58149 58369 59077Male-to-male sexual contact and injection drug use 23965 24434 24725 25085High-risk heterosexual contacta 40084 42559 44915 47562Otherb 3218 3278 3325 3424Subtotal 306689 321665 336756 353825

Female adult or adolescentInjection drug use 32346 32735 32973 33470High-risk heterosexual contacta 80324 85348 90185 95403Otherb 2036 2123 2212 2321Subtotal 114705 120206 125370 131195

Child (lt13 yrs at diagnosis)Perinatal 6137 6154 6178 6143Otherc 570 575 571 560Subtotal 6707 6730 6748 6703

Subtotal for 33 states 428107 448605 468879 491727Data for US dependent areas 15809 16399 17150 17955

Totald 443916 465005 486028 509681Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 19

Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission categorymdash33 states with confidential name-based HIV infection reporting

Transmission category

White not Hispanic

Black not Hispanic Hispanic

AsianPacific Islander

American IndianAlaska

Native Totala

No No No No No No

Male adult or adolescentMale-to-male sexual contact 108259 77 70242 49 36043 57 1669 68 938 62 218676 62Injection drug use 12328 9 31339 22 14472 23 264 11 216 14 59077 17Male-to-male sexual contact

and injection drug use 11283 8 9587 7 3720 6 93 4 205 13 25085 7High-risk heterosexual contactb 6667 5 31140 22 8788 14 395 16 143 9 47562 13Otherc 1458 1 1492 1 404 1 30 1 17 1 3424 1Subtotal 139994 100 143799 100 63427 100 2450 100 1519 100 353825 100

Female adult or adolescentInjection drug use 8262 33 19136 23 5528 28 106 15 175 30 33470 26High-risk heterosexual contactb 16338 65 63204 75 14132 71 573 82 392 68 95403 73Otherc 450 2 1469 2 344 2 24 3 12 2 2321 2Subtotal 25050 100 83809 100 20004 100 703 100 578 100 131195 100

Child (lt13 yrs at diagnosis)Perinatal 801 84 4064 93 1183 92 28 82 20 95 6143 92Otherd 154 16 283 7 107 8 6 18 1 5 560 8Subtotal 955 100 4347 100 1290 100 34 100 21 100 6703 100

Totale 166000 231957 84720 3187 2119 491727Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of 33 states that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Includes 3745 persons of unknown race or multiple racesb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes 5 persons of unknown sex Because column totals were calculated independently of the values for the subpopulations the values

in each column may not sum to the column total

20 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Map 1 Estimated rates (per 100000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

Note Rates adjusted for reporting delays Rates of HIV infection include only persons living with HIV infection that has not progressed to AIDSSince 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 Islandsa Includes persons whose area of residence is unknown

Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

Note Rates adjusted for reporting delays Rates of HIV infection include only persons living with HIV infection that has not progressed to AIDSSince 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 Islandsa Includes persons whose area of residence is unknown

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 21

Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002ndash2006mdashUnited States and dependent areas

2002 2003 2004 2005 2006Data for 50 states and the District of Columbia

Age at end of year (yrs)lt13 2308 2006 1684 1394 111513ndash14 685 747 784 762 71115ndash19 1465 1694 1974 2243 248720ndash24 3910 4292 4629 5033 536725ndash29 12725 12743 13045 13505 1435930ndash34 35558 33870 32057 29949 2882435ndash39 70107 68106 65076 62235 5964940ndash44 80377 86294 91335 94021 9517445ndash49 64702 71276 77417 84153 9077550ndash54 41270 46855 53333 59256 6647655ndash59 20113 24145 28356 33522 3901460ndash64 9681 11293 13305 15380 18072gt65 7520 8946 10604 12430 14669

RaceethnicityWhite not Hispanic 129426 135278 141508 147426 154495Black not Hispanic 150488 161326 171654 181056 191590Hispanic 63424 67895 72024 76334 80815AsianPacific Islander 3060 3426 3759 4121 4526American IndianAlaska Native 1254 1356 1458 1562 1651

Transmission categoryMale adult or adolescentMale-to-male sexual contact 158092 168233 178551 188622 199693Injection drug use 56708 58436 59940 61229 62998Male-to-male sexual contact and injection drug use 24726 25457 26144 26785 27523High-risk heterosexual contacta 27329 30300 33181 35916 39004Otherb 3588 3665 3769 3888 4026Subtotal 270444 286091 301585 316440 333244

Female adult or adolescentInjection drug use 27863 28874 29828 30646 31575High-risk heterosexual contacta 46445 51489 56229 60693 65631Otherb 1903 2033 2178 2315 2465Subtotal 76210 82395 88236 93653 99671

Child (lt13 yrs at diagnosis)Perinatal 3633 3654 3651 3664 3660Otherc 129 124 123 122 115Subtotal 3762 3778 3774 3786 3775

Region of residenceNortheast 105599 110929 115562 120208 125620Midwest 36011 38571 41178 44171 47010South 137081 147284 157975 166962 177591West 71729 75483 78883 82540 86473

Subtotal for 50 states and the District of Columbia 350419 372267 393598 413882 436693

Data for US dependent areas 9880 10365 10713 11106 11359

Totald 360617 383024 404849 425646 448871Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

22 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission categorymdash50 states and the District of Columbia

Transmission category

White not Hispanic

Black not Hispanic Hispanic

AsianPacific Islander

American IndianAlaska

Native Totala

No No No No No No

Male adult or adolescentMale-to-male sexual contact 101299 75 57520 45 36087 57 2715 72 704 57 199693 60Injection drug use 13168 10 33911 27 14795 23 325 9 201 16 62998 19Male-to-male sexual contact and

injection drug use 12393 9 10121 8 4352 7 198 5 220 18 27523 8High-risk heterosexual contactb 6081 5 24205 19 7816 12 444 12 105 8 39004 12Otherc 1743 1 1602 1 574 1 69 2 16 1 4026 1Subtotal 134683 100 127359 100 63623 100 3752 100 1246 100 333244 100

Female adult or adolescentInjection drug use 7407 38 18531 30 5025 30 115 15 153 39 31575 32High-risk heterosexual contactb 11350 59 41741 68 11092 67 588 78 227 58 65631 66Otherc 508 3 1456 2 413 2 51 7 13 3 2465 2Subtotal 19264 100 61728 100 16531 100 753 100 393 100 99671 100

Child (lt13 yrs at diagnosis)Perinatal 500 92 2468 99 629 95 20 94 12 100 3660 97Otherd 46 8 34 1 33 5 1 6 0 0 115 3Subtotal 546 100 2503 100 662 100 21 100 12 100 3775 100

Totale 154495 191590 80815 4526 1651 436693

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Includes 3616 persons of unknown race or multiple racesb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes 3 person of unknown sex Because column totals were calculated independently of the values for the subpopulations the values in each column

may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 23

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by

area of residence and age categorymdashUnited States and dependent areas

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

Alabama 5469 17 5486 3744 11 3755Alaska 272 1 273 330 1 331Arizona 5744 49 5793 4922 7 4929Arkansas 2291 7 2298 2139 6 2145California mdash mdash mdash 61451 105 61555Colorado 5855 13 5869 4083 2 4085Connecticut mdash mdash mdash 7406 15 7421Delaware mdash mdash mdash 1753 7 1760District of Columbia mdash mdash mdash 10059 30 10089Floridab 35461 263 35723 46469 194 46663Georgia mdash mdash mdash 17336 47 17383Hawaii mdash mdash mdash 1234 3 1237Idaho 356 0 356 313 0 313Illinois mdash mdash mdash 16139 46 16185Indiana 3849 21 3870 3996 14 4010Iowa 588 2 590 869 3 872Kansas 1230 7 1237 1272 2 1274Kentucky mdash mdash mdash 2589 13 2602Louisiana 7361 101 7462 8052 21 8074Maine mdash mdash mdash 512 2 514Maryland mdash mdash mdash 14540 41 14581Massachusetts mdash mdash mdash 8806 20 8826Michigan 6118 55 6173 6615 12 6627Minnesota 3227 21 3248 2314 9 2323Mississippi 4200 32 4232 3155 13 3168Missouri 4999 33 5033 5479 7 5486Montana mdash mdash mdash 205 0 205Nebraska 688 12 700 771 2 773Nevada 3402 13 3415 2969 3 2972New Hampshire mdash mdash mdash 556 3 559New Jersey 16059 153 16212 17168 57 17226New Mexico 910 0 909 1252 3 1255New York 42220 801 43021 70697 148 70845North Carolina 11700 60 11760 8451 12 8463North Dakota 87 2 89 73 1 74Ohio 8266 57 8323 7054 30 7084Oklahoma 2191 17 2208 2191 3 2194Oregon mdash mdash mdash 2840 4 2844Pennsylvania mdash mdash mdash 18633 71 18703Rhode Island mdash mdash mdash 1296 7 1303South Carolina 6349 45 6394 7035 23 7058South Dakota 195 4 199 139 1 140Tennessee 6579 51 6631 6403 11 6414Texas 24741 262 25003 34010 53 34063Utah 893 10 903 1164 0 1164Vermont mdash mdash mdash 238 2 240Virginia 9937 41 9978 8423 24 8447Washington mdash mdash mdash 5471 5 5476West Virginia 660 5 665 749 5 754Wisconsin 2322 15 2337 2153 12 2165Wyoming 86 2 88 102 1 103

Subtotal 224303 2174 226477 435621 1115 436736

24 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age categorymdashUnited States and dependent areas (cont)

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

US dependent areasAmerican Samoa 2 0 2 1 0 1Guam 63 0 63 36 0 36Northern Mariana Islands 7 0 7 3 0 3Puerto Rico 6269 31 6300 10971 26 10997US Virgin Islands 228 2 230 312 2 314Otherc mdash mdash mdash 1 0 1

Totald 230872 2207 233079 447724 1147 448871

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reporting a See Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at

least 2003b Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterc Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasd Total number of persons living with HIV infection (not AIDS) includes persons reported from areas with confidential name-based HIV

infection reporting who were residents of other states or whose area of residence is unknown Total number of persons living with AIDS includes persons whose area of residence is unknown Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 25

Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristicsmdashUnited States and dependent areas

No of persons

Survival in months

gt12 gt24 gt36Data for 50 states and the District of Columbia

Age at diagnosis (yrs)lt13 101 096 094 09413ndash14 60 098 098 09515ndash19 305 098 096 09520ndash24 1351 096 093 09225ndash29 3034 095 092 09130ndash34 5499 094 091 08935ndash39 7888 093 090 08740ndash44 7085 092 088 08545ndash49 5090 089 085 08250ndash54 3067 086 081 07855ndash59 1505 083 078 07460ndash64 806 080 073 069gt65 614 073 068 065

RaceethnicityWhite not Hispanic 10706 092 089 087Black not Hispanic 18406 090 086 082Hispanic 6398 092 090 088AsianPacific Islander 404 094 092 090American IndianAlaska Native 167 084 081 075

Transmission categoryMale adult or adolescentMale-to-male sexual contact 12830 093 090 088Injection drug use 4048 089 084 081Male-to-male sexual contact and injection drug use 1701 093 089 086High-risk heterosexual contacta 3170 091 088 085Otherb 5019 086 083 080Subtotal 26768 091 088 085

Female adult or adolescentInjection drug use 2101 089 083 078High-risk heterosexual contacta 4686 093 089 086Otherb 2749 090 085 083Subtotal 9536 091 087 083

Child (lt13 yrs at diagnosis)Perinatal 98 096 095 095Otherc 3 100 067 067Subtotal 101 096 094 094

Subtotal for 50 states and the District of Columbia 36405 091 087 085

Data for US dependent areas 891 083 078 075

Total 37352d 091 087 084Note Excludes persons whose date of death was before or in the same month as date of diagnosis Excludes persons whose month of diagnosis or month of death is unknowna Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes 325 persons of unknown race or multiple races

26 Survival after AIDS Diagnosis

Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by year of diagnosismdashUnited States and dependent areas

Months after AIDS diagnosis

Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by age groupmdashUnited States and dependent areas

Months after AIDS diagnosis

Survival after AIDS Diagnosis 27

Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by raceethnicitymdashUnited States and dependent areas

Months after AIDS diagnosis

28 Survival after AIDS Diagnosis

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006

and cumulativemdashUnited States and dependent areas

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Alabama 510 112 462 100 8626 76 8702Alaska 24 36 38 57 648 7 655Arizona 626 105 539 87 10396 46 10442Arkansas 237 85 252 90 3891 36 3927California 4069 113 3960 109 142254 664 142918Colorado 351 75 322 68 8742 31 8773Connecticut 658 188 422 120 14716 183 14899Delaware 177 210 116 136 3547 26 3573District of Columbia 672 1155 853 1467 17372 189 17561Florida 4921 277 4932 273 104084 1530 105614Georgia 2325 255 1605 171 31734 231 31965Hawaii 105 82 93 72 2927 17 2944Idaho 24 17 26 18 604 2 606Illinois 1886 148 1382 108 33620 282 33902Indiana 407 65 346 55 8239 56 8295Iowa 93 31 86 29 1727 13 1740Kansas 105 38 120 43 2781 14 2795Kentucky 249 60 207 49 4600 32 4632Louisiana 936 208 824 192 17612 128 17740Maine 21 16 68 51 1110 8 1118Maryland 1558 279 1626 290 30252 319 30571Massachusetts 666 104 533 83 19181 214 19395Michigan 821 81 672 67 14941 113 15054Minnesota 226 44 212 41 4817 28 4845Mississippi 368 127 365 125 6642 56 6698Missouri 385 66 469 80 11016 61 11077Montana 21 22 7 07 373 3 376Nebraska 53 30 118 67 1479 11 1490Nevada 293 121 294 118 5733 29 5762New Hampshire 33 25 55 42 1074 10 1084New Jersey 1262 145 1065 122 48750 778 49528New Mexico 134 70 93 48 2603 7 2610New York 6201 321 5495 285 174908 2354 177262North Carolina 916 106 1229 139 15954 118 16072North Dakota 10 16 6 09 144 1 145Ohio 753 66 767 67 14957 138 15095Oklahoma 281 79 205 57 4836 26 4862Oregon 217 60 281 76 5995 20 6015Pennsylvania 1486 120 1893 152 33417 365 33782Rhode Island 87 81 111 104 2580 28 2608South Carolina 682 161 705 163 13301 105 13406South Dakota 18 23 18 23 255 5 260Tennessee 818 137 680 113 12457 59 12516Texas 3045 133 2998 128 69735 392 70127Utah 63 25 57 22 2295 20 2315Vermont 5 08 18 29 461 6 467Virginia 638 84 605 79 16802 177 16979Washington 485 77 389 61 11792 34 11826West Virginia 74 41 67 37 1500 11 1511Wisconsin 122 22 217 39 4513 33 4546Wyoming 6 12 8 16 228 2 230

Subtotal 40123 135 37911 127 952221 9094 961315

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 29

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulativemdashUnited States and dependent areas (cont)

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

US dependent areasAmerican Samoa 0 0 0 0 1 0 1Guam 0 0 0 0 68 1 69Northern Mariana Islands 0 0 0 0 3 0 3Puerto Rico 1029 263 850 216 29511 400 29911US Virgin Islands 17 156 32 295 629 18 647Otherb 0 0 0 0 3 0 3

Totalc 41357 138 39002 129 983343 9522 992865d

a From the beginning of the epidemic through 2006b Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasc Includes persons whose state or area of residence is unknownd Includes 916 persons whose state or area of residence is unknown

30 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

MSA (population gt 500000)

Akron Ohio 66 94 32 46 762 1 763

AlbanyndashSchenectadyndashTroy NY 97 114 105 123 2253 24 2277

Albuquerque N Mex 70 88 50 61 1404 2 1406

AllentownndashBethlehemndashEaston PandashNJ 72 91 119 149 1352 17 1369

AtlantandashSandy SpringsndashMarietta Ga 1586 319 1006 196 21896 128 22024

AugustandashRichmond County GandashSC 106 205 32 61 1851 24 1875

AustinndashRound Rock Tex 227 156 186 123 4830 26 4856

Bakersfield Calif 76 100 122 156 1528 8 1536

BaltimorendashTowson Md 1064 401 1001 377 20352 218 20570

Baton Rouge La 222 304 231 301 3732 20 3752

BirminghamndashHoover Ala 151 139 110 100 2614 25 2639

Boise CityndashNampa Idaho 14 26 14 25 281 0 281

Boston MassndashNHa 441 99 355 80 13476 147 13623

Boston Division 269 146 185 101 8451 91 8542

Cambridge Division 108 74 102 70 3126 35 3161

Essex Division 52 71 51 69 1577 20 1597

BridgeportndashStamfordndashNorwalk Conn 181 201 135 150 3733 57 3790

BuffalondashNiagara Falls NY 117 102 96 84 2476 20 2496

Cape CoralndashFort Myers Fla 44 81 91 159 1692 24 1716

CharlestonndashNorth Charleston SC 92 155 91 151 2034 18 2052

CharlottendashGastoniandashConcord NCndashSC 214 141 285 180 3242 22 3264

Chicago IllndashIndndashWis 1716 182 1159 122 30118 261 30379

Chicago Division 1604 203 1073 135 28300 248 28548

Gary Division 61 88 50 71 1038 8 1046

Lake Division 51 59 36 41 780 5 785

CincinnatindashMiddletown OhiondashKyndashInd 111 53 199 95 2735 17 2752

ClevelandndashElyriandashMentor Ohio 228 107 170 80 4226 48 4274

Colorado Springs Colo 19 32 21 35 576 5 581

Columbia SC 177 256 197 280 3274 24 3298

Columbus Ohio 166 97 165 96 3112 15 3127

Dallas Tex 874 150 929 155 20238 63 20301

Dallas Division 681 175 714 178 16038 37 16075

Fort Worth Division 193 100 215 108 4200 26 4226

Dayton Ohio 58 69 54 64 1217 15 1232

DenverndashAurora Colo 274 116 236 98 6899 22 6921

Des Moines Iowa 30 57 23 43 530 4 534

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 31

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Detroit Mich 570 127 445 100 10373 73 10446

Detroit Division 443 223 330 167 8268 57 8325

Warren Division 127 51 115 46 2105 16 2121

El Paso Tex 56 78 40 54 1476 10 1486

Fresno Calif 52 59 64 72 1430 11 1441

Grand RapidsndashWyoming Mich 46 60 51 66 816 6 822

GreensborondashHigh Point NC 52 77 66 96 1265 14 1279

Greenville SC 70 119 67 111 1292 4 1296

HarrisburgndashCarlisle Pa 23 44 67 128 1224 8 1232

HartfordndashWest HartfordndashEast Hartford Conn 256 216 135 114 5126 46 5172

Honolulu Hawaii 54 60 69 76 2121 14 2135

HoustonndashBaytownndashSugar Land Tex 1017 190 1092 197 25821 172 25993

Indianapolis Ind 191 116 150 90 3824 25 3849

Jackson Miss 134 257 117 221 2419 30 2449

Jacksonville Fla 309 248 315 246 6020 75 6095

Kansas City MondashKans 183 94 160 81 4669 15 4684

Knoxville Tenn 47 72 35 52 882 5 887

Lakeland Fla 103 190 112 199 1811 21 1832

Las VegasndashParadise Nev 245 143 258 145 4616 28 4644

Little RockndashNorth Little Rock Ark 87 135 75 115 1383 14 1397

Los Angeles Calif 1529 118 1684 130 57953 293 58246

Los Angeles Division 1339 135 1435 144 51098 250 51348

Santa Anna Division 190 63 249 83 6855 43 6898

Louisville KyndashInd 123 102 97 79 2286 22 2308

Madison Wis 10 19 29 53 520 4 524

McAllenndashEdinburgndashPharr Tex 57 84 45 64 630 11 641

Memphis TennndashMissndashArk 402 320 346 271 5128 19 5147

Miami Fla 2420 446 2289 419 55807 997 56804

Fort Lauderdale Division 810 455 769 430 16412 262 16674

Miami Division 1243 523 1165 485 29703 512 30215

West Palm Beach Division 367 290 355 279 9692 223 9915

MilwaukeendashWaukeshandashWest Allis Wis 68 45 109 72 2507 18 2525

MinneapolisndashSt PaulndashBloomington MinnndashWis 186 59 184 58 4259 22 4281

Modesto Calif 36 71 22 43 671 6 677

NashvillendashDavidsonndashMurfreesboro Tenn 224 158 172 118 3848 20 3868

New HavenndashMilford Conn 169 200 107 127 4573 73 4646

New OrleansndashMetairiendashKenner La 393 299 271 264 8835 67 8902

32 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

New York NYndashNJndashPa 6215 330 5500 292 195177 2906 198083

Edison Division 191 83 130 56 6709 139 6848

Nassau Division 262 93 246 88 8141 110 8251

New York Division 5266 456 4716 408 160408 2323 162731

Newark Division 496 231 408 190 19919 334 20253

Oklahoma City Okla 125 108 88 75 2255 5 2260

OmahandashCouncil Bluffs NebndashIowa 37 46 80 97 1035 3 1038

Orlando Fla 544 282 517 260 8653 92 8745

OxnardndashThousand OaksndashVentura Calif 49 62 21 26 1008 3 1011

Palm BayndashMelbournendashTitusville Fla 68 129 61 114 1512 11 1523

Philadelphia PandashNJndashDelndashMd 1261 217 1348 231 28221 313 28534

Camden Division 108 87 111 89 3118 42 3160

Philadelphia Division 1022 263 1144 294 22112 250 22362

Wilmington Division 131 191 93 134 2991 21 3012

PhoenixndashMesandashScottsdale Ariz 460 119 376 93 7459 31 7490

Pittsburgh Pa 143 60 135 57 3182 19 3201

PortlandndashSouth Portland Maine 9 18 34 66 562 1 563

PortlandndashVancouverndashBeaverton OrendashWash 170 81 215 101 4825 10 4835

PoughkeepsiendashNewburghndashMiddletown NY 136 204 113 168 3162 24 3186

ProvidencendashNew BedfordndashFall River RIndashMass 132 82 155 96 3900 44 3944

RaleighndashCary NC 138 145 201 202 1987 13 2000

Richmond Va 119 101 122 102 3371 35 3406

RiversidendashSan BernardinondashOntario Calif 361 92 306 76 8568 60 8628

Rochester NY 165 159 124 120 3134 13 3147

SacramentondashArden-ArcadendashRoseville Calif 154 75 169 82 4000 26 4026

St Louis MondashIll 192 69 366 131 5965 40 6005

Salt Lake City Utah 46 44 40 37 1743 10 1753

San Antonio Tex 215 114 247 127 4987 30 5017

San DiegondashCarlsbadndashSan Marcos Calif 491 167 384 131 12934 61 12995

San Francisco Calif 867 209 690 165 40152 96 40248

Oakland Division 312 126 246 99 9546 48 9594

San Francisco Division 555 329 444 261 30606 48 30654

San JosendashSunnyvalendashSanta Clara Calif 88 50 145 81 3747 15 3762

San JuanndashCaguasndashGuaynabo PR 745 289 578 223 21402 277 21679

SarasotandashBradentonndashVenice Fla 82 122 104 152 1978 27 2005

ScrantonndashWilkes-Barre Pa 27 49 47 85 572 6 578

Seattle Wash 353 110 280 86 9172 27 9199

Seattle Division 316 129 255 102 8161 18 8179

Tacoma Division 37 49 25 33 1011 9 1020

Springfield Mass 88 128 45 66 2075 26 2101

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 33

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Stockton Calif 52 78 52 77 1076 15 1091

Syracuse NY 52 80 49 75 1317 8 1325

TampandashSt PetersburgndashClearwater Fla 559 211 605 224 11174 112 11286

Toledo Ohio 25 38 66 101 812 14 826

Tucson Ariz 103 111 100 106 2010 10 2020

Tulsa Okla 83 94 65 72 1494 10 1504

Virginia BeachndashNorfolkndashNewport News VandashNC 183 111 132 80 4711 63 4774

Washington DCndashVandashMdndashWV 1322 252 1684 318 31130 315 31445

Bethesda Division 135 118 173 150 2774 23 2797

Washington Division 1187 289 1511 365 28356 292 28648

Wichita Kans 35 60 38 64 851 2 853

Worcester Mass 76 97 79 101 1783 20 1803

YoungstownndashWarrenndashBoardman OhiondashPa 27 46 26 44 519 0 519

Subtotal for MSAs (population gt500000) 33602 173 31274 159 829633 8171 837804

Metropolitan areas (population of 50000 to 499999) 4477 80 4466 79 94829 847 95676

Nonmetropolitan areas 2666 54 2732 55 52063 445 52508

Totalb 41144 137 38749 128 981708 9494 991202

Note Because of the lack of census information for all US dependent areas includes data for only the 50 states the District of Columbia and Puerto RicoMSA metropolitan statistical areaMSA definitions for this report can be found at httpwwwcensusgovpopulationwwwestimatesmetrodefhtmla Reported case counts for the metropolitan divisions do not sum to the MSA total MSA total includes data from 1 metropolitan division with

population of lt500000b Includes persons whose county of residence is unknown

34 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Alabama (January 1988) 502 6041 48 6089

Alaska (February 1999) 38 285 2 287

Arizona (January 1987) 617 5877 80 5957

Arkansas (July 1989) 206 2349 20 2369

California (April 2006) 6581 7056 92 7148

Colorado (November 1985) 319 6084 31 6115

Connecticut (January 2005)b 826 2500 101 2601

Delaware (February 2006) 788 801 18 819

Florida (July 1997)c 4163 36386 397 36783

Georgia (December 2003) 2245 8197 194 8391

Idaho (June 1986) 35 340 4 344

Illinois (January 2006) 6241 6661 162 6823

Indiana (July 1988) 399 4027 43 4070

Iowa (July 1998) 69 586 5 591

Kansas (July 1999) 142 1225 15 1240

Kentucky (October 2004) 333 1303 13 1316

Louisiana (February 1993) 728 8149 166 8315

Maine (January 2006) 386 393 3 396

Michigan (April 1992) 635 6702 134 6836

Minnesota (October 1985) 309 3356 40 3396

Mississippi (August 1988) 352 4549 59 4608

Missouri (October 1987) 502 5086 55 5141

Nebraska (September 1995) 91 672 14 686

Nevada (February 1992) 339 3532 24 3556

New Hampshire (January 2005) 59 466 9 475

New Jersey (January 1992) 1477 17513 325 17838

New Mexico (January 1998) 114 949 4 953

New York (June 2000) 5326 42345 1820 44165

North Carolina (February 1990) 1615 13879 143 14022

North Dakota (January 1988) 4 82 1 83

Ohio (June 1990) 867 8222 101 8323

Oklahoma (June 1988) 229 2401 30 2431

Oregon (April 2006) 49 95 19 114

Pennsylvania (October 2002)d 4269 9537 179 9716

Rhode Island (July 2006) 14 21 0 21

South Carolina (February 1986) 493 6970 93 7063

South Dakota (January 1988) 18 215 6 221

Tennessee (January 1992) 732 7115 90 7205

Texas (January 1999)e 3370 24282 417 24699

Utah (April 1989) 106 893 14 907

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 35

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Virginia (July 1989) 864 10257 95 10352

Washington (March 2006) 4048 4157 40 4197

West Virginia (January 1989) 66 673 8 681

Wisconsin (November 1985) 261 2500 31 2531

Wyoming (June 1989) 7 93 1 94

Subtotal 50834 274822 5146 279968

US dependent areas

American Samoa (August 2001) 0 1 0 1

Guam (March 2000) 2 66 0 66

Northern Mariana Islands (October 2001) 2 7 0 7

Puerto Rico (January 2003) 1471 5610 91 5701

US Virgin Islands (December 1998) 22 247 6 253

Persons reported from areas with confidential name-based HIV infection reporting but who were residents of other areas 132 685 21 706

Totalf 52878 282640 5314 287954

Note Includes data from 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through 2006b Beginning in 1992 Connecticut had name-based HIV reporting for cases in children only From January 2002 through December 2004

Connecticut had name- or code-based HIV reporting for cases in adolescents and adults As of January 2005 Connecticut has name-based reporting of all cases of HIV infection

c Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterd On October 18 2002 Pennsylvania initiated confidential name-based HIV infection reporting in all areas except Philadelphia Code-based

reporting was implemented in Philadelphia in March 2004 and the switch to name-based reporting was made in October 2005e From February 1994 through December 1998 Texas reported HIV infection in children onlyf Includes 1252 persons reported from areas with confidential name-based HIV infection reporting but whose area of residence is unknown

36 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulativemdashUnited States and dependent areas

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No Adult or adolescentMale-to-male sexual contact 13775 49 429897 54 mdash mdash mdash mdash 13775 35 429897 44Injection drug use 3413 12 163070 21 1826 17 67693 35 5239 13 230763 23Male-to-male sexual contact and

injection drug use 1603 6 65524 8 mdash mdash mdash mdash 1603 4 65524 7Hemophiliacoagulation disorder 43 0 5176 1 11 0 348 0 54 0 5524 1High-risk heterosexual contactc 2997 11 49610 6 4839 46 85186 44 7836 20 134796 14

Sex with injection drug user 330 1 11683 1 706 7 26073 14 1036 3 37756 4Sex with bisexual male mdash mdash mdash mdash 234 2 5162 3 234 1 5162 1Sex with person with hemophilia 1 0 84 0 11 0 502 0 12 0 586 0Sex with HIV-infected transfusion

recipient 22 0 553 0 21 0 793 0 43 0 1346 0Sex with HIV-infected person risk

factor not specified 2644 9 37290 5 3867 37 52656 27 6511 17 89946 9Receipt of blood transfusion blood

d components or tissue 63 0 5213 1 68 1 4176 2 131 0 9389 1Otherrisk factor not reported or

identifiede 6484 23 73136 9 3793 36 34311 18 10278 26 107450 11Subtotal 28378 100 791626 100 10537 100 191714 100 38916 100 983343 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 0 0 222 5 0 0 7 0 0 0 229 2Mother with documented HIV infection or

1 of the following risk factors 24 75 4315 89 50 93 4423 95 74 86 8738 92Injection drug use 4 13 1676 35 4 7 1665 36 8 9 3341 35Sex with injection drug user 4 13 789 16 4 7 750 16 8 9 1539 16Sex with bisexual male 1 3 101 2 2 4 110 2 3 3 211 2Sex with person with hemophilia 0 0 20 0 0 0 16 0 0 0 36 0Sex with HIV-infected transfusion

recipient 0 0 11 0 0 0 15 0 0 0 26 0Sex with HIV-infected person risk

factor not specified 6 19 742 15 17 31 790 17 23 27 1532 16Receipt of blood transfusion blood

components or tissue 0 0 70 1 0 0 82 2 0 0 152 2Has HIV infection risk factor not

specified 9 28 906 19 23 43 995 21 32 37 1901 20Receipt of blood transfusion blood

fcomponents or tissue 1 3 243 5 0 0 144 3 1 1 387 4Otherrisk factor not reported or

identifiedg 7 22 75 2 4 7 93 2 11 13 168 2Subtotal 32 100 4855 100 54 100 4667 100 86 100 9522 100

Total 28410 100 796481 100 10591 100 196381 100 39002 100 992865 100a From the beginning of the epidemic through 2006b From the beginning of the epidemic through 2006 Includes 3 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infectiond AIDS developed in 47 adultsadolescents after they received blood that had tested negative for HIV antibodies AIDS developed in 14 additional adults

after they received tissue organs or artificial insemination from HIV-infected donors Four of the 14 received tissue or organs from a donor who was negative for HIV antibody at the time of donation

e Includes 37 adultsadolescents who were exposed to HIV-infected blood body fluids or concentrated virus in health care laboratory or household settings as supported by seroconversion epidemiologic andor laboratory evidence One person was infected after intentional inoculation with HIV-infected blood Includes an additional 740 persons who acquired HIV infection perinatally but who were more than 12 years of age when AIDS was diagnosed These 740 persons are not counted in the values for the pediatric transmission category

f AIDS developed in 3 children after they received blood that had tested negative for HIV antibodiesg Includes 5 children who were exposed to HIV-infected blood as supported by seroconversion epidemiologic andor laboratory evidence 1 child was

infected after intentional inoculation with HIV-infected blood and 5 children were exposed to HIV-infected blood in a household setting Of the 168 children 26 had sexual contact with an adult with or at high risk for HIV infection

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 37

Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No

Adult or adolescentMale-to-male sexual contact 22912 59 103679 52 mdash mdash mdash mdash 22912 44 103679 37

Injection drug use 3503 9 24255 12 2124 16 13925 17 5627 11 38181 14

Male-to-male sexual contact and injection drug use 1946 5 10704 5 mdash mdash mdash mdash 1946 4 10704 4

Hemophiliacoagulation disorder 43 0 495 0 6 0 73 0 49 0 568 0

High-risk heterosexual contactc 2874 7 16830 8 5939 45 38315 47 8813 17 55145 20

Sex with injection drug user 308 1 2601 1 757 6 6791 8 1065 2 9392 3

Sex with bisexual male mdash mdash mdash mdash 328 2 2265 3 328 1 2265 1

Sex with person with hemophilia 4 0 31 0 16 0 201 0 20 0 232 0

Sex with HIV-infected transfusion recipient 13 0 131 0 28 0 223 0 41 0 354 0

Sex with HIV-infected person risk factor not specified 2549 7 14067 7 4810 36 28835 35 7359 14 42902 15

Receipt of blood transfusion blood components or tissue 61 0 489 0 50 0 536 1 111 0 1025 0

Otherrisk factor not reported or identified 7748 20 44021 22 5106 39 29312 36 12854 25 73338 26

Subtotal 39087 100 200473 100 13225 100 82161 100 52312 100 282640 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 8 3 106 4 0 0 1 0 8 1 107 2

Mother with documented HIV infection or 1 of the following risk factors 197 74 2195 85 254 85 2417 89 451 80 4612 87

Injection drug use 34 13 532 21 53 18 561 21 87 15 1093 21

Sex with injection drug user 12 5 208 8 21 7 213 8 33 6 421 8

Sex with bisexual male 5 2 37 1 4 1 32 1 9 2 69 1

Sex with person with hemophilia 0 0 3 0 1 0 7 0 1 0 10 0

Sex with HIV-infected transfusion recipient 0 0 4 0 0 0 4 0 0 0 8 0

Sex with HIV-infected person risk factor not specified 54 20 534 21 76 25 629 23 130 23 1163 22

Receipt of blood transfusion blood components or tissue 0 0 17 1 2 1 20 1 2 0 37 1

Has HIV infection risk factor not specified 92 35 860 33 97 32 951 35 189 33 1811 34

Receipt of blood transfusion blood components or tissue 6 2 28 1 3 1 24 1 9 2 52 1

Otherrisk factor not reported or identified 55 21 260 10 43 14 283 10 98 17 543 10

Subtotal 266 100 2589 100 300 100 2725 100 566 100 5314 100

Total 39353 100 203062 100 13525 100 84886 100 52878 100 287954 100

Note See Table 16 for the list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006b From the beginning of the epidemic through December 2006 Includes 6 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infection

38 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity

2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 6251 65 253927 73Injection drug use 733 8 31737 9Male-to-male sexual contact and injection drug use 732 8 31434 9Hemophiliacoagulation disorder 26 0 3989 1High-risk heterosexual contactb 416 4 7850 2

Sex with injection drug user 74 1 2310 1

Sex with person with hemophilia 0 0 36 0

Sex with HIV-infected transfusion recipient 2 0 176 0

Sex with HIV-infected person risk factor not specified 340 4 5328 2Receipt of blood transfusion blood components or tissue 20 0 3194 1Otherrisk factor not reported or identified 1400 15 16469 5

Total 9578 100 348600 100

Black not HispanicMale-to-male sexual contact 4309 36 103297 37Injection drug use 1635 14 83369 30Male-to-male sexual contact and injection drug use 526 4 22134 8Hemophiliacoagulation disorder 10 0 604 0High-risk heterosexual contactb 1875 16 29952 11

Sex with injection drug user 167 1 6823 2Sex with person with hemophilia 1 0 36 0Sex with HIV-infected transfusion recipient 15 0 237 0Sex with HIV-infected person risk factor not specified 1692 14 22856 8

Receipt of blood transfusion blood components or tissue 24 0 1218 0Otherrisk factor not reported or identified 3579 30 40268 14

Total 11958 100 280842 100

HispanicMale-to-male sexual contact 2816 47 64893 44Injection drug use 965 16 46337 31Male-to-male sexual contact and injection drug use 287 5 10884 7Hemophiliacoagulation disorder 6 0 466 0High-risk heterosexual contactb 638 11 10950 7

Sex with injection drug user 84 1 2409 2Sex with person with hemophilia 0 0 11 0Sex with HIV-infected transfusion recipient 5 0 125 0Sex with HIV-infected person risk factor not specified 549 9 8405 6

Receipt of blood transfusion blood components or tissue 17 0 657 0Otherrisk factor not reported or identified 1326 22 14832 10

Total 6055 100 149019 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 39

a

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulative

No No

AsianPacific IslanderMale-to-male sexual contact 225 54 4475 68Injection drug use 20 5 317 5Male-to-male sexual contact and injection drug use 17 4 284 4Hemophiliacoagulation disorder 1 0 70 1High-risk heterosexual contactb 34 8 376 6

Sex with injection drug user 1 0 54 1Sex with person with hemophilia 0 0 1 0Sex with HIV-infected transfusion recipient 0 0 8 0Sex with HIV-infected person risk factor not specified 33 8 313 5

Receipt of blood transfusion blood components or tissue 2 0 112 2Otherrisk factor not reported or identified 114 28 949 14

Total 413 100 6583 100

American IndianAlaska NativeMale-to-male sexual contact 61 49 1403 55Injection drug use 15 12 395 15Male-to-male sexual contact and injection drug use 23 19 457 18Hemophiliacoagulation disorder 0 0 27 1High-risk heterosexual contactb 9 7 118 5

Sex with injection drug user 1 1 33 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 8 6 82 3

Receipt of blood transfusion blood components or tissue 0 0 8 0Otherrisk factor not reported or identified 16 13 155 6

Total 124 100 2563 100

Total casesMale-to-male sexual contact 13775 49 429897 54Injection drug use 3413 12 163070 21Male-to-male sexual contact and injection drug use 1603 6 65524 8Hemophiliacoagulation disorder 43 0 5176 1High-risk heterosexual contactb 2997 11 49610 6

Sex with injection drug user 330 1 11683 1Sex with person with hemophilia 1 0 84 0Sex with HIV-infected transfusion recipient 22 0 553 0Sex with HIV-infected person risk factor not specified 2644 9 37290 5

Receipt of blood transfusion blood components or tissue 63 0 5213 1Otherrisk factor not reported or identified 6484 23 73136 9

Total 28378c 100 791626d 100a From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 4019 males of unknown race or multiple races

40 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 11963 73 55725 69Injection drug use 858 5 5512 7Male-to-male sexual contact and injection drug use 1092 7 5578 7Hemophiliacoagulation disorder 29 0 355 0High-risk heterosexual contactb 522 3 2658 3

Sex with injection drug user 65 0 544 1Sex with person with hemophilia 0 0 8 0Sex with HIV-infected transfusion recipient 3 0 33 0Sex with HIV-infected person risk factor not specified 454 3 2073 3

Receipt of blood transfusion blood components or tissue 14 0 197 0Otherrisk factor not reported or identified 1956 12 11147 14

Total 16434 100 81172 100

Black not HispanicMale-to-male sexual contact 6203 44 30148 37Injection drug use 1594 11 11997 15Male-to-male sexual contact and injection drug use 483 3 3489 4Hemophiliacoagulation disorder 10 0 109 0High-risk heterosexual contactb 1714 12 10905 13

Sex with injection drug user 169 1 1554 2Sex with person with hemophilia 4 0 17 0Sex with HIV-infected transfusion recipient 6 0 77 0Sex with HIV-infected person risk factor not specified 1535 11 9257 11

Receipt of blood transfusion blood components or tissue 32 0 223 0Otherrisk factor not reported or identified 4151 29 24632 30

Total 14187 100 81503 100

HispanicMale-to-male sexual contact 4094 55 15623 47Injection drug use 993 13 6407 19Male-to-male sexual contact and injection drug use 316 4 1402 4Hemophiliacoagulation disorder 3 0 26 0High-risk heterosexual contactb 582 8 2963 9

Sex with injection drug user 65 1 455 1Sex with person with hemophilia 0 0 6 0Sex with HIV-infected transfusion recipient 4 0 18 0Sex with HIV-infected person risk factor not specified 513 7 2484 7

Receipt of blood transfusion blood components or tissue 11 0 55 0Otherrisk factor not reported or identified 1475 20 6977 21

Total 7474 100 33453 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 41

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderMale-to-male sexual contact 402 70 1006 63Injection drug use 17 3 55 3Male-to-male sexual contact and injection drug use 15 3 38 2Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 25 4 96 6

Sex with injection drug user 3 1 10 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 22 4 83 5

Receipt of blood transfusion blood components or tissue 4 1 7 0Otherrisk factor not reported or identified 109 19 397 25

Total 572 100 1600 100

American IndianAlaska NativeMale-to-male sexual contact 104 61 516 57Injection drug use 13 8 101 11Male-to-male sexual contact and injection drug use 19 11 110 12Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 10 6 53 6

Sex with injection drug user 2 1 14 2Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 8 5 39 4

Receipt of blood transfusion blood components or tissue 0 0 2 0Otherrisk factor not reported or identified 24 14 125 14

Total 170 100 907 100

Total casesMale-to-male sexual contact 22912 59 103679 52Injection drug use 3503 9 24255 12Male-to-male sexual contact and injection drug use 1946 5 10704 5Hemophiliacoagulation disorder 43 0 495 0High-risk heterosexual contactb 2874 7 16830 8

Sex with injection drug user 308 1 2601 1Sex with person with hemophilia 4 0 31 0Sex with HIV-infected transfusion recipient 13 0 131 0Sex with HIV-infected person risk factor not specified 2549 7 14067 7

Receipt of blood transfusion blood components or tissue 61 0 489 0Otherrisk factor not reported or identified 7748 20 44021 22

Total 39087c 100 200473d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 1838 males of unknown race or multiple races

42 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race

ethnicity 2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 482 28 14981 40Hemophiliacoagulation disorder 4 0 123 0High-risk heterosexual contactb 725 42 15799 42

Sex with injection drug user 153 9 5650 15Sex with bisexual male 63 4 1859 5Sex with person with hemophilia 5 0 329 1Sex with HIV-infected transfusion recipient 5 0 338 1Sex with HIV-infected person risk factor not specified 499 29 7623 20

Receipt of blood transfusion blood components or tissue 15 1 1870 5Otherrisk factor not reported or identified 499 29 4801 13

Total 1725 100 37574 100

Black not HispanicInjection drug use 982 15 38914 34Hemophiliacoagulation disorder 3 0 145 0High-risk heterosexual contactb 3103 46 49876 44

Sex with injection drug user 373 6 13530 12Sex with bisexual male 136 2 2352 2Sex with person with hemophilia 4 0 121 0Sex with HIV-infected transfusion recipient 8 0 277 0Sex with HIV-infected person risk factor not specified 2582 38 33596 29

Receipt of blood transfusion blood components or tissue 39 1 1546 1Otherrisk factor not reported or identified 2612 39 23894 21

Total 6739 100 114375 100

HispanicInjection drug use 322 18 12892 35Hemophiliacoagulation disorder 4 0 67 0High-risk heterosexual contactb 894 49 17995 49

Sex with injection drug user 166 9 6522 18Sex with bisexual male 32 2 818 2Sex with person with hemophilia 1 0 45 0Sex with HIV-infected transfusion recipient 7 0 141 0Sex with HIV-infected person risk factor not specified 688 38 10469 29

Receipt of blood transfusion blood components or tissue 12 1 619 2Otherrisk factor not reported or identified 592 32 5023 14

Total 1824 100 36596 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 43

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 8 8 125 12Hemophiliacoagulation disorder 0 0 7 1High-risk heterosexual contactb 49 47 574 53

Sex with injection drug user 4 4 114 11Sex with bisexual male 2 2 80 7Sex with person with hemophilia 0 0 4 0Sex with HIV-infected transfusion recipient 1 1 25 2Sex with HIV-infected person risk factor not specified 42 40 351 33

Receipt of blood transfusion blood components or tissue 1 1 93 9Otherrisk factor not reported or identified 46 44 279 26

Total 104 100 1078 100

American IndianAlaska NativeInjection drug use 13 32 280 42Hemophiliacoagulation disorder 0 0 3 0High-risk heterosexual contactb 15 37 277 41

Sex with injection drug user 4 10 107 16Sex with bisexual male 1 2 27 4Sex with person with hemophilia 0 0 2 0Sex with HIV-infected transfusion recipient 0 0 6 1Sex with HIV-infected person risk factor not specified 10 24 135 20

Receipt of blood transfusion blood components or tissue 1 2 17 3Otherrisk factor not reported or identified 12 29 95 14

Total 41 100 672 100

Total casesInjection drug use 1826 17 67693 35Hemophiliacoagulation disorder 11 0 348 0High-risk heterosexual contactb 4839 46 85186 44

Sex with injection drug user 706 7 26073 14Sex with bisexual male 234 2 5162 3Sex with person with hemophilia 11 0 502 0Sex with HIV-infected transfusion recipient 21 0 793 0Sex with HIV-infected person risk factor not specified 3867 37 52656 27

Receipt of blood transfusion blood components or tissue 68 1 4176 2Otherrisk factor not reported or identified 3793 36 34311 18

Total 10537c 100 191714d 100a From the beginning of the epidemic through 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 104 females of unknown race or multiple racesd Includes 1419 females of unknown race or multiple races

44 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 690 26 4260 26Hemophiliacoagulation disorder 3 0 24 0

bHigh-risk heterosexual contact 1132 42 7593 46Sex with injection drug user 205 8 1876 11Sex with bisexual male 98 4 659 4Sex with person with hemophilia 10 0 115 1Sex with HIV-infected transfusion recipient 7 0 64 0Sex with HIV-infected person risk factor not specified 812 30 4879 29

Receipt of blood transfusion blood components or tissue 12 0 146 1Otherrisk factor not reported or identified 850 32 4567 28

Total 2687 100 16590 100

Black not HispanicInjection drug use 1034 13 7105 14Hemophiliacoagulation disorder 1 0 35 0

bHigh-risk heterosexual contact 3451 44 23732 46Sex with injection drug user 313 4 3473 7Sex with bisexual male 155 2 1294 3Sex with person with hemophilia 5 0 71 0Sex with HIV-infected transfusion recipient 14 0 120 0Sex with HIV-infected person risk factor not specified 2964 38 18774 36

Receipt of blood transfusion blood components or tissue 26 0 324 1Otherrisk factor not reported or identified 3370 43 20244 39

Total 7882 100 51440 100

HispanicInjection drug use 339 15 2280 18Hemophiliacoagulation disorder 2 0 11 0

bHigh-risk heterosexual contact 1198 52 6264 50Sex with injection drug user 218 9 1324 11Sex with bisexual male 62 3 266 2Sex with person with hemophilia 1 0 11 0Sex with HIV-infected transfusion recipient 7 0 39 0Sex with HIV-infected person risk factor not specified 910 39 4624 37

Receipt of blood transfusion blood components or tissue 12 1 58 0Otherrisk factor not reported or identified 767 33 3843 31

Total 2318 100 12456 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 45

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 6: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

of trends in the epidemic Data to estimate the number of cases of HIVAIDS or AIDS the number of persons living with HIVAIDS AIDS or HIV infection (not AIDS) and the number of deaths among persons with AIDS have been statistically adjusted to correct for delays in the reporting of cases and deaths

To assess trends in cases deaths or prevalence it is preferable to use adjusted data presented by year of diagnosis instead of year of report to eliminate arti-facts of reporting in the surveillance system Therefore for trends the reader is encouraged to use the tables in Sections 1ndash3 that present trends by year of diagnosis year of death or year-end prevalence Section 4 pre-sents estimates of survival for persons whose AIDS diagnosis was made during 2002 (Table 13) and for persons whose diagnosis was made during 1998ndash2005 (Figures 2ndash4) Proportions of persons who survived for various lengths of time after diagnosis are presented by year of diagnosis age group raceethnicity and HIV transmission category

Finally Section 5 presents reports of cases of HIV infection (not AIDS) and cases of AIDS reported through 2006 The areas included in tabulations of reported cases of HIV infection (not AIDS) are based on the date that confidential name-based HIV infection reporting was implemented For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US dependent areas) to describe reports of HIV infection These data which have not been adjusted for delays in reporting are presented by year of report to CDC Tables that present cases by year of report represent the most up-to-date information reported to CDC however cases by year of report do not represent inci-dent cases the most recent diagnoses trends or deaths

HIGHLIGHTS OF ANALYSES

Cases of HIVAIDS and Cases of AIDS

Cases of HIVAIDSFrom 2003 through 2006 the estimated number of

HIVAIDS cases in the 33 states with confidential name-based HIV infection reporting remained stable (Table 1) In 2006 the estimated rate of HIVAIDS cases in the 33 states was 185 per 100000 population (Table 5b)

bull Age group From 2003 through 2006 the estimated number of newly diagnosed HIVAIDS

6 Comm

cases decreased among children (less than 13 years of age) and in the following age groups 13ndash14 30ndash34 and 35ndash39 years (Table 1) The estimated number of HIVAIDS cases remained stable among persons aged 40ndash44 years and increased among persons aged 15ndash19 20ndash24 25ndash29 45ndash49 50ndash54 55ndash59 60ndash64 and 65 years and older In 2006 the largest number of HIVAIDS cases occurred among persons aged 40ndash44 years who accounted for 16 of all HIVAIDS cases diagnosed during that year

bull Raceethnicity From 2003 through 2006 the estimated number of newly diagnosed HIVAIDS cases increased among whites and AsiansPacific Islanders remained stable among blacks and Hispanics and fluctuated among American IndiansAlaska Natives (Table 1) Blacks accounted for 49 of all HIVAIDS cases diagnosed in 2006 In 2006 rates of HIVAIDS cases were 677 per 100000 in the black population 255 per 100000 in the Hispanic population 88 per 100000 in the American IndianAlaska Native population 82 per 100000 in the white population and 67 per 100000 in the AsianPacific Islander population (Table 5b)

bull Sex From 2003 through 2006 the estimated number of HIVAIDS cases increased approximately 5 among males and decreased 6 among females (Table 1) In 2006 males accounted for 74 of all HIVAIDS cases among adults and adolescents In 2006 rates were 338 per 100000 among males and 115 per 100000 among females (Table 5b)

bull Transmission category From 2003 through 2006 the estimated number of HIVAIDS cases increased among men who have sex with men (MSM) and remained stable among adults and adolescents with HIV infection attributed to high-risk heterosexual contact (heterosexual contact with a person known to have or to be at high risk for HIV infection) (Table 1) The estimated number of HIVAIDS cases decreased among injection drug users (IDUs) MSM who were also IDUs and among children MSM (49) and persons exposed through high-risk heterosexual contact (33) accounted for 82 of all HIVAIDS cases diagnosed in 2006

entary

Of all HIV infections diagnosed in 2005 in the 33 states with confidential name-based HIV reporting 38 progressed to AIDS within 12 months after HIV infection was diagnosed AIDS was diagnosed within 12 months after the diagnosis of HIV infection for larger proportions of persons aged 13ndash14 years and 35 years and older for Hispanics for IDUs and for males with HIV infection attributed to high-risk heterosexual contact (Table 2)

Cases of AIDSFrom 2002 through 2006 the estimated number of

newly diagnosed AIDS cases in the 50 states and the District of Columbia remained stable (Table 3) In 2006 the estimated rate of AIDS cases in the United States was 123 per 100000 population (Table 5a)

bull Age group From 2002 through 2006 the estimated number of AIDS cases decreased 64 among children (less than 13 years of age) (Table 3) The estimated number of AIDS cases also decreased among persons in the age groups 30ndash34 and 35ndash39 years (Table 3) The estimated number of AIDS cases remained stable among persons aged 40ndash44 years and increased in the following age groups 13ndash14 15ndash19 20ndash24 25ndash29 45ndash49 50ndash54 55ndash59 60ndash64 and 65 years and older In 2006 the largest number of AIDS cases occurred among persons aged 40ndash44 years who accounted for 20 of all AIDS cases diagnosed during that year in the 50 states and the District of Columbia

bull Raceethnicity From 2002 through 2006 the estimated number of AIDS cases decreased among blacks and American IndiansAlaska Natives remained stable among whites and Hispanics and increased among AsiansPacific Islanders (Table 3) In 2006 rates of AIDS cases were 476 per 100000 in the black population 156 per 100000 in the Hispanic population 62 per 100000 in the American IndianAlaska Native population 54 per 100000 in the white population and 37 per 100000 in the AsianPacific Islander population (Table 5a)

bull Sex From 2002 through 2006 the estimated number of AIDS cases remained stable among both male and female adults and adolescents (Table 3) Males accounted for 73 of all AIDS cases diagnosed in 2006 for adults and adolescents in the 50 states and the District of Columbia (Table

Comm

3) Rates of AIDS cases in 2006 were 224 per 100000 among males and 78 per 100000 among females (Table 5a)

bull Transmission category From 2002 through 2006 among male adults and adolescents the estimated number of AIDS cases decreased among IDUs and MSM who were also IDUs (Table 3) The numbers of males exposed through male-to-male sexual contact and high-risk heterosexual contact remained stable Among female adults and adolescents the estimated number of AIDS cases decreased among IDUs and fluctuated among females exposed through high-risk heterosexual contact

bull Region From 2002 through 2006 the estimated number of AIDS cases decreased 10 in the West and 6 in the Northeast and remained stable in the South and the Midwest

DeathsFrom 2002 through 2006 the estimated number of

deaths of persons with AIDS who resided in the 50 states and the District of Columbia decreased 17 (Table 7)

bull Age group The estimated number of deaths decreased among children (less than 13 years of age) and in the following age groups 13ndash14 25ndash29 30ndash34 35ndash39 40ndash44 and 45ndash49 years The estimated number of deaths remained stable among persons aged 50ndash54 years and increased in the age groups 15ndash19 20ndash24 55ndash59 60ndash64 and 65 years and older

bull Raceethnicity The estimated number of deaths of persons with AIDS decreased among whites blacks and American IndiansAlaska Natives The estimated number of deaths of persons with AIDS remained stable among Hispanics and increased among AsiansPacific Islanders

bull Sex and transmission category The estimated number of deaths of adults and adolescents decreased among MSM and IDUs and remained stable among persons exposed through high-risk heterosexual contact

bull Region The estimated number of deaths decreased in all regions of the United States

entary 7

Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS

Persons living with HIVAIDSFrom 2003 through 2006 the estimated number of

persons living with HIVAIDS increased steadily in the 33 states with confidential name-based HIV infec-tion reporting (Table 8) At the end of 2006 an esti-mated 491727 persons in these states were living with HIVAIDS

bull By age group most (21) were aged 40ndash44 years

bull By raceethnicity 47 were black 34 white 17 Hispanic and less than 1 each were American IndianAlaska Native or AsianPacific Islander

bull By sex 73 of adults and adolescents living with HIVAIDS were male

bull Of the estimated 353825 male adults and adolescents living with HIVAIDS 62 had been exposed through male-to-male sexual contact 17 had been exposed through injection drug use 13 had been exposed through high-risk heterosexual contact and 7 had been exposed through both male-to-male sexual contact and injection drug use Of the estimated 131195 female adults and adolescents living with HIVAIDS 73 had been exposed through high-risk heterosexual contact and 26 had been exposed through injection drug use Of the estimated 6703 children living with HIVAIDS 92 had been exposed perinatally

Prevalence rates of HIV infection (not AIDS)At the end of 2006 in the 38 areas with confidential

name-based HIV infection reporting since at least 2003 the prevalence rate of HIV infection (not AIDS) among adults and adolescents was estimated at 1437 per 100000 (Map 1) The rate for adults and adoles-cents living with HIV infection (not AIDS) ranged from an estimated 49 per 100000 (American Samoa) to an estimated 2617 per 100000 (New York) The prevalence rate of HIV infection (not AIDS) among children residing in the 38 areas was an estimated 65 per 100000 (Map 2) The rate for children living with HIV infection (not AIDS) ranged from an estimated zero per 100000 in Idaho New Mexico American Samoa Guam and the Northern Mariana Islands to an estimated 253 per 100000 in New York

8 Comm

Persons living with AIDSAIDS prevalence also increased steadily from 2002

through 2006 (Table 10) At the end of 2006 an esti-mated 436693 persons in the 50 states and the District of Columbia were living with AIDS

bull By age group most (22) were aged 40ndash44 years

bull By raceethnicity 44 were black 35 white 19 Hispanic 1 AsianPacific Islander and less than 1 were American IndianAlaska Native

bull By sex 77 of adults and adolescents living with AIDS were male

bull Of the estimated 333244 male adults and adolescents living with AIDS 60 had been exposed through male-to-male sexual contact 19 had been exposed through injection drug use 12 had been exposed through high-risk heterosexual contact and 8 had been exposed through both male-to-male sexual contact and injection drug use Of the estimated 99671 female adults and adolescents living with AIDS 66 had been exposed through high-risk heterosexual contact and 32 had been exposed through injection drug use

bull By region 41 resided in the South 29 in the Northeast 20 in the West and 11 in the Midwest

AIDS prevalence ratesAt the end of 2006 the prevalence rate of AIDS

among adults and adolescents in the United States was estimated at 1786 per 100000 (Map 1) The rate for adults and adolescents living with AIDS ranged from an estimated 25 per 100000 (American Samoa) to an estimated 20165 per 100000 (District of Columbia) The prevalence rate of AIDS among children in the United States was estimated at 22 per 100000 at the end of 2006 (Map 2) The rate for children living with AIDS ranged from an estimated zero per 100000 in Idaho Montana Utah American Samoa Guam and the Northern Mariana Islands to an estimated 365 per 100000 in the District of Columbia

Survival after AIDS DiagnosisTable 13 is limited to data on AIDS cases diagnosed

in 2002 in order to describe the survival of persons whose diagnosis was made relatively recently but far enough in the past to permit a meaningful measure of

entary

survival Figures 2 3 and 4 illustrate the proportion of surviving persons among persons whose diagnoses were made over a longer period 1998 through 2005

bull Survival (the estimated proportion of persons surviving a given length of time after diagnosis) increased with the year of diagnosis for diagnoses made during 1998ndash2000 Year-to-year differences were small during 2001ndash2005 (Figure 2)

bull Survival decreased as age at diagnosis increased among persons at least 35 years old at diagnosis and in comparison with persons younger than 35 Survival was similar for the age groups 13ndash24 and 25ndash34 (Figure 3)

bull Survival was greatest among MSM and among children with perinatally acquired HIV infection (Table 13) Survival was intermediate among male and female adults and adolescents who had heterosexual contact with someone known to be HIV infected or at high risk for HIV infection as well as among MSM who also were IDUs Survival was lowest among male and female adults and adolescents who were IDUs

bull Survival particularly at more than 48 months after diagnosis was greater among AsiansPacific Islanders whites and Hispanics than among blacks (Figure 4) Results were unstable or inconsistent for American IndiansAlaska Natives because the numbers of persons in this racialethnic category were small

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Tables 14ndash23 describe reports of cases of HIVAIDS AIDS and HIV infection (not AIDS) Tables 16 18 20 and 22 are based on reports of cases of HIV infection (not AIDS) through 2006 from the 50 areas that had implemented name-based HIV infection reporting Note that not all cases of HIV infection (not AIDS) or AIDS reported in 2006 reflect diagnoses made during 2006 rather the reported cases include cases diagnosed during earlier years

Reports of cases of HIV infection (not AIDS)Through 2006 a total of 287954 persons were

reported as having HIV infection (not AIDS) in the 50 areas with confidential name-based HIV infection reporting (Table 16) (see Technical Notes for discus-sion of surveillance of HIV infection [not AIDS])

Comm

Five states (Florida New Jersey New York North Carolina and Texas) reported 137507 (48) of the 287954 cumulative cases of HIV infection (not AIDS) reported to CDC In 2006 4 states (California Illinois New York and Pennsylvania) reported 22417 (42) of the 52878 cases of HIV infection (not AIDS)

bull In 2006 of the 52312 reported cases among adults and adolescents 75 were in males and 25 were in females (Table 18)

bull In 2006 566 cases in children were reported

Reports of AIDS casesThrough 2006 a total of 992865 persons in the

United States had been reported as having AIDS (Table 14) Three states (California Florida and New York) reported 43 of the cumulative AIDS cases and 37 of AIDS cases reported to CDC in 2006 In the United States the rate of reported AIDS cases in 2006 was 129 per 100000 population When the US dependent areas were included the rate of reported AIDS cases ranged from zero per 100000 (American Samoa Guam and the Northern Mariana Islands) to 1467 per 100000 (District of Columbia)

bull In 2006 males accounted for 73 and females for 27 of 38916 reported AIDS cases among adults and adolescents (Table 17)

bull In 2006 86 AIDS cases in children were reported

ADDITIONAL RESOURCES

The following were prepared by using HIVAIDS surveillance data

bull Selected MMWR articles at httpwwwcdcgovhivresourcesreportsmmwr

bull Public-use slides at httpwwwcdcgovhivtopicssurveillanceresourcesslides

bull Other surveillance reports at httpwwwcdcgovhivtopicssurveillanceresourcesreports

bull Public-use version of the AIDS surveillance data set (AIDS Public Information Data Set [APIDS]) at httpwwwcdcgovhivsoftwareapidshtm

SUGGESTED READINGS

CDC Advancing HIV Prevention New Strategies for a Changing EpidemicmdashUnited States 2003 MMWR 200352(15)329ndash332

entary 9

CDC Dear colleague letter CDC recommends that all states and territories adopt confidential name-based surveillance systems to report HIV infec-tions httpwwwcdcgovhivpubs070505_dearcolleague_gerberdingpdf Pub-lished July 5 2005 Accessed March 11 2008

1981ndash2005 CDC Epidemiology of HIVAIDSmdashUnited States

MMWR 200655(21)589ndash592CDC Guidelines for national HIV case surveil-

lance including monitoring for HIV infection and AIDS MMWR 199948(RR-13)1ndash31

CDC HIV prevention strategic plan extended through 2010 httpwwwcdcgovhivresourcesreportspsp Published October 2007 Accessed March 11 2008

CDC Revised recommendations for HIV testing of adults adolescents and pregnant women in health-care settings MMWR 200655(RR-14)1ndash17

CDC Twenty-five years of HIVAIDSmdashUnited States 1981ndash2006 MMWR 200655(21)585ndash589

Glynn MK Lee LM McKenna MT The status of national HIV case surveillance United States 2006 Public Health Rep 2007122(suppl 1)63ndash71

Janssen RS Satten GA Stramer SL et al New test-ing strategy to detect early HIV-1 infection for use in incidence estimates and for clinical and prevention purposes JAMA 1998280(1)42ndash48

Lee LM McKenna MT Monitoring the incidence of HIV infection in the United States Public Health Rep 2007122(suppl 1)72ndash79

10 Comm

entary

Cases of HIVAIDS and AIDS

Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003ndash2006mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

Year of diagnosis

2003 2004 2005 2006

Data for 33 statesAge at diagnosis (yrs)lt13 211 183 169 13513ndash14 53 36 40 4115ndash19 993 993 1126 133220ndash24 3163 3368 3592 388625ndash29 4023 4057 4236 460330ndash34 5189 4820 4676 446635ndash39 6369 5807 5535 544240ndash44 5786 5429 5529 571845ndash49 4028 3877 4028 420450ndash54 2451 2401 2547 271855ndash59 1279 1363 1455 143860ndash64 655 702 692 714gt65 570 624 613 618

RaceethnicityWhite not Hispanic 10033 10181 10528 10758Black not Hispanic 17668 16718 16629 17356Hispanic 6355 6010 6217 6481AsianPacific Islander 338 339 373 397American IndianAlaska Native 179 171 182 166

Transmission categoryMale adult or adolescentMale-to-male sexual contact 15409 15880 16833 17465Injection drug use 3514 3083 2978 3016Male-to-male sexual contact and injection drug use 1349 1299 1247 1180High-risk heterosexual contacta 4269 3959 3871 4152Otherb 125 110 107 114Subtotal 24666 24331 25036 25928

Female adult or adolescentInjection drug use 2027 1856 1720 1712High-risk heterosexual contacta 7731 7182 7216 7432Otherb 134 107 97 109Subtotal 9892 9145 9033 9252

Child (lt13 yrs at diagnosis)Perinatal 190 157 147 115Otherc 23 27 23 20Subtotal 213 184 170 135

Subtotal for 33 states 34770 33659 34239 35314

Data for US dependent areas 1331 1234 1395 1503

Totald 36102 34894 35634 36817Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

Cases of HIVAIDS and AIDS 11

Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

gt12 Months after diagnosis aof HIV infection

lt12 Months after diagnosis of HIV infectionb Total

No ()c No ()c No

Data for 33 statesAge at diagnosis (yrs)lt13 148 88 21 12 16913ndash14 22 54 18 46 4015ndash19 912 81 215 19 112620ndash24 2874 80 714 20 358925ndash29 3077 73 1157 27 423430ndash34 3016 65 1655 35 467135ndash39 3353 61 2176 39 553040ndash44 3181 58 2338 42 551945ndash49 2145 53 1874 47 401950ndash54 1307 51 1239 49 254655ndash59 725 50 728 50 145360ndash64 316 46 376 54 692gt65 266 44 346 56 612RaceethnicityWhite not Hispanic 6839 65 3677 35 10516Black not Hispanic 10372 62 6242 38 16614Hispanic 3593 58 2614 42 6206AsianPacific Islander 232 62 139 38 371American IndianAlaska Native 110 61 72 39 182Transmission category

Male adult or adolescentMale-to-male sexual contact 10917 65 5902 35 16819Injection drug use 1544 52 1427 48 2971Male-to-male sexual contact and injection drug use 733 59 512 41 1245High-risk heterosexual contactd 2091 54 1773 46 3864Othere 45 42 61 58 107Subtotal 15331 61 9675 39 25006Female adult or adolescentInjection drug use 1056 62 660 38 1716High-risk heterosexual contactd 4761 66 2450 34 7210Othere 47 48 50 52 97Subtotal 5864 65 3160 35 9023Child (lt13 yrs at diagnosis)Perinatal 126 86 21 14 147Otherf 22 94 2 6 23Subtotal 148 87 22 13 170

Subtotal for 33 states 21343 62 12857 38 34200Data for US dependent areas 855 61 541 39 1395

Totalg 22197 62 13398 38 35595h

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003Data exclude 39 persons whose month of diagnosis of HIV infection is unknowna Includes persons in whom AIDS has not developedb Includes persons whose diagnoses of HIV infection and AIDS were made at the same timec Percentages represent proportions of the total number of diagnoses of HIVAIDS made during 2005 for the corresponding group (see row

entries)d Heterosexual contact with a person known to have or to be at high risk for HIV infectione Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedf Includes hemophilia blood transfusion and risk factor not reported or not identifiedg Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the

column totalh Includes 310 persons of unknown race or multiple races

12 Cases of HIVAIDS and AIDS

Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas

Year of diagnosis2002 2003 2004 2005 2006 Cumulativea

Data for 50 states and the District of ColumbiaAge at diagnosis (yrs)lt13 106 70 53 53 38 915613ndash14 62 74 70 66 73 107815ndash19 316 302 334 410 401 562620ndash24 1399 1568 1624 1675 1669 3622525ndash29 3137 3059 3196 3110 3423 11709930ndash34 5701 5521 5144 4668 4349 19753035ndash39 8217 8017 7072 6479 6402 21357340ndash44 7404 7626 7703 7378 7298 17053145ndash49 5358 5617 5498 5727 5628 10720750ndash54 3271 3364 3491 3527 3687 5990755ndash59 1607 1693 1836 1861 2071 3219060ndash64 872 864 913 872 955 17303gt65 682 763 791 727 835 15074

RaceethnicityWhite not Hispanic 11233 10948 11066 10676 10929 394024Black not Hispanic 19246 19512 18909 18081 17960 409982Hispanic 6712 7102 6771 6823 6907 161505AsianPacific Islander 425 450 444 450 519 7951American IndianAlaska Native 177 176 182 170 155 3345

Transmission categoryMale adult or adolescentMale-to-male sexual contact 15709 16078 16054 15711 16001 465965Injection drug use 5483 5275 4818 4603 4410 170171Male-to-male sexual contact and injection drug use 2075 2029 1925 1930 1803 68516High-risk heterosexual contactb 4547 4471 4506 4306 4558 65241Otherc 253 226 228 237 217 13893Subtotal 28067 28079 27532 26787 26989 783786

Female adult or adolescentInjection drug use 2897 2836 2810 2586 2385 74718High-risk heterosexual contactb 6855 7336 7113 6922 7196 108252Otherc 207 217 217 205 220 6596Subtotal 9959 10389 10141 9713 9801 189566

Child (lt13 yrs at diagnosis)Perinatal 104 70 53 52 37 8508Otherd 2 0 0 0 0 636Subtotal 106 70 53 53 38 9144

Region of residenceNortheast 10092 10342 9412 9396 9486 306241Midwest 4125 4226 4089 4371 4164 101479South 17198 17630 18225 16894 17104 374800West 6718 6339 6000 5891 6074 199978Subtotal for 50 states and the District of Columbia 38132 38538 37726 36552 36828 982498

Data for US dependent areas 1058 1060 921 955 833 31217

Totale 39250 39690 38807 37662 37852 1014797Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes persons of unknown race or multiple races and persons of unknown sex Cumulative total includes 5691 persons of unknown race or multiple

races 3 persons of unknown sex 1079 persons of unknown state of residence and 3 persons who were residents of other areas Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Cases of HIVAIDS and AIDS 13

Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002ndash2006 and cumulativemdash50 states and the District of Columbia

Year of diagnosisCumulativea2002 2003 2004 2005 2006

RaceethnicityWhite not Hispanic 14 12 7 4 4 1599Black not Hispanic 70 46 33 38 30 5654Hispanic 18 10 9 8 3 1748AsianPacific Islander 1 0 1 1 1 54American IndianAlaska Native 1 0 1 0 0 31

Transmission categoryHemophiliacoagulation disorder 0 0 0 0 0 226Mother with documented HIV infection or 1 of the following risk factors 104 70 53 52 37 8508

Injection drug use 12 8 5 3 4 3220Sex with injection drug user 4 6 3 2 1 1397Sex with bisexual male 2 0 3 1 1 209Sex with person with hemophilia 0 0 0 0 0 35Sex with HIV-infected transfusion recipient 0 0 0 0 0 22Sex with HIV-infected person risk factor not specified 36 20 20 25 13 1530Receipt of blood transfusion blood components or tissue 2 1 0 0 0 144Has HIV infection risk factor not specified 47 34 21 21 17 1951

Receipt of blood transfusion blood components or tissue 2 0 0 0 0 374Otherrisk factor not reported or identified 0 0 0 0 0 36

Totalb 106 70 53 53 38 9144

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga From the beginning of the epidemic through 2006b Includes children of unknown race or multiple races Cumulative total includes 58 children of unknown race or multiple races Because column totals

were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992ndash2006mdash50 states and the District of Columbia

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reporting

14 Cases of HIVAIDS and AIDS

Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006mdash50 states and the District of Columbia

Raceethnicity

Adults or adolescents

Children (lt13 yrs) TotalaMales Females Totala

No Rate No Rate No Rate No Rate No Rate

White not Hispanic 9267 112 1659 19 10926 64 4 00 10929 54Black not Hispanic 11540 829 6391 404 17930 603 30 04 17960 476Hispanic 5388 313 1516 95 6903 208 3 00 6907 156AsianPacific Islander 423 75 95 16 518 44 1 00 519 37American IndianAlaska Native 118 122 37 36 155 78 0 00 155 62

Totalb 26989 224 9801 78 36790 149 38 01 36828c 123

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reportingData exclude cases in persons whose state or area of residence is unknown as well as cases from US dependent areas for which census information about race and age categories is lackinga Because row totals were calculated independently of the values for the subpopulations the values in each row may not sum to the row totalb Includes person of unknown race or multiple races Because column totals were calculated independently of the values for the subpopulations the

values in each column may not sum to the column totalc Includes 358 persons of unknown race or multiple races

Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006mdash33 states with confidential name-based HIV infection reporting

Raceethnicity

Adults or adolescents

Children (lt13 yrs) TotalaMales Females Totala

No Rate No Rate No Rate No Rate No Rate

White not Hispanic 9078 167 1664 29 10742 96 16 01 10758 82Black not Hispanic 11230 1191 6033 562 17263 856 93 17 17356 677Hispanic 5058 509 1400 151 6458 337 23 04 6481 255AsianPacific Islander 318 135 79 32 397 82 0 00 397 67American IndianAlaska Native 129 177 35 46 164 110 2 06 166 88

Totalb 25928 338 9252 115 35180 224 135 04 35314c 185

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Because row totals were calculated independently of the values for the subpopulations the values in each row may not sum to the row totalb Includes persons of unknown race or multiple races Because column totals were calculated independently of the values for the subpopulations the

values in each column may not sum to the column totalc Includes 156 persons of unknown race or multiple races

Cases of HIVAIDS and AIDS 15

Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006mdashUnited States and dependent areas

Transmission category

Place of birth

United StatesCentralSouth

America Cuba Mexico Puerto Rico Totala

No No No No No No

Male-to-male sexual contact 1172 45 402 49 89 62 790 59 249 18 3337 43Injection drug use 569 22 83 10 13 9 133 10 533 40 1650 21Male-to-male sexual contact

and injection drug use 158 6 25 3 6 4 59 4 63 5 357 5High-risk heterosexual

contactb 661 25 296 36 35 24 342 26 487 36 2282 30Otherc 47 2 8 1 0 0 9 1 14 1 103 1

Totald 2608 100 814 100 145 100 1334 100 1346 100 7728 100Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Includes 222 persons whose place of birth is not among those listed and 1260 persons whose place of birth is unknownb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the

column total

16 Cases of HIVAIDS and AIDS

Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas

Year of death

Cumulativea2002 2003 2004 2005 2006

Data for 50 states and the District of ColumbiaAge at death (yrs)lt13 25 22 15 7 13 4889

13ndash14 10 6 15 12 5 276

15ndash19 39 36 36 38 44 1104

20ndash24 151 157 175 147 162 8716

25ndash29 553 512 482 458 405 43671

30ndash34 1480 1272 1128 1069 785 95351

35ndash39 2967 2763 2425 2096 1682 116746

40ndash44 3595 3516 3393 3317 2636 104133

45ndash49 3294 3234 3251 3275 2886 72831

50ndash54 2318 2373 2502 2645 2343 44255

55ndash59 1209 1322 1425 1543 1480 25123

60ndash64 616 705 741 797 771 14315

gt65 691 773 807 865 805 14393

RaceethnicityWhite not Hispanic 5214 5097 4836 4758 3860 239529

Black not Hispanic 9037 8675 8581 8679 7426 218392

Hispanic 2429 2632 2641 2513 2425 80690

AsianPacific Islander 97 84 111 87 114 3426

American IndianAlaska Native 83 73 80 65 66 1693

Transmission categoryMale adult or adolescentMale-to-male sexual contact 5960 5937 5735 5641 4930 266272

Injection drug use 3738 3547 3315 3314 2641 107173

Male-to-male sexual contact and injection drug use 1278 1299 1237 1289 1064 40993

High-risk heterosexual contactb 1465 1501 1625 1571 1470 26236

Otherc 160 149 125 117 80 9867

Subtotal 12601 12431 12038 11932 10184 450541

Female adult or adolescentInjection drug use 1923 1825 1855 1768 1456 43143

High-risk heterosexual contactb 2281 2292 2373 2458 2258 42620

Otherc 84 87 72 68 70 4131

Subtotal 4289 4204 4300 4295 3784 89895

Child (lt13 yrs at diagnosis)Perinatal 53 49 56 39 42 4848

Otherd 4 5 1 2 7 521

Subtotal 57 54 57 41 48 5369

Deaths 17

Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas (cont)

Year of death

Cumulativea2002 2003 2004 2005 2006

Region of residenceNortheast 5313 5012 4779 4750 4074 180623

Midwest 1726 1666 1482 1378 1325 54468

South 7337 7427 7535 7907 6475 197209

West 2571 2585 2600 2234 2141 113506

Subtotal for 50 states and the District of Columbia 16948 16690 16395 16268 14016 545805

Data for US dependent areas 667 575 572 562 580 19858

Totale 17628 17283 16982 16865 14627 565927f

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column totalf Includes 2082 persons of unknown race or multiple races 261 persons of unknown state of residence and 2 persons who were residents

of other areas

18 Deaths

Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003ndash2006mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

2003 2004 2005 2006Data for 33 states

Age at end of year (yrs)lt13 4154 3700 3294 286713ndash14 1130 1238 1212 113915ndash19 3298 3627 4024 453920ndash24 12389 12826 13411 1430125ndash29 26167 26924 28164 2960030ndash34 49602 47577 45109 4418935ndash39 80703 77871 75842 7363440ndash44 92040 97109 100102 10176445ndash49 71345 77490 83816 9028350ndash54 45133 51033 56640 6319555ndash59 22793 26610 31186 3600860ndash64 10820 12642 14422 16658gt65 8531 9959 11657 13551

RaceethnicityWhite not Hispanic 145081 151694 158375 166000Black not Hispanic 202951 212425 221439 231957Hispanic 72612 76503 80491 84720AsianPacific Islander 2234 2529 2858 3187American IndianAlaska Native 1788 1889 2008 2119

Transmission categoryMale adult or adolescentMale-to-male sexual contact 181771 193245 205423 218676Injection drug use 57651 58149 58369 59077Male-to-male sexual contact and injection drug use 23965 24434 24725 25085High-risk heterosexual contacta 40084 42559 44915 47562Otherb 3218 3278 3325 3424Subtotal 306689 321665 336756 353825

Female adult or adolescentInjection drug use 32346 32735 32973 33470High-risk heterosexual contacta 80324 85348 90185 95403Otherb 2036 2123 2212 2321Subtotal 114705 120206 125370 131195

Child (lt13 yrs at diagnosis)Perinatal 6137 6154 6178 6143Otherc 570 575 571 560Subtotal 6707 6730 6748 6703

Subtotal for 33 states 428107 448605 468879 491727Data for US dependent areas 15809 16399 17150 17955

Totald 443916 465005 486028 509681Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 19

Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission categorymdash33 states with confidential name-based HIV infection reporting

Transmission category

White not Hispanic

Black not Hispanic Hispanic

AsianPacific Islander

American IndianAlaska

Native Totala

No No No No No No

Male adult or adolescentMale-to-male sexual contact 108259 77 70242 49 36043 57 1669 68 938 62 218676 62Injection drug use 12328 9 31339 22 14472 23 264 11 216 14 59077 17Male-to-male sexual contact

and injection drug use 11283 8 9587 7 3720 6 93 4 205 13 25085 7High-risk heterosexual contactb 6667 5 31140 22 8788 14 395 16 143 9 47562 13Otherc 1458 1 1492 1 404 1 30 1 17 1 3424 1Subtotal 139994 100 143799 100 63427 100 2450 100 1519 100 353825 100

Female adult or adolescentInjection drug use 8262 33 19136 23 5528 28 106 15 175 30 33470 26High-risk heterosexual contactb 16338 65 63204 75 14132 71 573 82 392 68 95403 73Otherc 450 2 1469 2 344 2 24 3 12 2 2321 2Subtotal 25050 100 83809 100 20004 100 703 100 578 100 131195 100

Child (lt13 yrs at diagnosis)Perinatal 801 84 4064 93 1183 92 28 82 20 95 6143 92Otherd 154 16 283 7 107 8 6 18 1 5 560 8Subtotal 955 100 4347 100 1290 100 34 100 21 100 6703 100

Totale 166000 231957 84720 3187 2119 491727Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of 33 states that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Includes 3745 persons of unknown race or multiple racesb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes 5 persons of unknown sex Because column totals were calculated independently of the values for the subpopulations the values

in each column may not sum to the column total

20 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Map 1 Estimated rates (per 100000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

Note Rates adjusted for reporting delays Rates of HIV infection include only persons living with HIV infection that has not progressed to AIDSSince 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 Islandsa Includes persons whose area of residence is unknown

Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

Note Rates adjusted for reporting delays Rates of HIV infection include only persons living with HIV infection that has not progressed to AIDSSince 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 Islandsa Includes persons whose area of residence is unknown

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 21

Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002ndash2006mdashUnited States and dependent areas

2002 2003 2004 2005 2006Data for 50 states and the District of Columbia

Age at end of year (yrs)lt13 2308 2006 1684 1394 111513ndash14 685 747 784 762 71115ndash19 1465 1694 1974 2243 248720ndash24 3910 4292 4629 5033 536725ndash29 12725 12743 13045 13505 1435930ndash34 35558 33870 32057 29949 2882435ndash39 70107 68106 65076 62235 5964940ndash44 80377 86294 91335 94021 9517445ndash49 64702 71276 77417 84153 9077550ndash54 41270 46855 53333 59256 6647655ndash59 20113 24145 28356 33522 3901460ndash64 9681 11293 13305 15380 18072gt65 7520 8946 10604 12430 14669

RaceethnicityWhite not Hispanic 129426 135278 141508 147426 154495Black not Hispanic 150488 161326 171654 181056 191590Hispanic 63424 67895 72024 76334 80815AsianPacific Islander 3060 3426 3759 4121 4526American IndianAlaska Native 1254 1356 1458 1562 1651

Transmission categoryMale adult or adolescentMale-to-male sexual contact 158092 168233 178551 188622 199693Injection drug use 56708 58436 59940 61229 62998Male-to-male sexual contact and injection drug use 24726 25457 26144 26785 27523High-risk heterosexual contacta 27329 30300 33181 35916 39004Otherb 3588 3665 3769 3888 4026Subtotal 270444 286091 301585 316440 333244

Female adult or adolescentInjection drug use 27863 28874 29828 30646 31575High-risk heterosexual contacta 46445 51489 56229 60693 65631Otherb 1903 2033 2178 2315 2465Subtotal 76210 82395 88236 93653 99671

Child (lt13 yrs at diagnosis)Perinatal 3633 3654 3651 3664 3660Otherc 129 124 123 122 115Subtotal 3762 3778 3774 3786 3775

Region of residenceNortheast 105599 110929 115562 120208 125620Midwest 36011 38571 41178 44171 47010South 137081 147284 157975 166962 177591West 71729 75483 78883 82540 86473

Subtotal for 50 states and the District of Columbia 350419 372267 393598 413882 436693

Data for US dependent areas 9880 10365 10713 11106 11359

Totald 360617 383024 404849 425646 448871Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

22 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission categorymdash50 states and the District of Columbia

Transmission category

White not Hispanic

Black not Hispanic Hispanic

AsianPacific Islander

American IndianAlaska

Native Totala

No No No No No No

Male adult or adolescentMale-to-male sexual contact 101299 75 57520 45 36087 57 2715 72 704 57 199693 60Injection drug use 13168 10 33911 27 14795 23 325 9 201 16 62998 19Male-to-male sexual contact and

injection drug use 12393 9 10121 8 4352 7 198 5 220 18 27523 8High-risk heterosexual contactb 6081 5 24205 19 7816 12 444 12 105 8 39004 12Otherc 1743 1 1602 1 574 1 69 2 16 1 4026 1Subtotal 134683 100 127359 100 63623 100 3752 100 1246 100 333244 100

Female adult or adolescentInjection drug use 7407 38 18531 30 5025 30 115 15 153 39 31575 32High-risk heterosexual contactb 11350 59 41741 68 11092 67 588 78 227 58 65631 66Otherc 508 3 1456 2 413 2 51 7 13 3 2465 2Subtotal 19264 100 61728 100 16531 100 753 100 393 100 99671 100

Child (lt13 yrs at diagnosis)Perinatal 500 92 2468 99 629 95 20 94 12 100 3660 97Otherd 46 8 34 1 33 5 1 6 0 0 115 3Subtotal 546 100 2503 100 662 100 21 100 12 100 3775 100

Totale 154495 191590 80815 4526 1651 436693

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Includes 3616 persons of unknown race or multiple racesb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes 3 person of unknown sex Because column totals were calculated independently of the values for the subpopulations the values in each column

may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 23

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by

area of residence and age categorymdashUnited States and dependent areas

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

Alabama 5469 17 5486 3744 11 3755Alaska 272 1 273 330 1 331Arizona 5744 49 5793 4922 7 4929Arkansas 2291 7 2298 2139 6 2145California mdash mdash mdash 61451 105 61555Colorado 5855 13 5869 4083 2 4085Connecticut mdash mdash mdash 7406 15 7421Delaware mdash mdash mdash 1753 7 1760District of Columbia mdash mdash mdash 10059 30 10089Floridab 35461 263 35723 46469 194 46663Georgia mdash mdash mdash 17336 47 17383Hawaii mdash mdash mdash 1234 3 1237Idaho 356 0 356 313 0 313Illinois mdash mdash mdash 16139 46 16185Indiana 3849 21 3870 3996 14 4010Iowa 588 2 590 869 3 872Kansas 1230 7 1237 1272 2 1274Kentucky mdash mdash mdash 2589 13 2602Louisiana 7361 101 7462 8052 21 8074Maine mdash mdash mdash 512 2 514Maryland mdash mdash mdash 14540 41 14581Massachusetts mdash mdash mdash 8806 20 8826Michigan 6118 55 6173 6615 12 6627Minnesota 3227 21 3248 2314 9 2323Mississippi 4200 32 4232 3155 13 3168Missouri 4999 33 5033 5479 7 5486Montana mdash mdash mdash 205 0 205Nebraska 688 12 700 771 2 773Nevada 3402 13 3415 2969 3 2972New Hampshire mdash mdash mdash 556 3 559New Jersey 16059 153 16212 17168 57 17226New Mexico 910 0 909 1252 3 1255New York 42220 801 43021 70697 148 70845North Carolina 11700 60 11760 8451 12 8463North Dakota 87 2 89 73 1 74Ohio 8266 57 8323 7054 30 7084Oklahoma 2191 17 2208 2191 3 2194Oregon mdash mdash mdash 2840 4 2844Pennsylvania mdash mdash mdash 18633 71 18703Rhode Island mdash mdash mdash 1296 7 1303South Carolina 6349 45 6394 7035 23 7058South Dakota 195 4 199 139 1 140Tennessee 6579 51 6631 6403 11 6414Texas 24741 262 25003 34010 53 34063Utah 893 10 903 1164 0 1164Vermont mdash mdash mdash 238 2 240Virginia 9937 41 9978 8423 24 8447Washington mdash mdash mdash 5471 5 5476West Virginia 660 5 665 749 5 754Wisconsin 2322 15 2337 2153 12 2165Wyoming 86 2 88 102 1 103

Subtotal 224303 2174 226477 435621 1115 436736

24 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age categorymdashUnited States and dependent areas (cont)

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

US dependent areasAmerican Samoa 2 0 2 1 0 1Guam 63 0 63 36 0 36Northern Mariana Islands 7 0 7 3 0 3Puerto Rico 6269 31 6300 10971 26 10997US Virgin Islands 228 2 230 312 2 314Otherc mdash mdash mdash 1 0 1

Totald 230872 2207 233079 447724 1147 448871

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reporting a See Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at

least 2003b Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterc Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasd Total number of persons living with HIV infection (not AIDS) includes persons reported from areas with confidential name-based HIV

infection reporting who were residents of other states or whose area of residence is unknown Total number of persons living with AIDS includes persons whose area of residence is unknown Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 25

Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristicsmdashUnited States and dependent areas

No of persons

Survival in months

gt12 gt24 gt36Data for 50 states and the District of Columbia

Age at diagnosis (yrs)lt13 101 096 094 09413ndash14 60 098 098 09515ndash19 305 098 096 09520ndash24 1351 096 093 09225ndash29 3034 095 092 09130ndash34 5499 094 091 08935ndash39 7888 093 090 08740ndash44 7085 092 088 08545ndash49 5090 089 085 08250ndash54 3067 086 081 07855ndash59 1505 083 078 07460ndash64 806 080 073 069gt65 614 073 068 065

RaceethnicityWhite not Hispanic 10706 092 089 087Black not Hispanic 18406 090 086 082Hispanic 6398 092 090 088AsianPacific Islander 404 094 092 090American IndianAlaska Native 167 084 081 075

Transmission categoryMale adult or adolescentMale-to-male sexual contact 12830 093 090 088Injection drug use 4048 089 084 081Male-to-male sexual contact and injection drug use 1701 093 089 086High-risk heterosexual contacta 3170 091 088 085Otherb 5019 086 083 080Subtotal 26768 091 088 085

Female adult or adolescentInjection drug use 2101 089 083 078High-risk heterosexual contacta 4686 093 089 086Otherb 2749 090 085 083Subtotal 9536 091 087 083

Child (lt13 yrs at diagnosis)Perinatal 98 096 095 095Otherc 3 100 067 067Subtotal 101 096 094 094

Subtotal for 50 states and the District of Columbia 36405 091 087 085

Data for US dependent areas 891 083 078 075

Total 37352d 091 087 084Note Excludes persons whose date of death was before or in the same month as date of diagnosis Excludes persons whose month of diagnosis or month of death is unknowna Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes 325 persons of unknown race or multiple races

26 Survival after AIDS Diagnosis

Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by year of diagnosismdashUnited States and dependent areas

Months after AIDS diagnosis

Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by age groupmdashUnited States and dependent areas

Months after AIDS diagnosis

Survival after AIDS Diagnosis 27

Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by raceethnicitymdashUnited States and dependent areas

Months after AIDS diagnosis

28 Survival after AIDS Diagnosis

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006

and cumulativemdashUnited States and dependent areas

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Alabama 510 112 462 100 8626 76 8702Alaska 24 36 38 57 648 7 655Arizona 626 105 539 87 10396 46 10442Arkansas 237 85 252 90 3891 36 3927California 4069 113 3960 109 142254 664 142918Colorado 351 75 322 68 8742 31 8773Connecticut 658 188 422 120 14716 183 14899Delaware 177 210 116 136 3547 26 3573District of Columbia 672 1155 853 1467 17372 189 17561Florida 4921 277 4932 273 104084 1530 105614Georgia 2325 255 1605 171 31734 231 31965Hawaii 105 82 93 72 2927 17 2944Idaho 24 17 26 18 604 2 606Illinois 1886 148 1382 108 33620 282 33902Indiana 407 65 346 55 8239 56 8295Iowa 93 31 86 29 1727 13 1740Kansas 105 38 120 43 2781 14 2795Kentucky 249 60 207 49 4600 32 4632Louisiana 936 208 824 192 17612 128 17740Maine 21 16 68 51 1110 8 1118Maryland 1558 279 1626 290 30252 319 30571Massachusetts 666 104 533 83 19181 214 19395Michigan 821 81 672 67 14941 113 15054Minnesota 226 44 212 41 4817 28 4845Mississippi 368 127 365 125 6642 56 6698Missouri 385 66 469 80 11016 61 11077Montana 21 22 7 07 373 3 376Nebraska 53 30 118 67 1479 11 1490Nevada 293 121 294 118 5733 29 5762New Hampshire 33 25 55 42 1074 10 1084New Jersey 1262 145 1065 122 48750 778 49528New Mexico 134 70 93 48 2603 7 2610New York 6201 321 5495 285 174908 2354 177262North Carolina 916 106 1229 139 15954 118 16072North Dakota 10 16 6 09 144 1 145Ohio 753 66 767 67 14957 138 15095Oklahoma 281 79 205 57 4836 26 4862Oregon 217 60 281 76 5995 20 6015Pennsylvania 1486 120 1893 152 33417 365 33782Rhode Island 87 81 111 104 2580 28 2608South Carolina 682 161 705 163 13301 105 13406South Dakota 18 23 18 23 255 5 260Tennessee 818 137 680 113 12457 59 12516Texas 3045 133 2998 128 69735 392 70127Utah 63 25 57 22 2295 20 2315Vermont 5 08 18 29 461 6 467Virginia 638 84 605 79 16802 177 16979Washington 485 77 389 61 11792 34 11826West Virginia 74 41 67 37 1500 11 1511Wisconsin 122 22 217 39 4513 33 4546Wyoming 6 12 8 16 228 2 230

Subtotal 40123 135 37911 127 952221 9094 961315

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 29

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulativemdashUnited States and dependent areas (cont)

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

US dependent areasAmerican Samoa 0 0 0 0 1 0 1Guam 0 0 0 0 68 1 69Northern Mariana Islands 0 0 0 0 3 0 3Puerto Rico 1029 263 850 216 29511 400 29911US Virgin Islands 17 156 32 295 629 18 647Otherb 0 0 0 0 3 0 3

Totalc 41357 138 39002 129 983343 9522 992865d

a From the beginning of the epidemic through 2006b Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasc Includes persons whose state or area of residence is unknownd Includes 916 persons whose state or area of residence is unknown

30 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

MSA (population gt 500000)

Akron Ohio 66 94 32 46 762 1 763

AlbanyndashSchenectadyndashTroy NY 97 114 105 123 2253 24 2277

Albuquerque N Mex 70 88 50 61 1404 2 1406

AllentownndashBethlehemndashEaston PandashNJ 72 91 119 149 1352 17 1369

AtlantandashSandy SpringsndashMarietta Ga 1586 319 1006 196 21896 128 22024

AugustandashRichmond County GandashSC 106 205 32 61 1851 24 1875

AustinndashRound Rock Tex 227 156 186 123 4830 26 4856

Bakersfield Calif 76 100 122 156 1528 8 1536

BaltimorendashTowson Md 1064 401 1001 377 20352 218 20570

Baton Rouge La 222 304 231 301 3732 20 3752

BirminghamndashHoover Ala 151 139 110 100 2614 25 2639

Boise CityndashNampa Idaho 14 26 14 25 281 0 281

Boston MassndashNHa 441 99 355 80 13476 147 13623

Boston Division 269 146 185 101 8451 91 8542

Cambridge Division 108 74 102 70 3126 35 3161

Essex Division 52 71 51 69 1577 20 1597

BridgeportndashStamfordndashNorwalk Conn 181 201 135 150 3733 57 3790

BuffalondashNiagara Falls NY 117 102 96 84 2476 20 2496

Cape CoralndashFort Myers Fla 44 81 91 159 1692 24 1716

CharlestonndashNorth Charleston SC 92 155 91 151 2034 18 2052

CharlottendashGastoniandashConcord NCndashSC 214 141 285 180 3242 22 3264

Chicago IllndashIndndashWis 1716 182 1159 122 30118 261 30379

Chicago Division 1604 203 1073 135 28300 248 28548

Gary Division 61 88 50 71 1038 8 1046

Lake Division 51 59 36 41 780 5 785

CincinnatindashMiddletown OhiondashKyndashInd 111 53 199 95 2735 17 2752

ClevelandndashElyriandashMentor Ohio 228 107 170 80 4226 48 4274

Colorado Springs Colo 19 32 21 35 576 5 581

Columbia SC 177 256 197 280 3274 24 3298

Columbus Ohio 166 97 165 96 3112 15 3127

Dallas Tex 874 150 929 155 20238 63 20301

Dallas Division 681 175 714 178 16038 37 16075

Fort Worth Division 193 100 215 108 4200 26 4226

Dayton Ohio 58 69 54 64 1217 15 1232

DenverndashAurora Colo 274 116 236 98 6899 22 6921

Des Moines Iowa 30 57 23 43 530 4 534

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 31

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Detroit Mich 570 127 445 100 10373 73 10446

Detroit Division 443 223 330 167 8268 57 8325

Warren Division 127 51 115 46 2105 16 2121

El Paso Tex 56 78 40 54 1476 10 1486

Fresno Calif 52 59 64 72 1430 11 1441

Grand RapidsndashWyoming Mich 46 60 51 66 816 6 822

GreensborondashHigh Point NC 52 77 66 96 1265 14 1279

Greenville SC 70 119 67 111 1292 4 1296

HarrisburgndashCarlisle Pa 23 44 67 128 1224 8 1232

HartfordndashWest HartfordndashEast Hartford Conn 256 216 135 114 5126 46 5172

Honolulu Hawaii 54 60 69 76 2121 14 2135

HoustonndashBaytownndashSugar Land Tex 1017 190 1092 197 25821 172 25993

Indianapolis Ind 191 116 150 90 3824 25 3849

Jackson Miss 134 257 117 221 2419 30 2449

Jacksonville Fla 309 248 315 246 6020 75 6095

Kansas City MondashKans 183 94 160 81 4669 15 4684

Knoxville Tenn 47 72 35 52 882 5 887

Lakeland Fla 103 190 112 199 1811 21 1832

Las VegasndashParadise Nev 245 143 258 145 4616 28 4644

Little RockndashNorth Little Rock Ark 87 135 75 115 1383 14 1397

Los Angeles Calif 1529 118 1684 130 57953 293 58246

Los Angeles Division 1339 135 1435 144 51098 250 51348

Santa Anna Division 190 63 249 83 6855 43 6898

Louisville KyndashInd 123 102 97 79 2286 22 2308

Madison Wis 10 19 29 53 520 4 524

McAllenndashEdinburgndashPharr Tex 57 84 45 64 630 11 641

Memphis TennndashMissndashArk 402 320 346 271 5128 19 5147

Miami Fla 2420 446 2289 419 55807 997 56804

Fort Lauderdale Division 810 455 769 430 16412 262 16674

Miami Division 1243 523 1165 485 29703 512 30215

West Palm Beach Division 367 290 355 279 9692 223 9915

MilwaukeendashWaukeshandashWest Allis Wis 68 45 109 72 2507 18 2525

MinneapolisndashSt PaulndashBloomington MinnndashWis 186 59 184 58 4259 22 4281

Modesto Calif 36 71 22 43 671 6 677

NashvillendashDavidsonndashMurfreesboro Tenn 224 158 172 118 3848 20 3868

New HavenndashMilford Conn 169 200 107 127 4573 73 4646

New OrleansndashMetairiendashKenner La 393 299 271 264 8835 67 8902

32 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

New York NYndashNJndashPa 6215 330 5500 292 195177 2906 198083

Edison Division 191 83 130 56 6709 139 6848

Nassau Division 262 93 246 88 8141 110 8251

New York Division 5266 456 4716 408 160408 2323 162731

Newark Division 496 231 408 190 19919 334 20253

Oklahoma City Okla 125 108 88 75 2255 5 2260

OmahandashCouncil Bluffs NebndashIowa 37 46 80 97 1035 3 1038

Orlando Fla 544 282 517 260 8653 92 8745

OxnardndashThousand OaksndashVentura Calif 49 62 21 26 1008 3 1011

Palm BayndashMelbournendashTitusville Fla 68 129 61 114 1512 11 1523

Philadelphia PandashNJndashDelndashMd 1261 217 1348 231 28221 313 28534

Camden Division 108 87 111 89 3118 42 3160

Philadelphia Division 1022 263 1144 294 22112 250 22362

Wilmington Division 131 191 93 134 2991 21 3012

PhoenixndashMesandashScottsdale Ariz 460 119 376 93 7459 31 7490

Pittsburgh Pa 143 60 135 57 3182 19 3201

PortlandndashSouth Portland Maine 9 18 34 66 562 1 563

PortlandndashVancouverndashBeaverton OrendashWash 170 81 215 101 4825 10 4835

PoughkeepsiendashNewburghndashMiddletown NY 136 204 113 168 3162 24 3186

ProvidencendashNew BedfordndashFall River RIndashMass 132 82 155 96 3900 44 3944

RaleighndashCary NC 138 145 201 202 1987 13 2000

Richmond Va 119 101 122 102 3371 35 3406

RiversidendashSan BernardinondashOntario Calif 361 92 306 76 8568 60 8628

Rochester NY 165 159 124 120 3134 13 3147

SacramentondashArden-ArcadendashRoseville Calif 154 75 169 82 4000 26 4026

St Louis MondashIll 192 69 366 131 5965 40 6005

Salt Lake City Utah 46 44 40 37 1743 10 1753

San Antonio Tex 215 114 247 127 4987 30 5017

San DiegondashCarlsbadndashSan Marcos Calif 491 167 384 131 12934 61 12995

San Francisco Calif 867 209 690 165 40152 96 40248

Oakland Division 312 126 246 99 9546 48 9594

San Francisco Division 555 329 444 261 30606 48 30654

San JosendashSunnyvalendashSanta Clara Calif 88 50 145 81 3747 15 3762

San JuanndashCaguasndashGuaynabo PR 745 289 578 223 21402 277 21679

SarasotandashBradentonndashVenice Fla 82 122 104 152 1978 27 2005

ScrantonndashWilkes-Barre Pa 27 49 47 85 572 6 578

Seattle Wash 353 110 280 86 9172 27 9199

Seattle Division 316 129 255 102 8161 18 8179

Tacoma Division 37 49 25 33 1011 9 1020

Springfield Mass 88 128 45 66 2075 26 2101

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 33

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Stockton Calif 52 78 52 77 1076 15 1091

Syracuse NY 52 80 49 75 1317 8 1325

TampandashSt PetersburgndashClearwater Fla 559 211 605 224 11174 112 11286

Toledo Ohio 25 38 66 101 812 14 826

Tucson Ariz 103 111 100 106 2010 10 2020

Tulsa Okla 83 94 65 72 1494 10 1504

Virginia BeachndashNorfolkndashNewport News VandashNC 183 111 132 80 4711 63 4774

Washington DCndashVandashMdndashWV 1322 252 1684 318 31130 315 31445

Bethesda Division 135 118 173 150 2774 23 2797

Washington Division 1187 289 1511 365 28356 292 28648

Wichita Kans 35 60 38 64 851 2 853

Worcester Mass 76 97 79 101 1783 20 1803

YoungstownndashWarrenndashBoardman OhiondashPa 27 46 26 44 519 0 519

Subtotal for MSAs (population gt500000) 33602 173 31274 159 829633 8171 837804

Metropolitan areas (population of 50000 to 499999) 4477 80 4466 79 94829 847 95676

Nonmetropolitan areas 2666 54 2732 55 52063 445 52508

Totalb 41144 137 38749 128 981708 9494 991202

Note Because of the lack of census information for all US dependent areas includes data for only the 50 states the District of Columbia and Puerto RicoMSA metropolitan statistical areaMSA definitions for this report can be found at httpwwwcensusgovpopulationwwwestimatesmetrodefhtmla Reported case counts for the metropolitan divisions do not sum to the MSA total MSA total includes data from 1 metropolitan division with

population of lt500000b Includes persons whose county of residence is unknown

34 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Alabama (January 1988) 502 6041 48 6089

Alaska (February 1999) 38 285 2 287

Arizona (January 1987) 617 5877 80 5957

Arkansas (July 1989) 206 2349 20 2369

California (April 2006) 6581 7056 92 7148

Colorado (November 1985) 319 6084 31 6115

Connecticut (January 2005)b 826 2500 101 2601

Delaware (February 2006) 788 801 18 819

Florida (July 1997)c 4163 36386 397 36783

Georgia (December 2003) 2245 8197 194 8391

Idaho (June 1986) 35 340 4 344

Illinois (January 2006) 6241 6661 162 6823

Indiana (July 1988) 399 4027 43 4070

Iowa (July 1998) 69 586 5 591

Kansas (July 1999) 142 1225 15 1240

Kentucky (October 2004) 333 1303 13 1316

Louisiana (February 1993) 728 8149 166 8315

Maine (January 2006) 386 393 3 396

Michigan (April 1992) 635 6702 134 6836

Minnesota (October 1985) 309 3356 40 3396

Mississippi (August 1988) 352 4549 59 4608

Missouri (October 1987) 502 5086 55 5141

Nebraska (September 1995) 91 672 14 686

Nevada (February 1992) 339 3532 24 3556

New Hampshire (January 2005) 59 466 9 475

New Jersey (January 1992) 1477 17513 325 17838

New Mexico (January 1998) 114 949 4 953

New York (June 2000) 5326 42345 1820 44165

North Carolina (February 1990) 1615 13879 143 14022

North Dakota (January 1988) 4 82 1 83

Ohio (June 1990) 867 8222 101 8323

Oklahoma (June 1988) 229 2401 30 2431

Oregon (April 2006) 49 95 19 114

Pennsylvania (October 2002)d 4269 9537 179 9716

Rhode Island (July 2006) 14 21 0 21

South Carolina (February 1986) 493 6970 93 7063

South Dakota (January 1988) 18 215 6 221

Tennessee (January 1992) 732 7115 90 7205

Texas (January 1999)e 3370 24282 417 24699

Utah (April 1989) 106 893 14 907

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 35

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Virginia (July 1989) 864 10257 95 10352

Washington (March 2006) 4048 4157 40 4197

West Virginia (January 1989) 66 673 8 681

Wisconsin (November 1985) 261 2500 31 2531

Wyoming (June 1989) 7 93 1 94

Subtotal 50834 274822 5146 279968

US dependent areas

American Samoa (August 2001) 0 1 0 1

Guam (March 2000) 2 66 0 66

Northern Mariana Islands (October 2001) 2 7 0 7

Puerto Rico (January 2003) 1471 5610 91 5701

US Virgin Islands (December 1998) 22 247 6 253

Persons reported from areas with confidential name-based HIV infection reporting but who were residents of other areas 132 685 21 706

Totalf 52878 282640 5314 287954

Note Includes data from 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through 2006b Beginning in 1992 Connecticut had name-based HIV reporting for cases in children only From January 2002 through December 2004

Connecticut had name- or code-based HIV reporting for cases in adolescents and adults As of January 2005 Connecticut has name-based reporting of all cases of HIV infection

c Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterd On October 18 2002 Pennsylvania initiated confidential name-based HIV infection reporting in all areas except Philadelphia Code-based

reporting was implemented in Philadelphia in March 2004 and the switch to name-based reporting was made in October 2005e From February 1994 through December 1998 Texas reported HIV infection in children onlyf Includes 1252 persons reported from areas with confidential name-based HIV infection reporting but whose area of residence is unknown

36 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulativemdashUnited States and dependent areas

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No Adult or adolescentMale-to-male sexual contact 13775 49 429897 54 mdash mdash mdash mdash 13775 35 429897 44Injection drug use 3413 12 163070 21 1826 17 67693 35 5239 13 230763 23Male-to-male sexual contact and

injection drug use 1603 6 65524 8 mdash mdash mdash mdash 1603 4 65524 7Hemophiliacoagulation disorder 43 0 5176 1 11 0 348 0 54 0 5524 1High-risk heterosexual contactc 2997 11 49610 6 4839 46 85186 44 7836 20 134796 14

Sex with injection drug user 330 1 11683 1 706 7 26073 14 1036 3 37756 4Sex with bisexual male mdash mdash mdash mdash 234 2 5162 3 234 1 5162 1Sex with person with hemophilia 1 0 84 0 11 0 502 0 12 0 586 0Sex with HIV-infected transfusion

recipient 22 0 553 0 21 0 793 0 43 0 1346 0Sex with HIV-infected person risk

factor not specified 2644 9 37290 5 3867 37 52656 27 6511 17 89946 9Receipt of blood transfusion blood

d components or tissue 63 0 5213 1 68 1 4176 2 131 0 9389 1Otherrisk factor not reported or

identifiede 6484 23 73136 9 3793 36 34311 18 10278 26 107450 11Subtotal 28378 100 791626 100 10537 100 191714 100 38916 100 983343 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 0 0 222 5 0 0 7 0 0 0 229 2Mother with documented HIV infection or

1 of the following risk factors 24 75 4315 89 50 93 4423 95 74 86 8738 92Injection drug use 4 13 1676 35 4 7 1665 36 8 9 3341 35Sex with injection drug user 4 13 789 16 4 7 750 16 8 9 1539 16Sex with bisexual male 1 3 101 2 2 4 110 2 3 3 211 2Sex with person with hemophilia 0 0 20 0 0 0 16 0 0 0 36 0Sex with HIV-infected transfusion

recipient 0 0 11 0 0 0 15 0 0 0 26 0Sex with HIV-infected person risk

factor not specified 6 19 742 15 17 31 790 17 23 27 1532 16Receipt of blood transfusion blood

components or tissue 0 0 70 1 0 0 82 2 0 0 152 2Has HIV infection risk factor not

specified 9 28 906 19 23 43 995 21 32 37 1901 20Receipt of blood transfusion blood

fcomponents or tissue 1 3 243 5 0 0 144 3 1 1 387 4Otherrisk factor not reported or

identifiedg 7 22 75 2 4 7 93 2 11 13 168 2Subtotal 32 100 4855 100 54 100 4667 100 86 100 9522 100

Total 28410 100 796481 100 10591 100 196381 100 39002 100 992865 100a From the beginning of the epidemic through 2006b From the beginning of the epidemic through 2006 Includes 3 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infectiond AIDS developed in 47 adultsadolescents after they received blood that had tested negative for HIV antibodies AIDS developed in 14 additional adults

after they received tissue organs or artificial insemination from HIV-infected donors Four of the 14 received tissue or organs from a donor who was negative for HIV antibody at the time of donation

e Includes 37 adultsadolescents who were exposed to HIV-infected blood body fluids or concentrated virus in health care laboratory or household settings as supported by seroconversion epidemiologic andor laboratory evidence One person was infected after intentional inoculation with HIV-infected blood Includes an additional 740 persons who acquired HIV infection perinatally but who were more than 12 years of age when AIDS was diagnosed These 740 persons are not counted in the values for the pediatric transmission category

f AIDS developed in 3 children after they received blood that had tested negative for HIV antibodiesg Includes 5 children who were exposed to HIV-infected blood as supported by seroconversion epidemiologic andor laboratory evidence 1 child was

infected after intentional inoculation with HIV-infected blood and 5 children were exposed to HIV-infected blood in a household setting Of the 168 children 26 had sexual contact with an adult with or at high risk for HIV infection

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 37

Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No

Adult or adolescentMale-to-male sexual contact 22912 59 103679 52 mdash mdash mdash mdash 22912 44 103679 37

Injection drug use 3503 9 24255 12 2124 16 13925 17 5627 11 38181 14

Male-to-male sexual contact and injection drug use 1946 5 10704 5 mdash mdash mdash mdash 1946 4 10704 4

Hemophiliacoagulation disorder 43 0 495 0 6 0 73 0 49 0 568 0

High-risk heterosexual contactc 2874 7 16830 8 5939 45 38315 47 8813 17 55145 20

Sex with injection drug user 308 1 2601 1 757 6 6791 8 1065 2 9392 3

Sex with bisexual male mdash mdash mdash mdash 328 2 2265 3 328 1 2265 1

Sex with person with hemophilia 4 0 31 0 16 0 201 0 20 0 232 0

Sex with HIV-infected transfusion recipient 13 0 131 0 28 0 223 0 41 0 354 0

Sex with HIV-infected person risk factor not specified 2549 7 14067 7 4810 36 28835 35 7359 14 42902 15

Receipt of blood transfusion blood components or tissue 61 0 489 0 50 0 536 1 111 0 1025 0

Otherrisk factor not reported or identified 7748 20 44021 22 5106 39 29312 36 12854 25 73338 26

Subtotal 39087 100 200473 100 13225 100 82161 100 52312 100 282640 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 8 3 106 4 0 0 1 0 8 1 107 2

Mother with documented HIV infection or 1 of the following risk factors 197 74 2195 85 254 85 2417 89 451 80 4612 87

Injection drug use 34 13 532 21 53 18 561 21 87 15 1093 21

Sex with injection drug user 12 5 208 8 21 7 213 8 33 6 421 8

Sex with bisexual male 5 2 37 1 4 1 32 1 9 2 69 1

Sex with person with hemophilia 0 0 3 0 1 0 7 0 1 0 10 0

Sex with HIV-infected transfusion recipient 0 0 4 0 0 0 4 0 0 0 8 0

Sex with HIV-infected person risk factor not specified 54 20 534 21 76 25 629 23 130 23 1163 22

Receipt of blood transfusion blood components or tissue 0 0 17 1 2 1 20 1 2 0 37 1

Has HIV infection risk factor not specified 92 35 860 33 97 32 951 35 189 33 1811 34

Receipt of blood transfusion blood components or tissue 6 2 28 1 3 1 24 1 9 2 52 1

Otherrisk factor not reported or identified 55 21 260 10 43 14 283 10 98 17 543 10

Subtotal 266 100 2589 100 300 100 2725 100 566 100 5314 100

Total 39353 100 203062 100 13525 100 84886 100 52878 100 287954 100

Note See Table 16 for the list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006b From the beginning of the epidemic through December 2006 Includes 6 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infection

38 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity

2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 6251 65 253927 73Injection drug use 733 8 31737 9Male-to-male sexual contact and injection drug use 732 8 31434 9Hemophiliacoagulation disorder 26 0 3989 1High-risk heterosexual contactb 416 4 7850 2

Sex with injection drug user 74 1 2310 1

Sex with person with hemophilia 0 0 36 0

Sex with HIV-infected transfusion recipient 2 0 176 0

Sex with HIV-infected person risk factor not specified 340 4 5328 2Receipt of blood transfusion blood components or tissue 20 0 3194 1Otherrisk factor not reported or identified 1400 15 16469 5

Total 9578 100 348600 100

Black not HispanicMale-to-male sexual contact 4309 36 103297 37Injection drug use 1635 14 83369 30Male-to-male sexual contact and injection drug use 526 4 22134 8Hemophiliacoagulation disorder 10 0 604 0High-risk heterosexual contactb 1875 16 29952 11

Sex with injection drug user 167 1 6823 2Sex with person with hemophilia 1 0 36 0Sex with HIV-infected transfusion recipient 15 0 237 0Sex with HIV-infected person risk factor not specified 1692 14 22856 8

Receipt of blood transfusion blood components or tissue 24 0 1218 0Otherrisk factor not reported or identified 3579 30 40268 14

Total 11958 100 280842 100

HispanicMale-to-male sexual contact 2816 47 64893 44Injection drug use 965 16 46337 31Male-to-male sexual contact and injection drug use 287 5 10884 7Hemophiliacoagulation disorder 6 0 466 0High-risk heterosexual contactb 638 11 10950 7

Sex with injection drug user 84 1 2409 2Sex with person with hemophilia 0 0 11 0Sex with HIV-infected transfusion recipient 5 0 125 0Sex with HIV-infected person risk factor not specified 549 9 8405 6

Receipt of blood transfusion blood components or tissue 17 0 657 0Otherrisk factor not reported or identified 1326 22 14832 10

Total 6055 100 149019 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 39

a

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulative

No No

AsianPacific IslanderMale-to-male sexual contact 225 54 4475 68Injection drug use 20 5 317 5Male-to-male sexual contact and injection drug use 17 4 284 4Hemophiliacoagulation disorder 1 0 70 1High-risk heterosexual contactb 34 8 376 6

Sex with injection drug user 1 0 54 1Sex with person with hemophilia 0 0 1 0Sex with HIV-infected transfusion recipient 0 0 8 0Sex with HIV-infected person risk factor not specified 33 8 313 5

Receipt of blood transfusion blood components or tissue 2 0 112 2Otherrisk factor not reported or identified 114 28 949 14

Total 413 100 6583 100

American IndianAlaska NativeMale-to-male sexual contact 61 49 1403 55Injection drug use 15 12 395 15Male-to-male sexual contact and injection drug use 23 19 457 18Hemophiliacoagulation disorder 0 0 27 1High-risk heterosexual contactb 9 7 118 5

Sex with injection drug user 1 1 33 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 8 6 82 3

Receipt of blood transfusion blood components or tissue 0 0 8 0Otherrisk factor not reported or identified 16 13 155 6

Total 124 100 2563 100

Total casesMale-to-male sexual contact 13775 49 429897 54Injection drug use 3413 12 163070 21Male-to-male sexual contact and injection drug use 1603 6 65524 8Hemophiliacoagulation disorder 43 0 5176 1High-risk heterosexual contactb 2997 11 49610 6

Sex with injection drug user 330 1 11683 1Sex with person with hemophilia 1 0 84 0Sex with HIV-infected transfusion recipient 22 0 553 0Sex with HIV-infected person risk factor not specified 2644 9 37290 5

Receipt of blood transfusion blood components or tissue 63 0 5213 1Otherrisk factor not reported or identified 6484 23 73136 9

Total 28378c 100 791626d 100a From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 4019 males of unknown race or multiple races

40 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 11963 73 55725 69Injection drug use 858 5 5512 7Male-to-male sexual contact and injection drug use 1092 7 5578 7Hemophiliacoagulation disorder 29 0 355 0High-risk heterosexual contactb 522 3 2658 3

Sex with injection drug user 65 0 544 1Sex with person with hemophilia 0 0 8 0Sex with HIV-infected transfusion recipient 3 0 33 0Sex with HIV-infected person risk factor not specified 454 3 2073 3

Receipt of blood transfusion blood components or tissue 14 0 197 0Otherrisk factor not reported or identified 1956 12 11147 14

Total 16434 100 81172 100

Black not HispanicMale-to-male sexual contact 6203 44 30148 37Injection drug use 1594 11 11997 15Male-to-male sexual contact and injection drug use 483 3 3489 4Hemophiliacoagulation disorder 10 0 109 0High-risk heterosexual contactb 1714 12 10905 13

Sex with injection drug user 169 1 1554 2Sex with person with hemophilia 4 0 17 0Sex with HIV-infected transfusion recipient 6 0 77 0Sex with HIV-infected person risk factor not specified 1535 11 9257 11

Receipt of blood transfusion blood components or tissue 32 0 223 0Otherrisk factor not reported or identified 4151 29 24632 30

Total 14187 100 81503 100

HispanicMale-to-male sexual contact 4094 55 15623 47Injection drug use 993 13 6407 19Male-to-male sexual contact and injection drug use 316 4 1402 4Hemophiliacoagulation disorder 3 0 26 0High-risk heterosexual contactb 582 8 2963 9

Sex with injection drug user 65 1 455 1Sex with person with hemophilia 0 0 6 0Sex with HIV-infected transfusion recipient 4 0 18 0Sex with HIV-infected person risk factor not specified 513 7 2484 7

Receipt of blood transfusion blood components or tissue 11 0 55 0Otherrisk factor not reported or identified 1475 20 6977 21

Total 7474 100 33453 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 41

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderMale-to-male sexual contact 402 70 1006 63Injection drug use 17 3 55 3Male-to-male sexual contact and injection drug use 15 3 38 2Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 25 4 96 6

Sex with injection drug user 3 1 10 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 22 4 83 5

Receipt of blood transfusion blood components or tissue 4 1 7 0Otherrisk factor not reported or identified 109 19 397 25

Total 572 100 1600 100

American IndianAlaska NativeMale-to-male sexual contact 104 61 516 57Injection drug use 13 8 101 11Male-to-male sexual contact and injection drug use 19 11 110 12Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 10 6 53 6

Sex with injection drug user 2 1 14 2Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 8 5 39 4

Receipt of blood transfusion blood components or tissue 0 0 2 0Otherrisk factor not reported or identified 24 14 125 14

Total 170 100 907 100

Total casesMale-to-male sexual contact 22912 59 103679 52Injection drug use 3503 9 24255 12Male-to-male sexual contact and injection drug use 1946 5 10704 5Hemophiliacoagulation disorder 43 0 495 0High-risk heterosexual contactb 2874 7 16830 8

Sex with injection drug user 308 1 2601 1Sex with person with hemophilia 4 0 31 0Sex with HIV-infected transfusion recipient 13 0 131 0Sex with HIV-infected person risk factor not specified 2549 7 14067 7

Receipt of blood transfusion blood components or tissue 61 0 489 0Otherrisk factor not reported or identified 7748 20 44021 22

Total 39087c 100 200473d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 1838 males of unknown race or multiple races

42 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race

ethnicity 2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 482 28 14981 40Hemophiliacoagulation disorder 4 0 123 0High-risk heterosexual contactb 725 42 15799 42

Sex with injection drug user 153 9 5650 15Sex with bisexual male 63 4 1859 5Sex with person with hemophilia 5 0 329 1Sex with HIV-infected transfusion recipient 5 0 338 1Sex with HIV-infected person risk factor not specified 499 29 7623 20

Receipt of blood transfusion blood components or tissue 15 1 1870 5Otherrisk factor not reported or identified 499 29 4801 13

Total 1725 100 37574 100

Black not HispanicInjection drug use 982 15 38914 34Hemophiliacoagulation disorder 3 0 145 0High-risk heterosexual contactb 3103 46 49876 44

Sex with injection drug user 373 6 13530 12Sex with bisexual male 136 2 2352 2Sex with person with hemophilia 4 0 121 0Sex with HIV-infected transfusion recipient 8 0 277 0Sex with HIV-infected person risk factor not specified 2582 38 33596 29

Receipt of blood transfusion blood components or tissue 39 1 1546 1Otherrisk factor not reported or identified 2612 39 23894 21

Total 6739 100 114375 100

HispanicInjection drug use 322 18 12892 35Hemophiliacoagulation disorder 4 0 67 0High-risk heterosexual contactb 894 49 17995 49

Sex with injection drug user 166 9 6522 18Sex with bisexual male 32 2 818 2Sex with person with hemophilia 1 0 45 0Sex with HIV-infected transfusion recipient 7 0 141 0Sex with HIV-infected person risk factor not specified 688 38 10469 29

Receipt of blood transfusion blood components or tissue 12 1 619 2Otherrisk factor not reported or identified 592 32 5023 14

Total 1824 100 36596 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 43

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 8 8 125 12Hemophiliacoagulation disorder 0 0 7 1High-risk heterosexual contactb 49 47 574 53

Sex with injection drug user 4 4 114 11Sex with bisexual male 2 2 80 7Sex with person with hemophilia 0 0 4 0Sex with HIV-infected transfusion recipient 1 1 25 2Sex with HIV-infected person risk factor not specified 42 40 351 33

Receipt of blood transfusion blood components or tissue 1 1 93 9Otherrisk factor not reported or identified 46 44 279 26

Total 104 100 1078 100

American IndianAlaska NativeInjection drug use 13 32 280 42Hemophiliacoagulation disorder 0 0 3 0High-risk heterosexual contactb 15 37 277 41

Sex with injection drug user 4 10 107 16Sex with bisexual male 1 2 27 4Sex with person with hemophilia 0 0 2 0Sex with HIV-infected transfusion recipient 0 0 6 1Sex with HIV-infected person risk factor not specified 10 24 135 20

Receipt of blood transfusion blood components or tissue 1 2 17 3Otherrisk factor not reported or identified 12 29 95 14

Total 41 100 672 100

Total casesInjection drug use 1826 17 67693 35Hemophiliacoagulation disorder 11 0 348 0High-risk heterosexual contactb 4839 46 85186 44

Sex with injection drug user 706 7 26073 14Sex with bisexual male 234 2 5162 3Sex with person with hemophilia 11 0 502 0Sex with HIV-infected transfusion recipient 21 0 793 0Sex with HIV-infected person risk factor not specified 3867 37 52656 27

Receipt of blood transfusion blood components or tissue 68 1 4176 2Otherrisk factor not reported or identified 3793 36 34311 18

Total 10537c 100 191714d 100a From the beginning of the epidemic through 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 104 females of unknown race or multiple racesd Includes 1419 females of unknown race or multiple races

44 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 690 26 4260 26Hemophiliacoagulation disorder 3 0 24 0

bHigh-risk heterosexual contact 1132 42 7593 46Sex with injection drug user 205 8 1876 11Sex with bisexual male 98 4 659 4Sex with person with hemophilia 10 0 115 1Sex with HIV-infected transfusion recipient 7 0 64 0Sex with HIV-infected person risk factor not specified 812 30 4879 29

Receipt of blood transfusion blood components or tissue 12 0 146 1Otherrisk factor not reported or identified 850 32 4567 28

Total 2687 100 16590 100

Black not HispanicInjection drug use 1034 13 7105 14Hemophiliacoagulation disorder 1 0 35 0

bHigh-risk heterosexual contact 3451 44 23732 46Sex with injection drug user 313 4 3473 7Sex with bisexual male 155 2 1294 3Sex with person with hemophilia 5 0 71 0Sex with HIV-infected transfusion recipient 14 0 120 0Sex with HIV-infected person risk factor not specified 2964 38 18774 36

Receipt of blood transfusion blood components or tissue 26 0 324 1Otherrisk factor not reported or identified 3370 43 20244 39

Total 7882 100 51440 100

HispanicInjection drug use 339 15 2280 18Hemophiliacoagulation disorder 2 0 11 0

bHigh-risk heterosexual contact 1198 52 6264 50Sex with injection drug user 218 9 1324 11Sex with bisexual male 62 3 266 2Sex with person with hemophilia 1 0 11 0Sex with HIV-infected transfusion recipient 7 0 39 0Sex with HIV-infected person risk factor not specified 910 39 4624 37

Receipt of blood transfusion blood components or tissue 12 1 58 0Otherrisk factor not reported or identified 767 33 3843 31

Total 2318 100 12456 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 45

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 7: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Of all HIV infections diagnosed in 2005 in the 33 states with confidential name-based HIV reporting 38 progressed to AIDS within 12 months after HIV infection was diagnosed AIDS was diagnosed within 12 months after the diagnosis of HIV infection for larger proportions of persons aged 13ndash14 years and 35 years and older for Hispanics for IDUs and for males with HIV infection attributed to high-risk heterosexual contact (Table 2)

Cases of AIDSFrom 2002 through 2006 the estimated number of

newly diagnosed AIDS cases in the 50 states and the District of Columbia remained stable (Table 3) In 2006 the estimated rate of AIDS cases in the United States was 123 per 100000 population (Table 5a)

bull Age group From 2002 through 2006 the estimated number of AIDS cases decreased 64 among children (less than 13 years of age) (Table 3) The estimated number of AIDS cases also decreased among persons in the age groups 30ndash34 and 35ndash39 years (Table 3) The estimated number of AIDS cases remained stable among persons aged 40ndash44 years and increased in the following age groups 13ndash14 15ndash19 20ndash24 25ndash29 45ndash49 50ndash54 55ndash59 60ndash64 and 65 years and older In 2006 the largest number of AIDS cases occurred among persons aged 40ndash44 years who accounted for 20 of all AIDS cases diagnosed during that year in the 50 states and the District of Columbia

bull Raceethnicity From 2002 through 2006 the estimated number of AIDS cases decreased among blacks and American IndiansAlaska Natives remained stable among whites and Hispanics and increased among AsiansPacific Islanders (Table 3) In 2006 rates of AIDS cases were 476 per 100000 in the black population 156 per 100000 in the Hispanic population 62 per 100000 in the American IndianAlaska Native population 54 per 100000 in the white population and 37 per 100000 in the AsianPacific Islander population (Table 5a)

bull Sex From 2002 through 2006 the estimated number of AIDS cases remained stable among both male and female adults and adolescents (Table 3) Males accounted for 73 of all AIDS cases diagnosed in 2006 for adults and adolescents in the 50 states and the District of Columbia (Table

Comm

3) Rates of AIDS cases in 2006 were 224 per 100000 among males and 78 per 100000 among females (Table 5a)

bull Transmission category From 2002 through 2006 among male adults and adolescents the estimated number of AIDS cases decreased among IDUs and MSM who were also IDUs (Table 3) The numbers of males exposed through male-to-male sexual contact and high-risk heterosexual contact remained stable Among female adults and adolescents the estimated number of AIDS cases decreased among IDUs and fluctuated among females exposed through high-risk heterosexual contact

bull Region From 2002 through 2006 the estimated number of AIDS cases decreased 10 in the West and 6 in the Northeast and remained stable in the South and the Midwest

DeathsFrom 2002 through 2006 the estimated number of

deaths of persons with AIDS who resided in the 50 states and the District of Columbia decreased 17 (Table 7)

bull Age group The estimated number of deaths decreased among children (less than 13 years of age) and in the following age groups 13ndash14 25ndash29 30ndash34 35ndash39 40ndash44 and 45ndash49 years The estimated number of deaths remained stable among persons aged 50ndash54 years and increased in the age groups 15ndash19 20ndash24 55ndash59 60ndash64 and 65 years and older

bull Raceethnicity The estimated number of deaths of persons with AIDS decreased among whites blacks and American IndiansAlaska Natives The estimated number of deaths of persons with AIDS remained stable among Hispanics and increased among AsiansPacific Islanders

bull Sex and transmission category The estimated number of deaths of adults and adolescents decreased among MSM and IDUs and remained stable among persons exposed through high-risk heterosexual contact

bull Region The estimated number of deaths decreased in all regions of the United States

entary 7

Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS

Persons living with HIVAIDSFrom 2003 through 2006 the estimated number of

persons living with HIVAIDS increased steadily in the 33 states with confidential name-based HIV infec-tion reporting (Table 8) At the end of 2006 an esti-mated 491727 persons in these states were living with HIVAIDS

bull By age group most (21) were aged 40ndash44 years

bull By raceethnicity 47 were black 34 white 17 Hispanic and less than 1 each were American IndianAlaska Native or AsianPacific Islander

bull By sex 73 of adults and adolescents living with HIVAIDS were male

bull Of the estimated 353825 male adults and adolescents living with HIVAIDS 62 had been exposed through male-to-male sexual contact 17 had been exposed through injection drug use 13 had been exposed through high-risk heterosexual contact and 7 had been exposed through both male-to-male sexual contact and injection drug use Of the estimated 131195 female adults and adolescents living with HIVAIDS 73 had been exposed through high-risk heterosexual contact and 26 had been exposed through injection drug use Of the estimated 6703 children living with HIVAIDS 92 had been exposed perinatally

Prevalence rates of HIV infection (not AIDS)At the end of 2006 in the 38 areas with confidential

name-based HIV infection reporting since at least 2003 the prevalence rate of HIV infection (not AIDS) among adults and adolescents was estimated at 1437 per 100000 (Map 1) The rate for adults and adoles-cents living with HIV infection (not AIDS) ranged from an estimated 49 per 100000 (American Samoa) to an estimated 2617 per 100000 (New York) The prevalence rate of HIV infection (not AIDS) among children residing in the 38 areas was an estimated 65 per 100000 (Map 2) The rate for children living with HIV infection (not AIDS) ranged from an estimated zero per 100000 in Idaho New Mexico American Samoa Guam and the Northern Mariana Islands to an estimated 253 per 100000 in New York

8 Comm

Persons living with AIDSAIDS prevalence also increased steadily from 2002

through 2006 (Table 10) At the end of 2006 an esti-mated 436693 persons in the 50 states and the District of Columbia were living with AIDS

bull By age group most (22) were aged 40ndash44 years

bull By raceethnicity 44 were black 35 white 19 Hispanic 1 AsianPacific Islander and less than 1 were American IndianAlaska Native

bull By sex 77 of adults and adolescents living with AIDS were male

bull Of the estimated 333244 male adults and adolescents living with AIDS 60 had been exposed through male-to-male sexual contact 19 had been exposed through injection drug use 12 had been exposed through high-risk heterosexual contact and 8 had been exposed through both male-to-male sexual contact and injection drug use Of the estimated 99671 female adults and adolescents living with AIDS 66 had been exposed through high-risk heterosexual contact and 32 had been exposed through injection drug use

bull By region 41 resided in the South 29 in the Northeast 20 in the West and 11 in the Midwest

AIDS prevalence ratesAt the end of 2006 the prevalence rate of AIDS

among adults and adolescents in the United States was estimated at 1786 per 100000 (Map 1) The rate for adults and adolescents living with AIDS ranged from an estimated 25 per 100000 (American Samoa) to an estimated 20165 per 100000 (District of Columbia) The prevalence rate of AIDS among children in the United States was estimated at 22 per 100000 at the end of 2006 (Map 2) The rate for children living with AIDS ranged from an estimated zero per 100000 in Idaho Montana Utah American Samoa Guam and the Northern Mariana Islands to an estimated 365 per 100000 in the District of Columbia

Survival after AIDS DiagnosisTable 13 is limited to data on AIDS cases diagnosed

in 2002 in order to describe the survival of persons whose diagnosis was made relatively recently but far enough in the past to permit a meaningful measure of

entary

survival Figures 2 3 and 4 illustrate the proportion of surviving persons among persons whose diagnoses were made over a longer period 1998 through 2005

bull Survival (the estimated proportion of persons surviving a given length of time after diagnosis) increased with the year of diagnosis for diagnoses made during 1998ndash2000 Year-to-year differences were small during 2001ndash2005 (Figure 2)

bull Survival decreased as age at diagnosis increased among persons at least 35 years old at diagnosis and in comparison with persons younger than 35 Survival was similar for the age groups 13ndash24 and 25ndash34 (Figure 3)

bull Survival was greatest among MSM and among children with perinatally acquired HIV infection (Table 13) Survival was intermediate among male and female adults and adolescents who had heterosexual contact with someone known to be HIV infected or at high risk for HIV infection as well as among MSM who also were IDUs Survival was lowest among male and female adults and adolescents who were IDUs

bull Survival particularly at more than 48 months after diagnosis was greater among AsiansPacific Islanders whites and Hispanics than among blacks (Figure 4) Results were unstable or inconsistent for American IndiansAlaska Natives because the numbers of persons in this racialethnic category were small

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Tables 14ndash23 describe reports of cases of HIVAIDS AIDS and HIV infection (not AIDS) Tables 16 18 20 and 22 are based on reports of cases of HIV infection (not AIDS) through 2006 from the 50 areas that had implemented name-based HIV infection reporting Note that not all cases of HIV infection (not AIDS) or AIDS reported in 2006 reflect diagnoses made during 2006 rather the reported cases include cases diagnosed during earlier years

Reports of cases of HIV infection (not AIDS)Through 2006 a total of 287954 persons were

reported as having HIV infection (not AIDS) in the 50 areas with confidential name-based HIV infection reporting (Table 16) (see Technical Notes for discus-sion of surveillance of HIV infection [not AIDS])

Comm

Five states (Florida New Jersey New York North Carolina and Texas) reported 137507 (48) of the 287954 cumulative cases of HIV infection (not AIDS) reported to CDC In 2006 4 states (California Illinois New York and Pennsylvania) reported 22417 (42) of the 52878 cases of HIV infection (not AIDS)

bull In 2006 of the 52312 reported cases among adults and adolescents 75 were in males and 25 were in females (Table 18)

bull In 2006 566 cases in children were reported

Reports of AIDS casesThrough 2006 a total of 992865 persons in the

United States had been reported as having AIDS (Table 14) Three states (California Florida and New York) reported 43 of the cumulative AIDS cases and 37 of AIDS cases reported to CDC in 2006 In the United States the rate of reported AIDS cases in 2006 was 129 per 100000 population When the US dependent areas were included the rate of reported AIDS cases ranged from zero per 100000 (American Samoa Guam and the Northern Mariana Islands) to 1467 per 100000 (District of Columbia)

bull In 2006 males accounted for 73 and females for 27 of 38916 reported AIDS cases among adults and adolescents (Table 17)

bull In 2006 86 AIDS cases in children were reported

ADDITIONAL RESOURCES

The following were prepared by using HIVAIDS surveillance data

bull Selected MMWR articles at httpwwwcdcgovhivresourcesreportsmmwr

bull Public-use slides at httpwwwcdcgovhivtopicssurveillanceresourcesslides

bull Other surveillance reports at httpwwwcdcgovhivtopicssurveillanceresourcesreports

bull Public-use version of the AIDS surveillance data set (AIDS Public Information Data Set [APIDS]) at httpwwwcdcgovhivsoftwareapidshtm

SUGGESTED READINGS

CDC Advancing HIV Prevention New Strategies for a Changing EpidemicmdashUnited States 2003 MMWR 200352(15)329ndash332

entary 9

CDC Dear colleague letter CDC recommends that all states and territories adopt confidential name-based surveillance systems to report HIV infec-tions httpwwwcdcgovhivpubs070505_dearcolleague_gerberdingpdf Pub-lished July 5 2005 Accessed March 11 2008

1981ndash2005 CDC Epidemiology of HIVAIDSmdashUnited States

MMWR 200655(21)589ndash592CDC Guidelines for national HIV case surveil-

lance including monitoring for HIV infection and AIDS MMWR 199948(RR-13)1ndash31

CDC HIV prevention strategic plan extended through 2010 httpwwwcdcgovhivresourcesreportspsp Published October 2007 Accessed March 11 2008

CDC Revised recommendations for HIV testing of adults adolescents and pregnant women in health-care settings MMWR 200655(RR-14)1ndash17

CDC Twenty-five years of HIVAIDSmdashUnited States 1981ndash2006 MMWR 200655(21)585ndash589

Glynn MK Lee LM McKenna MT The status of national HIV case surveillance United States 2006 Public Health Rep 2007122(suppl 1)63ndash71

Janssen RS Satten GA Stramer SL et al New test-ing strategy to detect early HIV-1 infection for use in incidence estimates and for clinical and prevention purposes JAMA 1998280(1)42ndash48

Lee LM McKenna MT Monitoring the incidence of HIV infection in the United States Public Health Rep 2007122(suppl 1)72ndash79

10 Comm

entary

Cases of HIVAIDS and AIDS

Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003ndash2006mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

Year of diagnosis

2003 2004 2005 2006

Data for 33 statesAge at diagnosis (yrs)lt13 211 183 169 13513ndash14 53 36 40 4115ndash19 993 993 1126 133220ndash24 3163 3368 3592 388625ndash29 4023 4057 4236 460330ndash34 5189 4820 4676 446635ndash39 6369 5807 5535 544240ndash44 5786 5429 5529 571845ndash49 4028 3877 4028 420450ndash54 2451 2401 2547 271855ndash59 1279 1363 1455 143860ndash64 655 702 692 714gt65 570 624 613 618

RaceethnicityWhite not Hispanic 10033 10181 10528 10758Black not Hispanic 17668 16718 16629 17356Hispanic 6355 6010 6217 6481AsianPacific Islander 338 339 373 397American IndianAlaska Native 179 171 182 166

Transmission categoryMale adult or adolescentMale-to-male sexual contact 15409 15880 16833 17465Injection drug use 3514 3083 2978 3016Male-to-male sexual contact and injection drug use 1349 1299 1247 1180High-risk heterosexual contacta 4269 3959 3871 4152Otherb 125 110 107 114Subtotal 24666 24331 25036 25928

Female adult or adolescentInjection drug use 2027 1856 1720 1712High-risk heterosexual contacta 7731 7182 7216 7432Otherb 134 107 97 109Subtotal 9892 9145 9033 9252

Child (lt13 yrs at diagnosis)Perinatal 190 157 147 115Otherc 23 27 23 20Subtotal 213 184 170 135

Subtotal for 33 states 34770 33659 34239 35314

Data for US dependent areas 1331 1234 1395 1503

Totald 36102 34894 35634 36817Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

Cases of HIVAIDS and AIDS 11

Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

gt12 Months after diagnosis aof HIV infection

lt12 Months after diagnosis of HIV infectionb Total

No ()c No ()c No

Data for 33 statesAge at diagnosis (yrs)lt13 148 88 21 12 16913ndash14 22 54 18 46 4015ndash19 912 81 215 19 112620ndash24 2874 80 714 20 358925ndash29 3077 73 1157 27 423430ndash34 3016 65 1655 35 467135ndash39 3353 61 2176 39 553040ndash44 3181 58 2338 42 551945ndash49 2145 53 1874 47 401950ndash54 1307 51 1239 49 254655ndash59 725 50 728 50 145360ndash64 316 46 376 54 692gt65 266 44 346 56 612RaceethnicityWhite not Hispanic 6839 65 3677 35 10516Black not Hispanic 10372 62 6242 38 16614Hispanic 3593 58 2614 42 6206AsianPacific Islander 232 62 139 38 371American IndianAlaska Native 110 61 72 39 182Transmission category

Male adult or adolescentMale-to-male sexual contact 10917 65 5902 35 16819Injection drug use 1544 52 1427 48 2971Male-to-male sexual contact and injection drug use 733 59 512 41 1245High-risk heterosexual contactd 2091 54 1773 46 3864Othere 45 42 61 58 107Subtotal 15331 61 9675 39 25006Female adult or adolescentInjection drug use 1056 62 660 38 1716High-risk heterosexual contactd 4761 66 2450 34 7210Othere 47 48 50 52 97Subtotal 5864 65 3160 35 9023Child (lt13 yrs at diagnosis)Perinatal 126 86 21 14 147Otherf 22 94 2 6 23Subtotal 148 87 22 13 170

Subtotal for 33 states 21343 62 12857 38 34200Data for US dependent areas 855 61 541 39 1395

Totalg 22197 62 13398 38 35595h

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003Data exclude 39 persons whose month of diagnosis of HIV infection is unknowna Includes persons in whom AIDS has not developedb Includes persons whose diagnoses of HIV infection and AIDS were made at the same timec Percentages represent proportions of the total number of diagnoses of HIVAIDS made during 2005 for the corresponding group (see row

entries)d Heterosexual contact with a person known to have or to be at high risk for HIV infectione Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedf Includes hemophilia blood transfusion and risk factor not reported or not identifiedg Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the

column totalh Includes 310 persons of unknown race or multiple races

12 Cases of HIVAIDS and AIDS

Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas

Year of diagnosis2002 2003 2004 2005 2006 Cumulativea

Data for 50 states and the District of ColumbiaAge at diagnosis (yrs)lt13 106 70 53 53 38 915613ndash14 62 74 70 66 73 107815ndash19 316 302 334 410 401 562620ndash24 1399 1568 1624 1675 1669 3622525ndash29 3137 3059 3196 3110 3423 11709930ndash34 5701 5521 5144 4668 4349 19753035ndash39 8217 8017 7072 6479 6402 21357340ndash44 7404 7626 7703 7378 7298 17053145ndash49 5358 5617 5498 5727 5628 10720750ndash54 3271 3364 3491 3527 3687 5990755ndash59 1607 1693 1836 1861 2071 3219060ndash64 872 864 913 872 955 17303gt65 682 763 791 727 835 15074

RaceethnicityWhite not Hispanic 11233 10948 11066 10676 10929 394024Black not Hispanic 19246 19512 18909 18081 17960 409982Hispanic 6712 7102 6771 6823 6907 161505AsianPacific Islander 425 450 444 450 519 7951American IndianAlaska Native 177 176 182 170 155 3345

Transmission categoryMale adult or adolescentMale-to-male sexual contact 15709 16078 16054 15711 16001 465965Injection drug use 5483 5275 4818 4603 4410 170171Male-to-male sexual contact and injection drug use 2075 2029 1925 1930 1803 68516High-risk heterosexual contactb 4547 4471 4506 4306 4558 65241Otherc 253 226 228 237 217 13893Subtotal 28067 28079 27532 26787 26989 783786

Female adult or adolescentInjection drug use 2897 2836 2810 2586 2385 74718High-risk heterosexual contactb 6855 7336 7113 6922 7196 108252Otherc 207 217 217 205 220 6596Subtotal 9959 10389 10141 9713 9801 189566

Child (lt13 yrs at diagnosis)Perinatal 104 70 53 52 37 8508Otherd 2 0 0 0 0 636Subtotal 106 70 53 53 38 9144

Region of residenceNortheast 10092 10342 9412 9396 9486 306241Midwest 4125 4226 4089 4371 4164 101479South 17198 17630 18225 16894 17104 374800West 6718 6339 6000 5891 6074 199978Subtotal for 50 states and the District of Columbia 38132 38538 37726 36552 36828 982498

Data for US dependent areas 1058 1060 921 955 833 31217

Totale 39250 39690 38807 37662 37852 1014797Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes persons of unknown race or multiple races and persons of unknown sex Cumulative total includes 5691 persons of unknown race or multiple

races 3 persons of unknown sex 1079 persons of unknown state of residence and 3 persons who were residents of other areas Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Cases of HIVAIDS and AIDS 13

Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002ndash2006 and cumulativemdash50 states and the District of Columbia

Year of diagnosisCumulativea2002 2003 2004 2005 2006

RaceethnicityWhite not Hispanic 14 12 7 4 4 1599Black not Hispanic 70 46 33 38 30 5654Hispanic 18 10 9 8 3 1748AsianPacific Islander 1 0 1 1 1 54American IndianAlaska Native 1 0 1 0 0 31

Transmission categoryHemophiliacoagulation disorder 0 0 0 0 0 226Mother with documented HIV infection or 1 of the following risk factors 104 70 53 52 37 8508

Injection drug use 12 8 5 3 4 3220Sex with injection drug user 4 6 3 2 1 1397Sex with bisexual male 2 0 3 1 1 209Sex with person with hemophilia 0 0 0 0 0 35Sex with HIV-infected transfusion recipient 0 0 0 0 0 22Sex with HIV-infected person risk factor not specified 36 20 20 25 13 1530Receipt of blood transfusion blood components or tissue 2 1 0 0 0 144Has HIV infection risk factor not specified 47 34 21 21 17 1951

Receipt of blood transfusion blood components or tissue 2 0 0 0 0 374Otherrisk factor not reported or identified 0 0 0 0 0 36

Totalb 106 70 53 53 38 9144

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga From the beginning of the epidemic through 2006b Includes children of unknown race or multiple races Cumulative total includes 58 children of unknown race or multiple races Because column totals

were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992ndash2006mdash50 states and the District of Columbia

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reporting

14 Cases of HIVAIDS and AIDS

Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006mdash50 states and the District of Columbia

Raceethnicity

Adults or adolescents

Children (lt13 yrs) TotalaMales Females Totala

No Rate No Rate No Rate No Rate No Rate

White not Hispanic 9267 112 1659 19 10926 64 4 00 10929 54Black not Hispanic 11540 829 6391 404 17930 603 30 04 17960 476Hispanic 5388 313 1516 95 6903 208 3 00 6907 156AsianPacific Islander 423 75 95 16 518 44 1 00 519 37American IndianAlaska Native 118 122 37 36 155 78 0 00 155 62

Totalb 26989 224 9801 78 36790 149 38 01 36828c 123

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reportingData exclude cases in persons whose state or area of residence is unknown as well as cases from US dependent areas for which census information about race and age categories is lackinga Because row totals were calculated independently of the values for the subpopulations the values in each row may not sum to the row totalb Includes person of unknown race or multiple races Because column totals were calculated independently of the values for the subpopulations the

values in each column may not sum to the column totalc Includes 358 persons of unknown race or multiple races

Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006mdash33 states with confidential name-based HIV infection reporting

Raceethnicity

Adults or adolescents

Children (lt13 yrs) TotalaMales Females Totala

No Rate No Rate No Rate No Rate No Rate

White not Hispanic 9078 167 1664 29 10742 96 16 01 10758 82Black not Hispanic 11230 1191 6033 562 17263 856 93 17 17356 677Hispanic 5058 509 1400 151 6458 337 23 04 6481 255AsianPacific Islander 318 135 79 32 397 82 0 00 397 67American IndianAlaska Native 129 177 35 46 164 110 2 06 166 88

Totalb 25928 338 9252 115 35180 224 135 04 35314c 185

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Because row totals were calculated independently of the values for the subpopulations the values in each row may not sum to the row totalb Includes persons of unknown race or multiple races Because column totals were calculated independently of the values for the subpopulations the

values in each column may not sum to the column totalc Includes 156 persons of unknown race or multiple races

Cases of HIVAIDS and AIDS 15

Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006mdashUnited States and dependent areas

Transmission category

Place of birth

United StatesCentralSouth

America Cuba Mexico Puerto Rico Totala

No No No No No No

Male-to-male sexual contact 1172 45 402 49 89 62 790 59 249 18 3337 43Injection drug use 569 22 83 10 13 9 133 10 533 40 1650 21Male-to-male sexual contact

and injection drug use 158 6 25 3 6 4 59 4 63 5 357 5High-risk heterosexual

contactb 661 25 296 36 35 24 342 26 487 36 2282 30Otherc 47 2 8 1 0 0 9 1 14 1 103 1

Totald 2608 100 814 100 145 100 1334 100 1346 100 7728 100Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Includes 222 persons whose place of birth is not among those listed and 1260 persons whose place of birth is unknownb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the

column total

16 Cases of HIVAIDS and AIDS

Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas

Year of death

Cumulativea2002 2003 2004 2005 2006

Data for 50 states and the District of ColumbiaAge at death (yrs)lt13 25 22 15 7 13 4889

13ndash14 10 6 15 12 5 276

15ndash19 39 36 36 38 44 1104

20ndash24 151 157 175 147 162 8716

25ndash29 553 512 482 458 405 43671

30ndash34 1480 1272 1128 1069 785 95351

35ndash39 2967 2763 2425 2096 1682 116746

40ndash44 3595 3516 3393 3317 2636 104133

45ndash49 3294 3234 3251 3275 2886 72831

50ndash54 2318 2373 2502 2645 2343 44255

55ndash59 1209 1322 1425 1543 1480 25123

60ndash64 616 705 741 797 771 14315

gt65 691 773 807 865 805 14393

RaceethnicityWhite not Hispanic 5214 5097 4836 4758 3860 239529

Black not Hispanic 9037 8675 8581 8679 7426 218392

Hispanic 2429 2632 2641 2513 2425 80690

AsianPacific Islander 97 84 111 87 114 3426

American IndianAlaska Native 83 73 80 65 66 1693

Transmission categoryMale adult or adolescentMale-to-male sexual contact 5960 5937 5735 5641 4930 266272

Injection drug use 3738 3547 3315 3314 2641 107173

Male-to-male sexual contact and injection drug use 1278 1299 1237 1289 1064 40993

High-risk heterosexual contactb 1465 1501 1625 1571 1470 26236

Otherc 160 149 125 117 80 9867

Subtotal 12601 12431 12038 11932 10184 450541

Female adult or adolescentInjection drug use 1923 1825 1855 1768 1456 43143

High-risk heterosexual contactb 2281 2292 2373 2458 2258 42620

Otherc 84 87 72 68 70 4131

Subtotal 4289 4204 4300 4295 3784 89895

Child (lt13 yrs at diagnosis)Perinatal 53 49 56 39 42 4848

Otherd 4 5 1 2 7 521

Subtotal 57 54 57 41 48 5369

Deaths 17

Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas (cont)

Year of death

Cumulativea2002 2003 2004 2005 2006

Region of residenceNortheast 5313 5012 4779 4750 4074 180623

Midwest 1726 1666 1482 1378 1325 54468

South 7337 7427 7535 7907 6475 197209

West 2571 2585 2600 2234 2141 113506

Subtotal for 50 states and the District of Columbia 16948 16690 16395 16268 14016 545805

Data for US dependent areas 667 575 572 562 580 19858

Totale 17628 17283 16982 16865 14627 565927f

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column totalf Includes 2082 persons of unknown race or multiple races 261 persons of unknown state of residence and 2 persons who were residents

of other areas

18 Deaths

Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003ndash2006mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

2003 2004 2005 2006Data for 33 states

Age at end of year (yrs)lt13 4154 3700 3294 286713ndash14 1130 1238 1212 113915ndash19 3298 3627 4024 453920ndash24 12389 12826 13411 1430125ndash29 26167 26924 28164 2960030ndash34 49602 47577 45109 4418935ndash39 80703 77871 75842 7363440ndash44 92040 97109 100102 10176445ndash49 71345 77490 83816 9028350ndash54 45133 51033 56640 6319555ndash59 22793 26610 31186 3600860ndash64 10820 12642 14422 16658gt65 8531 9959 11657 13551

RaceethnicityWhite not Hispanic 145081 151694 158375 166000Black not Hispanic 202951 212425 221439 231957Hispanic 72612 76503 80491 84720AsianPacific Islander 2234 2529 2858 3187American IndianAlaska Native 1788 1889 2008 2119

Transmission categoryMale adult or adolescentMale-to-male sexual contact 181771 193245 205423 218676Injection drug use 57651 58149 58369 59077Male-to-male sexual contact and injection drug use 23965 24434 24725 25085High-risk heterosexual contacta 40084 42559 44915 47562Otherb 3218 3278 3325 3424Subtotal 306689 321665 336756 353825

Female adult or adolescentInjection drug use 32346 32735 32973 33470High-risk heterosexual contacta 80324 85348 90185 95403Otherb 2036 2123 2212 2321Subtotal 114705 120206 125370 131195

Child (lt13 yrs at diagnosis)Perinatal 6137 6154 6178 6143Otherc 570 575 571 560Subtotal 6707 6730 6748 6703

Subtotal for 33 states 428107 448605 468879 491727Data for US dependent areas 15809 16399 17150 17955

Totald 443916 465005 486028 509681Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 19

Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission categorymdash33 states with confidential name-based HIV infection reporting

Transmission category

White not Hispanic

Black not Hispanic Hispanic

AsianPacific Islander

American IndianAlaska

Native Totala

No No No No No No

Male adult or adolescentMale-to-male sexual contact 108259 77 70242 49 36043 57 1669 68 938 62 218676 62Injection drug use 12328 9 31339 22 14472 23 264 11 216 14 59077 17Male-to-male sexual contact

and injection drug use 11283 8 9587 7 3720 6 93 4 205 13 25085 7High-risk heterosexual contactb 6667 5 31140 22 8788 14 395 16 143 9 47562 13Otherc 1458 1 1492 1 404 1 30 1 17 1 3424 1Subtotal 139994 100 143799 100 63427 100 2450 100 1519 100 353825 100

Female adult or adolescentInjection drug use 8262 33 19136 23 5528 28 106 15 175 30 33470 26High-risk heterosexual contactb 16338 65 63204 75 14132 71 573 82 392 68 95403 73Otherc 450 2 1469 2 344 2 24 3 12 2 2321 2Subtotal 25050 100 83809 100 20004 100 703 100 578 100 131195 100

Child (lt13 yrs at diagnosis)Perinatal 801 84 4064 93 1183 92 28 82 20 95 6143 92Otherd 154 16 283 7 107 8 6 18 1 5 560 8Subtotal 955 100 4347 100 1290 100 34 100 21 100 6703 100

Totale 166000 231957 84720 3187 2119 491727Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of 33 states that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Includes 3745 persons of unknown race or multiple racesb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes 5 persons of unknown sex Because column totals were calculated independently of the values for the subpopulations the values

in each column may not sum to the column total

20 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Map 1 Estimated rates (per 100000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

Note Rates adjusted for reporting delays Rates of HIV infection include only persons living with HIV infection that has not progressed to AIDSSince 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 Islandsa Includes persons whose area of residence is unknown

Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

Note Rates adjusted for reporting delays Rates of HIV infection include only persons living with HIV infection that has not progressed to AIDSSince 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 Islandsa Includes persons whose area of residence is unknown

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 21

Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002ndash2006mdashUnited States and dependent areas

2002 2003 2004 2005 2006Data for 50 states and the District of Columbia

Age at end of year (yrs)lt13 2308 2006 1684 1394 111513ndash14 685 747 784 762 71115ndash19 1465 1694 1974 2243 248720ndash24 3910 4292 4629 5033 536725ndash29 12725 12743 13045 13505 1435930ndash34 35558 33870 32057 29949 2882435ndash39 70107 68106 65076 62235 5964940ndash44 80377 86294 91335 94021 9517445ndash49 64702 71276 77417 84153 9077550ndash54 41270 46855 53333 59256 6647655ndash59 20113 24145 28356 33522 3901460ndash64 9681 11293 13305 15380 18072gt65 7520 8946 10604 12430 14669

RaceethnicityWhite not Hispanic 129426 135278 141508 147426 154495Black not Hispanic 150488 161326 171654 181056 191590Hispanic 63424 67895 72024 76334 80815AsianPacific Islander 3060 3426 3759 4121 4526American IndianAlaska Native 1254 1356 1458 1562 1651

Transmission categoryMale adult or adolescentMale-to-male sexual contact 158092 168233 178551 188622 199693Injection drug use 56708 58436 59940 61229 62998Male-to-male sexual contact and injection drug use 24726 25457 26144 26785 27523High-risk heterosexual contacta 27329 30300 33181 35916 39004Otherb 3588 3665 3769 3888 4026Subtotal 270444 286091 301585 316440 333244

Female adult or adolescentInjection drug use 27863 28874 29828 30646 31575High-risk heterosexual contacta 46445 51489 56229 60693 65631Otherb 1903 2033 2178 2315 2465Subtotal 76210 82395 88236 93653 99671

Child (lt13 yrs at diagnosis)Perinatal 3633 3654 3651 3664 3660Otherc 129 124 123 122 115Subtotal 3762 3778 3774 3786 3775

Region of residenceNortheast 105599 110929 115562 120208 125620Midwest 36011 38571 41178 44171 47010South 137081 147284 157975 166962 177591West 71729 75483 78883 82540 86473

Subtotal for 50 states and the District of Columbia 350419 372267 393598 413882 436693

Data for US dependent areas 9880 10365 10713 11106 11359

Totald 360617 383024 404849 425646 448871Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

22 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission categorymdash50 states and the District of Columbia

Transmission category

White not Hispanic

Black not Hispanic Hispanic

AsianPacific Islander

American IndianAlaska

Native Totala

No No No No No No

Male adult or adolescentMale-to-male sexual contact 101299 75 57520 45 36087 57 2715 72 704 57 199693 60Injection drug use 13168 10 33911 27 14795 23 325 9 201 16 62998 19Male-to-male sexual contact and

injection drug use 12393 9 10121 8 4352 7 198 5 220 18 27523 8High-risk heterosexual contactb 6081 5 24205 19 7816 12 444 12 105 8 39004 12Otherc 1743 1 1602 1 574 1 69 2 16 1 4026 1Subtotal 134683 100 127359 100 63623 100 3752 100 1246 100 333244 100

Female adult or adolescentInjection drug use 7407 38 18531 30 5025 30 115 15 153 39 31575 32High-risk heterosexual contactb 11350 59 41741 68 11092 67 588 78 227 58 65631 66Otherc 508 3 1456 2 413 2 51 7 13 3 2465 2Subtotal 19264 100 61728 100 16531 100 753 100 393 100 99671 100

Child (lt13 yrs at diagnosis)Perinatal 500 92 2468 99 629 95 20 94 12 100 3660 97Otherd 46 8 34 1 33 5 1 6 0 0 115 3Subtotal 546 100 2503 100 662 100 21 100 12 100 3775 100

Totale 154495 191590 80815 4526 1651 436693

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Includes 3616 persons of unknown race or multiple racesb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes 3 person of unknown sex Because column totals were calculated independently of the values for the subpopulations the values in each column

may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 23

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by

area of residence and age categorymdashUnited States and dependent areas

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

Alabama 5469 17 5486 3744 11 3755Alaska 272 1 273 330 1 331Arizona 5744 49 5793 4922 7 4929Arkansas 2291 7 2298 2139 6 2145California mdash mdash mdash 61451 105 61555Colorado 5855 13 5869 4083 2 4085Connecticut mdash mdash mdash 7406 15 7421Delaware mdash mdash mdash 1753 7 1760District of Columbia mdash mdash mdash 10059 30 10089Floridab 35461 263 35723 46469 194 46663Georgia mdash mdash mdash 17336 47 17383Hawaii mdash mdash mdash 1234 3 1237Idaho 356 0 356 313 0 313Illinois mdash mdash mdash 16139 46 16185Indiana 3849 21 3870 3996 14 4010Iowa 588 2 590 869 3 872Kansas 1230 7 1237 1272 2 1274Kentucky mdash mdash mdash 2589 13 2602Louisiana 7361 101 7462 8052 21 8074Maine mdash mdash mdash 512 2 514Maryland mdash mdash mdash 14540 41 14581Massachusetts mdash mdash mdash 8806 20 8826Michigan 6118 55 6173 6615 12 6627Minnesota 3227 21 3248 2314 9 2323Mississippi 4200 32 4232 3155 13 3168Missouri 4999 33 5033 5479 7 5486Montana mdash mdash mdash 205 0 205Nebraska 688 12 700 771 2 773Nevada 3402 13 3415 2969 3 2972New Hampshire mdash mdash mdash 556 3 559New Jersey 16059 153 16212 17168 57 17226New Mexico 910 0 909 1252 3 1255New York 42220 801 43021 70697 148 70845North Carolina 11700 60 11760 8451 12 8463North Dakota 87 2 89 73 1 74Ohio 8266 57 8323 7054 30 7084Oklahoma 2191 17 2208 2191 3 2194Oregon mdash mdash mdash 2840 4 2844Pennsylvania mdash mdash mdash 18633 71 18703Rhode Island mdash mdash mdash 1296 7 1303South Carolina 6349 45 6394 7035 23 7058South Dakota 195 4 199 139 1 140Tennessee 6579 51 6631 6403 11 6414Texas 24741 262 25003 34010 53 34063Utah 893 10 903 1164 0 1164Vermont mdash mdash mdash 238 2 240Virginia 9937 41 9978 8423 24 8447Washington mdash mdash mdash 5471 5 5476West Virginia 660 5 665 749 5 754Wisconsin 2322 15 2337 2153 12 2165Wyoming 86 2 88 102 1 103

Subtotal 224303 2174 226477 435621 1115 436736

24 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age categorymdashUnited States and dependent areas (cont)

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

US dependent areasAmerican Samoa 2 0 2 1 0 1Guam 63 0 63 36 0 36Northern Mariana Islands 7 0 7 3 0 3Puerto Rico 6269 31 6300 10971 26 10997US Virgin Islands 228 2 230 312 2 314Otherc mdash mdash mdash 1 0 1

Totald 230872 2207 233079 447724 1147 448871

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reporting a See Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at

least 2003b Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterc Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasd Total number of persons living with HIV infection (not AIDS) includes persons reported from areas with confidential name-based HIV

infection reporting who were residents of other states or whose area of residence is unknown Total number of persons living with AIDS includes persons whose area of residence is unknown Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 25

Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristicsmdashUnited States and dependent areas

No of persons

Survival in months

gt12 gt24 gt36Data for 50 states and the District of Columbia

Age at diagnosis (yrs)lt13 101 096 094 09413ndash14 60 098 098 09515ndash19 305 098 096 09520ndash24 1351 096 093 09225ndash29 3034 095 092 09130ndash34 5499 094 091 08935ndash39 7888 093 090 08740ndash44 7085 092 088 08545ndash49 5090 089 085 08250ndash54 3067 086 081 07855ndash59 1505 083 078 07460ndash64 806 080 073 069gt65 614 073 068 065

RaceethnicityWhite not Hispanic 10706 092 089 087Black not Hispanic 18406 090 086 082Hispanic 6398 092 090 088AsianPacific Islander 404 094 092 090American IndianAlaska Native 167 084 081 075

Transmission categoryMale adult or adolescentMale-to-male sexual contact 12830 093 090 088Injection drug use 4048 089 084 081Male-to-male sexual contact and injection drug use 1701 093 089 086High-risk heterosexual contacta 3170 091 088 085Otherb 5019 086 083 080Subtotal 26768 091 088 085

Female adult or adolescentInjection drug use 2101 089 083 078High-risk heterosexual contacta 4686 093 089 086Otherb 2749 090 085 083Subtotal 9536 091 087 083

Child (lt13 yrs at diagnosis)Perinatal 98 096 095 095Otherc 3 100 067 067Subtotal 101 096 094 094

Subtotal for 50 states and the District of Columbia 36405 091 087 085

Data for US dependent areas 891 083 078 075

Total 37352d 091 087 084Note Excludes persons whose date of death was before or in the same month as date of diagnosis Excludes persons whose month of diagnosis or month of death is unknowna Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes 325 persons of unknown race or multiple races

26 Survival after AIDS Diagnosis

Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by year of diagnosismdashUnited States and dependent areas

Months after AIDS diagnosis

Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by age groupmdashUnited States and dependent areas

Months after AIDS diagnosis

Survival after AIDS Diagnosis 27

Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by raceethnicitymdashUnited States and dependent areas

Months after AIDS diagnosis

28 Survival after AIDS Diagnosis

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006

and cumulativemdashUnited States and dependent areas

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Alabama 510 112 462 100 8626 76 8702Alaska 24 36 38 57 648 7 655Arizona 626 105 539 87 10396 46 10442Arkansas 237 85 252 90 3891 36 3927California 4069 113 3960 109 142254 664 142918Colorado 351 75 322 68 8742 31 8773Connecticut 658 188 422 120 14716 183 14899Delaware 177 210 116 136 3547 26 3573District of Columbia 672 1155 853 1467 17372 189 17561Florida 4921 277 4932 273 104084 1530 105614Georgia 2325 255 1605 171 31734 231 31965Hawaii 105 82 93 72 2927 17 2944Idaho 24 17 26 18 604 2 606Illinois 1886 148 1382 108 33620 282 33902Indiana 407 65 346 55 8239 56 8295Iowa 93 31 86 29 1727 13 1740Kansas 105 38 120 43 2781 14 2795Kentucky 249 60 207 49 4600 32 4632Louisiana 936 208 824 192 17612 128 17740Maine 21 16 68 51 1110 8 1118Maryland 1558 279 1626 290 30252 319 30571Massachusetts 666 104 533 83 19181 214 19395Michigan 821 81 672 67 14941 113 15054Minnesota 226 44 212 41 4817 28 4845Mississippi 368 127 365 125 6642 56 6698Missouri 385 66 469 80 11016 61 11077Montana 21 22 7 07 373 3 376Nebraska 53 30 118 67 1479 11 1490Nevada 293 121 294 118 5733 29 5762New Hampshire 33 25 55 42 1074 10 1084New Jersey 1262 145 1065 122 48750 778 49528New Mexico 134 70 93 48 2603 7 2610New York 6201 321 5495 285 174908 2354 177262North Carolina 916 106 1229 139 15954 118 16072North Dakota 10 16 6 09 144 1 145Ohio 753 66 767 67 14957 138 15095Oklahoma 281 79 205 57 4836 26 4862Oregon 217 60 281 76 5995 20 6015Pennsylvania 1486 120 1893 152 33417 365 33782Rhode Island 87 81 111 104 2580 28 2608South Carolina 682 161 705 163 13301 105 13406South Dakota 18 23 18 23 255 5 260Tennessee 818 137 680 113 12457 59 12516Texas 3045 133 2998 128 69735 392 70127Utah 63 25 57 22 2295 20 2315Vermont 5 08 18 29 461 6 467Virginia 638 84 605 79 16802 177 16979Washington 485 77 389 61 11792 34 11826West Virginia 74 41 67 37 1500 11 1511Wisconsin 122 22 217 39 4513 33 4546Wyoming 6 12 8 16 228 2 230

Subtotal 40123 135 37911 127 952221 9094 961315

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 29

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulativemdashUnited States and dependent areas (cont)

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

US dependent areasAmerican Samoa 0 0 0 0 1 0 1Guam 0 0 0 0 68 1 69Northern Mariana Islands 0 0 0 0 3 0 3Puerto Rico 1029 263 850 216 29511 400 29911US Virgin Islands 17 156 32 295 629 18 647Otherb 0 0 0 0 3 0 3

Totalc 41357 138 39002 129 983343 9522 992865d

a From the beginning of the epidemic through 2006b Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasc Includes persons whose state or area of residence is unknownd Includes 916 persons whose state or area of residence is unknown

30 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

MSA (population gt 500000)

Akron Ohio 66 94 32 46 762 1 763

AlbanyndashSchenectadyndashTroy NY 97 114 105 123 2253 24 2277

Albuquerque N Mex 70 88 50 61 1404 2 1406

AllentownndashBethlehemndashEaston PandashNJ 72 91 119 149 1352 17 1369

AtlantandashSandy SpringsndashMarietta Ga 1586 319 1006 196 21896 128 22024

AugustandashRichmond County GandashSC 106 205 32 61 1851 24 1875

AustinndashRound Rock Tex 227 156 186 123 4830 26 4856

Bakersfield Calif 76 100 122 156 1528 8 1536

BaltimorendashTowson Md 1064 401 1001 377 20352 218 20570

Baton Rouge La 222 304 231 301 3732 20 3752

BirminghamndashHoover Ala 151 139 110 100 2614 25 2639

Boise CityndashNampa Idaho 14 26 14 25 281 0 281

Boston MassndashNHa 441 99 355 80 13476 147 13623

Boston Division 269 146 185 101 8451 91 8542

Cambridge Division 108 74 102 70 3126 35 3161

Essex Division 52 71 51 69 1577 20 1597

BridgeportndashStamfordndashNorwalk Conn 181 201 135 150 3733 57 3790

BuffalondashNiagara Falls NY 117 102 96 84 2476 20 2496

Cape CoralndashFort Myers Fla 44 81 91 159 1692 24 1716

CharlestonndashNorth Charleston SC 92 155 91 151 2034 18 2052

CharlottendashGastoniandashConcord NCndashSC 214 141 285 180 3242 22 3264

Chicago IllndashIndndashWis 1716 182 1159 122 30118 261 30379

Chicago Division 1604 203 1073 135 28300 248 28548

Gary Division 61 88 50 71 1038 8 1046

Lake Division 51 59 36 41 780 5 785

CincinnatindashMiddletown OhiondashKyndashInd 111 53 199 95 2735 17 2752

ClevelandndashElyriandashMentor Ohio 228 107 170 80 4226 48 4274

Colorado Springs Colo 19 32 21 35 576 5 581

Columbia SC 177 256 197 280 3274 24 3298

Columbus Ohio 166 97 165 96 3112 15 3127

Dallas Tex 874 150 929 155 20238 63 20301

Dallas Division 681 175 714 178 16038 37 16075

Fort Worth Division 193 100 215 108 4200 26 4226

Dayton Ohio 58 69 54 64 1217 15 1232

DenverndashAurora Colo 274 116 236 98 6899 22 6921

Des Moines Iowa 30 57 23 43 530 4 534

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 31

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Detroit Mich 570 127 445 100 10373 73 10446

Detroit Division 443 223 330 167 8268 57 8325

Warren Division 127 51 115 46 2105 16 2121

El Paso Tex 56 78 40 54 1476 10 1486

Fresno Calif 52 59 64 72 1430 11 1441

Grand RapidsndashWyoming Mich 46 60 51 66 816 6 822

GreensborondashHigh Point NC 52 77 66 96 1265 14 1279

Greenville SC 70 119 67 111 1292 4 1296

HarrisburgndashCarlisle Pa 23 44 67 128 1224 8 1232

HartfordndashWest HartfordndashEast Hartford Conn 256 216 135 114 5126 46 5172

Honolulu Hawaii 54 60 69 76 2121 14 2135

HoustonndashBaytownndashSugar Land Tex 1017 190 1092 197 25821 172 25993

Indianapolis Ind 191 116 150 90 3824 25 3849

Jackson Miss 134 257 117 221 2419 30 2449

Jacksonville Fla 309 248 315 246 6020 75 6095

Kansas City MondashKans 183 94 160 81 4669 15 4684

Knoxville Tenn 47 72 35 52 882 5 887

Lakeland Fla 103 190 112 199 1811 21 1832

Las VegasndashParadise Nev 245 143 258 145 4616 28 4644

Little RockndashNorth Little Rock Ark 87 135 75 115 1383 14 1397

Los Angeles Calif 1529 118 1684 130 57953 293 58246

Los Angeles Division 1339 135 1435 144 51098 250 51348

Santa Anna Division 190 63 249 83 6855 43 6898

Louisville KyndashInd 123 102 97 79 2286 22 2308

Madison Wis 10 19 29 53 520 4 524

McAllenndashEdinburgndashPharr Tex 57 84 45 64 630 11 641

Memphis TennndashMissndashArk 402 320 346 271 5128 19 5147

Miami Fla 2420 446 2289 419 55807 997 56804

Fort Lauderdale Division 810 455 769 430 16412 262 16674

Miami Division 1243 523 1165 485 29703 512 30215

West Palm Beach Division 367 290 355 279 9692 223 9915

MilwaukeendashWaukeshandashWest Allis Wis 68 45 109 72 2507 18 2525

MinneapolisndashSt PaulndashBloomington MinnndashWis 186 59 184 58 4259 22 4281

Modesto Calif 36 71 22 43 671 6 677

NashvillendashDavidsonndashMurfreesboro Tenn 224 158 172 118 3848 20 3868

New HavenndashMilford Conn 169 200 107 127 4573 73 4646

New OrleansndashMetairiendashKenner La 393 299 271 264 8835 67 8902

32 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

New York NYndashNJndashPa 6215 330 5500 292 195177 2906 198083

Edison Division 191 83 130 56 6709 139 6848

Nassau Division 262 93 246 88 8141 110 8251

New York Division 5266 456 4716 408 160408 2323 162731

Newark Division 496 231 408 190 19919 334 20253

Oklahoma City Okla 125 108 88 75 2255 5 2260

OmahandashCouncil Bluffs NebndashIowa 37 46 80 97 1035 3 1038

Orlando Fla 544 282 517 260 8653 92 8745

OxnardndashThousand OaksndashVentura Calif 49 62 21 26 1008 3 1011

Palm BayndashMelbournendashTitusville Fla 68 129 61 114 1512 11 1523

Philadelphia PandashNJndashDelndashMd 1261 217 1348 231 28221 313 28534

Camden Division 108 87 111 89 3118 42 3160

Philadelphia Division 1022 263 1144 294 22112 250 22362

Wilmington Division 131 191 93 134 2991 21 3012

PhoenixndashMesandashScottsdale Ariz 460 119 376 93 7459 31 7490

Pittsburgh Pa 143 60 135 57 3182 19 3201

PortlandndashSouth Portland Maine 9 18 34 66 562 1 563

PortlandndashVancouverndashBeaverton OrendashWash 170 81 215 101 4825 10 4835

PoughkeepsiendashNewburghndashMiddletown NY 136 204 113 168 3162 24 3186

ProvidencendashNew BedfordndashFall River RIndashMass 132 82 155 96 3900 44 3944

RaleighndashCary NC 138 145 201 202 1987 13 2000

Richmond Va 119 101 122 102 3371 35 3406

RiversidendashSan BernardinondashOntario Calif 361 92 306 76 8568 60 8628

Rochester NY 165 159 124 120 3134 13 3147

SacramentondashArden-ArcadendashRoseville Calif 154 75 169 82 4000 26 4026

St Louis MondashIll 192 69 366 131 5965 40 6005

Salt Lake City Utah 46 44 40 37 1743 10 1753

San Antonio Tex 215 114 247 127 4987 30 5017

San DiegondashCarlsbadndashSan Marcos Calif 491 167 384 131 12934 61 12995

San Francisco Calif 867 209 690 165 40152 96 40248

Oakland Division 312 126 246 99 9546 48 9594

San Francisco Division 555 329 444 261 30606 48 30654

San JosendashSunnyvalendashSanta Clara Calif 88 50 145 81 3747 15 3762

San JuanndashCaguasndashGuaynabo PR 745 289 578 223 21402 277 21679

SarasotandashBradentonndashVenice Fla 82 122 104 152 1978 27 2005

ScrantonndashWilkes-Barre Pa 27 49 47 85 572 6 578

Seattle Wash 353 110 280 86 9172 27 9199

Seattle Division 316 129 255 102 8161 18 8179

Tacoma Division 37 49 25 33 1011 9 1020

Springfield Mass 88 128 45 66 2075 26 2101

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 33

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Stockton Calif 52 78 52 77 1076 15 1091

Syracuse NY 52 80 49 75 1317 8 1325

TampandashSt PetersburgndashClearwater Fla 559 211 605 224 11174 112 11286

Toledo Ohio 25 38 66 101 812 14 826

Tucson Ariz 103 111 100 106 2010 10 2020

Tulsa Okla 83 94 65 72 1494 10 1504

Virginia BeachndashNorfolkndashNewport News VandashNC 183 111 132 80 4711 63 4774

Washington DCndashVandashMdndashWV 1322 252 1684 318 31130 315 31445

Bethesda Division 135 118 173 150 2774 23 2797

Washington Division 1187 289 1511 365 28356 292 28648

Wichita Kans 35 60 38 64 851 2 853

Worcester Mass 76 97 79 101 1783 20 1803

YoungstownndashWarrenndashBoardman OhiondashPa 27 46 26 44 519 0 519

Subtotal for MSAs (population gt500000) 33602 173 31274 159 829633 8171 837804

Metropolitan areas (population of 50000 to 499999) 4477 80 4466 79 94829 847 95676

Nonmetropolitan areas 2666 54 2732 55 52063 445 52508

Totalb 41144 137 38749 128 981708 9494 991202

Note Because of the lack of census information for all US dependent areas includes data for only the 50 states the District of Columbia and Puerto RicoMSA metropolitan statistical areaMSA definitions for this report can be found at httpwwwcensusgovpopulationwwwestimatesmetrodefhtmla Reported case counts for the metropolitan divisions do not sum to the MSA total MSA total includes data from 1 metropolitan division with

population of lt500000b Includes persons whose county of residence is unknown

34 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Alabama (January 1988) 502 6041 48 6089

Alaska (February 1999) 38 285 2 287

Arizona (January 1987) 617 5877 80 5957

Arkansas (July 1989) 206 2349 20 2369

California (April 2006) 6581 7056 92 7148

Colorado (November 1985) 319 6084 31 6115

Connecticut (January 2005)b 826 2500 101 2601

Delaware (February 2006) 788 801 18 819

Florida (July 1997)c 4163 36386 397 36783

Georgia (December 2003) 2245 8197 194 8391

Idaho (June 1986) 35 340 4 344

Illinois (January 2006) 6241 6661 162 6823

Indiana (July 1988) 399 4027 43 4070

Iowa (July 1998) 69 586 5 591

Kansas (July 1999) 142 1225 15 1240

Kentucky (October 2004) 333 1303 13 1316

Louisiana (February 1993) 728 8149 166 8315

Maine (January 2006) 386 393 3 396

Michigan (April 1992) 635 6702 134 6836

Minnesota (October 1985) 309 3356 40 3396

Mississippi (August 1988) 352 4549 59 4608

Missouri (October 1987) 502 5086 55 5141

Nebraska (September 1995) 91 672 14 686

Nevada (February 1992) 339 3532 24 3556

New Hampshire (January 2005) 59 466 9 475

New Jersey (January 1992) 1477 17513 325 17838

New Mexico (January 1998) 114 949 4 953

New York (June 2000) 5326 42345 1820 44165

North Carolina (February 1990) 1615 13879 143 14022

North Dakota (January 1988) 4 82 1 83

Ohio (June 1990) 867 8222 101 8323

Oklahoma (June 1988) 229 2401 30 2431

Oregon (April 2006) 49 95 19 114

Pennsylvania (October 2002)d 4269 9537 179 9716

Rhode Island (July 2006) 14 21 0 21

South Carolina (February 1986) 493 6970 93 7063

South Dakota (January 1988) 18 215 6 221

Tennessee (January 1992) 732 7115 90 7205

Texas (January 1999)e 3370 24282 417 24699

Utah (April 1989) 106 893 14 907

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 35

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Virginia (July 1989) 864 10257 95 10352

Washington (March 2006) 4048 4157 40 4197

West Virginia (January 1989) 66 673 8 681

Wisconsin (November 1985) 261 2500 31 2531

Wyoming (June 1989) 7 93 1 94

Subtotal 50834 274822 5146 279968

US dependent areas

American Samoa (August 2001) 0 1 0 1

Guam (March 2000) 2 66 0 66

Northern Mariana Islands (October 2001) 2 7 0 7

Puerto Rico (January 2003) 1471 5610 91 5701

US Virgin Islands (December 1998) 22 247 6 253

Persons reported from areas with confidential name-based HIV infection reporting but who were residents of other areas 132 685 21 706

Totalf 52878 282640 5314 287954

Note Includes data from 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through 2006b Beginning in 1992 Connecticut had name-based HIV reporting for cases in children only From January 2002 through December 2004

Connecticut had name- or code-based HIV reporting for cases in adolescents and adults As of January 2005 Connecticut has name-based reporting of all cases of HIV infection

c Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterd On October 18 2002 Pennsylvania initiated confidential name-based HIV infection reporting in all areas except Philadelphia Code-based

reporting was implemented in Philadelphia in March 2004 and the switch to name-based reporting was made in October 2005e From February 1994 through December 1998 Texas reported HIV infection in children onlyf Includes 1252 persons reported from areas with confidential name-based HIV infection reporting but whose area of residence is unknown

36 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulativemdashUnited States and dependent areas

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No Adult or adolescentMale-to-male sexual contact 13775 49 429897 54 mdash mdash mdash mdash 13775 35 429897 44Injection drug use 3413 12 163070 21 1826 17 67693 35 5239 13 230763 23Male-to-male sexual contact and

injection drug use 1603 6 65524 8 mdash mdash mdash mdash 1603 4 65524 7Hemophiliacoagulation disorder 43 0 5176 1 11 0 348 0 54 0 5524 1High-risk heterosexual contactc 2997 11 49610 6 4839 46 85186 44 7836 20 134796 14

Sex with injection drug user 330 1 11683 1 706 7 26073 14 1036 3 37756 4Sex with bisexual male mdash mdash mdash mdash 234 2 5162 3 234 1 5162 1Sex with person with hemophilia 1 0 84 0 11 0 502 0 12 0 586 0Sex with HIV-infected transfusion

recipient 22 0 553 0 21 0 793 0 43 0 1346 0Sex with HIV-infected person risk

factor not specified 2644 9 37290 5 3867 37 52656 27 6511 17 89946 9Receipt of blood transfusion blood

d components or tissue 63 0 5213 1 68 1 4176 2 131 0 9389 1Otherrisk factor not reported or

identifiede 6484 23 73136 9 3793 36 34311 18 10278 26 107450 11Subtotal 28378 100 791626 100 10537 100 191714 100 38916 100 983343 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 0 0 222 5 0 0 7 0 0 0 229 2Mother with documented HIV infection or

1 of the following risk factors 24 75 4315 89 50 93 4423 95 74 86 8738 92Injection drug use 4 13 1676 35 4 7 1665 36 8 9 3341 35Sex with injection drug user 4 13 789 16 4 7 750 16 8 9 1539 16Sex with bisexual male 1 3 101 2 2 4 110 2 3 3 211 2Sex with person with hemophilia 0 0 20 0 0 0 16 0 0 0 36 0Sex with HIV-infected transfusion

recipient 0 0 11 0 0 0 15 0 0 0 26 0Sex with HIV-infected person risk

factor not specified 6 19 742 15 17 31 790 17 23 27 1532 16Receipt of blood transfusion blood

components or tissue 0 0 70 1 0 0 82 2 0 0 152 2Has HIV infection risk factor not

specified 9 28 906 19 23 43 995 21 32 37 1901 20Receipt of blood transfusion blood

fcomponents or tissue 1 3 243 5 0 0 144 3 1 1 387 4Otherrisk factor not reported or

identifiedg 7 22 75 2 4 7 93 2 11 13 168 2Subtotal 32 100 4855 100 54 100 4667 100 86 100 9522 100

Total 28410 100 796481 100 10591 100 196381 100 39002 100 992865 100a From the beginning of the epidemic through 2006b From the beginning of the epidemic through 2006 Includes 3 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infectiond AIDS developed in 47 adultsadolescents after they received blood that had tested negative for HIV antibodies AIDS developed in 14 additional adults

after they received tissue organs or artificial insemination from HIV-infected donors Four of the 14 received tissue or organs from a donor who was negative for HIV antibody at the time of donation

e Includes 37 adultsadolescents who were exposed to HIV-infected blood body fluids or concentrated virus in health care laboratory or household settings as supported by seroconversion epidemiologic andor laboratory evidence One person was infected after intentional inoculation with HIV-infected blood Includes an additional 740 persons who acquired HIV infection perinatally but who were more than 12 years of age when AIDS was diagnosed These 740 persons are not counted in the values for the pediatric transmission category

f AIDS developed in 3 children after they received blood that had tested negative for HIV antibodiesg Includes 5 children who were exposed to HIV-infected blood as supported by seroconversion epidemiologic andor laboratory evidence 1 child was

infected after intentional inoculation with HIV-infected blood and 5 children were exposed to HIV-infected blood in a household setting Of the 168 children 26 had sexual contact with an adult with or at high risk for HIV infection

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 37

Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No

Adult or adolescentMale-to-male sexual contact 22912 59 103679 52 mdash mdash mdash mdash 22912 44 103679 37

Injection drug use 3503 9 24255 12 2124 16 13925 17 5627 11 38181 14

Male-to-male sexual contact and injection drug use 1946 5 10704 5 mdash mdash mdash mdash 1946 4 10704 4

Hemophiliacoagulation disorder 43 0 495 0 6 0 73 0 49 0 568 0

High-risk heterosexual contactc 2874 7 16830 8 5939 45 38315 47 8813 17 55145 20

Sex with injection drug user 308 1 2601 1 757 6 6791 8 1065 2 9392 3

Sex with bisexual male mdash mdash mdash mdash 328 2 2265 3 328 1 2265 1

Sex with person with hemophilia 4 0 31 0 16 0 201 0 20 0 232 0

Sex with HIV-infected transfusion recipient 13 0 131 0 28 0 223 0 41 0 354 0

Sex with HIV-infected person risk factor not specified 2549 7 14067 7 4810 36 28835 35 7359 14 42902 15

Receipt of blood transfusion blood components or tissue 61 0 489 0 50 0 536 1 111 0 1025 0

Otherrisk factor not reported or identified 7748 20 44021 22 5106 39 29312 36 12854 25 73338 26

Subtotal 39087 100 200473 100 13225 100 82161 100 52312 100 282640 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 8 3 106 4 0 0 1 0 8 1 107 2

Mother with documented HIV infection or 1 of the following risk factors 197 74 2195 85 254 85 2417 89 451 80 4612 87

Injection drug use 34 13 532 21 53 18 561 21 87 15 1093 21

Sex with injection drug user 12 5 208 8 21 7 213 8 33 6 421 8

Sex with bisexual male 5 2 37 1 4 1 32 1 9 2 69 1

Sex with person with hemophilia 0 0 3 0 1 0 7 0 1 0 10 0

Sex with HIV-infected transfusion recipient 0 0 4 0 0 0 4 0 0 0 8 0

Sex with HIV-infected person risk factor not specified 54 20 534 21 76 25 629 23 130 23 1163 22

Receipt of blood transfusion blood components or tissue 0 0 17 1 2 1 20 1 2 0 37 1

Has HIV infection risk factor not specified 92 35 860 33 97 32 951 35 189 33 1811 34

Receipt of blood transfusion blood components or tissue 6 2 28 1 3 1 24 1 9 2 52 1

Otherrisk factor not reported or identified 55 21 260 10 43 14 283 10 98 17 543 10

Subtotal 266 100 2589 100 300 100 2725 100 566 100 5314 100

Total 39353 100 203062 100 13525 100 84886 100 52878 100 287954 100

Note See Table 16 for the list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006b From the beginning of the epidemic through December 2006 Includes 6 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infection

38 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity

2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 6251 65 253927 73Injection drug use 733 8 31737 9Male-to-male sexual contact and injection drug use 732 8 31434 9Hemophiliacoagulation disorder 26 0 3989 1High-risk heterosexual contactb 416 4 7850 2

Sex with injection drug user 74 1 2310 1

Sex with person with hemophilia 0 0 36 0

Sex with HIV-infected transfusion recipient 2 0 176 0

Sex with HIV-infected person risk factor not specified 340 4 5328 2Receipt of blood transfusion blood components or tissue 20 0 3194 1Otherrisk factor not reported or identified 1400 15 16469 5

Total 9578 100 348600 100

Black not HispanicMale-to-male sexual contact 4309 36 103297 37Injection drug use 1635 14 83369 30Male-to-male sexual contact and injection drug use 526 4 22134 8Hemophiliacoagulation disorder 10 0 604 0High-risk heterosexual contactb 1875 16 29952 11

Sex with injection drug user 167 1 6823 2Sex with person with hemophilia 1 0 36 0Sex with HIV-infected transfusion recipient 15 0 237 0Sex with HIV-infected person risk factor not specified 1692 14 22856 8

Receipt of blood transfusion blood components or tissue 24 0 1218 0Otherrisk factor not reported or identified 3579 30 40268 14

Total 11958 100 280842 100

HispanicMale-to-male sexual contact 2816 47 64893 44Injection drug use 965 16 46337 31Male-to-male sexual contact and injection drug use 287 5 10884 7Hemophiliacoagulation disorder 6 0 466 0High-risk heterosexual contactb 638 11 10950 7

Sex with injection drug user 84 1 2409 2Sex with person with hemophilia 0 0 11 0Sex with HIV-infected transfusion recipient 5 0 125 0Sex with HIV-infected person risk factor not specified 549 9 8405 6

Receipt of blood transfusion blood components or tissue 17 0 657 0Otherrisk factor not reported or identified 1326 22 14832 10

Total 6055 100 149019 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 39

a

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulative

No No

AsianPacific IslanderMale-to-male sexual contact 225 54 4475 68Injection drug use 20 5 317 5Male-to-male sexual contact and injection drug use 17 4 284 4Hemophiliacoagulation disorder 1 0 70 1High-risk heterosexual contactb 34 8 376 6

Sex with injection drug user 1 0 54 1Sex with person with hemophilia 0 0 1 0Sex with HIV-infected transfusion recipient 0 0 8 0Sex with HIV-infected person risk factor not specified 33 8 313 5

Receipt of blood transfusion blood components or tissue 2 0 112 2Otherrisk factor not reported or identified 114 28 949 14

Total 413 100 6583 100

American IndianAlaska NativeMale-to-male sexual contact 61 49 1403 55Injection drug use 15 12 395 15Male-to-male sexual contact and injection drug use 23 19 457 18Hemophiliacoagulation disorder 0 0 27 1High-risk heterosexual contactb 9 7 118 5

Sex with injection drug user 1 1 33 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 8 6 82 3

Receipt of blood transfusion blood components or tissue 0 0 8 0Otherrisk factor not reported or identified 16 13 155 6

Total 124 100 2563 100

Total casesMale-to-male sexual contact 13775 49 429897 54Injection drug use 3413 12 163070 21Male-to-male sexual contact and injection drug use 1603 6 65524 8Hemophiliacoagulation disorder 43 0 5176 1High-risk heterosexual contactb 2997 11 49610 6

Sex with injection drug user 330 1 11683 1Sex with person with hemophilia 1 0 84 0Sex with HIV-infected transfusion recipient 22 0 553 0Sex with HIV-infected person risk factor not specified 2644 9 37290 5

Receipt of blood transfusion blood components or tissue 63 0 5213 1Otherrisk factor not reported or identified 6484 23 73136 9

Total 28378c 100 791626d 100a From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 4019 males of unknown race or multiple races

40 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 11963 73 55725 69Injection drug use 858 5 5512 7Male-to-male sexual contact and injection drug use 1092 7 5578 7Hemophiliacoagulation disorder 29 0 355 0High-risk heterosexual contactb 522 3 2658 3

Sex with injection drug user 65 0 544 1Sex with person with hemophilia 0 0 8 0Sex with HIV-infected transfusion recipient 3 0 33 0Sex with HIV-infected person risk factor not specified 454 3 2073 3

Receipt of blood transfusion blood components or tissue 14 0 197 0Otherrisk factor not reported or identified 1956 12 11147 14

Total 16434 100 81172 100

Black not HispanicMale-to-male sexual contact 6203 44 30148 37Injection drug use 1594 11 11997 15Male-to-male sexual contact and injection drug use 483 3 3489 4Hemophiliacoagulation disorder 10 0 109 0High-risk heterosexual contactb 1714 12 10905 13

Sex with injection drug user 169 1 1554 2Sex with person with hemophilia 4 0 17 0Sex with HIV-infected transfusion recipient 6 0 77 0Sex with HIV-infected person risk factor not specified 1535 11 9257 11

Receipt of blood transfusion blood components or tissue 32 0 223 0Otherrisk factor not reported or identified 4151 29 24632 30

Total 14187 100 81503 100

HispanicMale-to-male sexual contact 4094 55 15623 47Injection drug use 993 13 6407 19Male-to-male sexual contact and injection drug use 316 4 1402 4Hemophiliacoagulation disorder 3 0 26 0High-risk heterosexual contactb 582 8 2963 9

Sex with injection drug user 65 1 455 1Sex with person with hemophilia 0 0 6 0Sex with HIV-infected transfusion recipient 4 0 18 0Sex with HIV-infected person risk factor not specified 513 7 2484 7

Receipt of blood transfusion blood components or tissue 11 0 55 0Otherrisk factor not reported or identified 1475 20 6977 21

Total 7474 100 33453 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 41

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderMale-to-male sexual contact 402 70 1006 63Injection drug use 17 3 55 3Male-to-male sexual contact and injection drug use 15 3 38 2Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 25 4 96 6

Sex with injection drug user 3 1 10 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 22 4 83 5

Receipt of blood transfusion blood components or tissue 4 1 7 0Otherrisk factor not reported or identified 109 19 397 25

Total 572 100 1600 100

American IndianAlaska NativeMale-to-male sexual contact 104 61 516 57Injection drug use 13 8 101 11Male-to-male sexual contact and injection drug use 19 11 110 12Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 10 6 53 6

Sex with injection drug user 2 1 14 2Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 8 5 39 4

Receipt of blood transfusion blood components or tissue 0 0 2 0Otherrisk factor not reported or identified 24 14 125 14

Total 170 100 907 100

Total casesMale-to-male sexual contact 22912 59 103679 52Injection drug use 3503 9 24255 12Male-to-male sexual contact and injection drug use 1946 5 10704 5Hemophiliacoagulation disorder 43 0 495 0High-risk heterosexual contactb 2874 7 16830 8

Sex with injection drug user 308 1 2601 1Sex with person with hemophilia 4 0 31 0Sex with HIV-infected transfusion recipient 13 0 131 0Sex with HIV-infected person risk factor not specified 2549 7 14067 7

Receipt of blood transfusion blood components or tissue 61 0 489 0Otherrisk factor not reported or identified 7748 20 44021 22

Total 39087c 100 200473d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 1838 males of unknown race or multiple races

42 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race

ethnicity 2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 482 28 14981 40Hemophiliacoagulation disorder 4 0 123 0High-risk heterosexual contactb 725 42 15799 42

Sex with injection drug user 153 9 5650 15Sex with bisexual male 63 4 1859 5Sex with person with hemophilia 5 0 329 1Sex with HIV-infected transfusion recipient 5 0 338 1Sex with HIV-infected person risk factor not specified 499 29 7623 20

Receipt of blood transfusion blood components or tissue 15 1 1870 5Otherrisk factor not reported or identified 499 29 4801 13

Total 1725 100 37574 100

Black not HispanicInjection drug use 982 15 38914 34Hemophiliacoagulation disorder 3 0 145 0High-risk heterosexual contactb 3103 46 49876 44

Sex with injection drug user 373 6 13530 12Sex with bisexual male 136 2 2352 2Sex with person with hemophilia 4 0 121 0Sex with HIV-infected transfusion recipient 8 0 277 0Sex with HIV-infected person risk factor not specified 2582 38 33596 29

Receipt of blood transfusion blood components or tissue 39 1 1546 1Otherrisk factor not reported or identified 2612 39 23894 21

Total 6739 100 114375 100

HispanicInjection drug use 322 18 12892 35Hemophiliacoagulation disorder 4 0 67 0High-risk heterosexual contactb 894 49 17995 49

Sex with injection drug user 166 9 6522 18Sex with bisexual male 32 2 818 2Sex with person with hemophilia 1 0 45 0Sex with HIV-infected transfusion recipient 7 0 141 0Sex with HIV-infected person risk factor not specified 688 38 10469 29

Receipt of blood transfusion blood components or tissue 12 1 619 2Otherrisk factor not reported or identified 592 32 5023 14

Total 1824 100 36596 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 43

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 8 8 125 12Hemophiliacoagulation disorder 0 0 7 1High-risk heterosexual contactb 49 47 574 53

Sex with injection drug user 4 4 114 11Sex with bisexual male 2 2 80 7Sex with person with hemophilia 0 0 4 0Sex with HIV-infected transfusion recipient 1 1 25 2Sex with HIV-infected person risk factor not specified 42 40 351 33

Receipt of blood transfusion blood components or tissue 1 1 93 9Otherrisk factor not reported or identified 46 44 279 26

Total 104 100 1078 100

American IndianAlaska NativeInjection drug use 13 32 280 42Hemophiliacoagulation disorder 0 0 3 0High-risk heterosexual contactb 15 37 277 41

Sex with injection drug user 4 10 107 16Sex with bisexual male 1 2 27 4Sex with person with hemophilia 0 0 2 0Sex with HIV-infected transfusion recipient 0 0 6 1Sex with HIV-infected person risk factor not specified 10 24 135 20

Receipt of blood transfusion blood components or tissue 1 2 17 3Otherrisk factor not reported or identified 12 29 95 14

Total 41 100 672 100

Total casesInjection drug use 1826 17 67693 35Hemophiliacoagulation disorder 11 0 348 0High-risk heterosexual contactb 4839 46 85186 44

Sex with injection drug user 706 7 26073 14Sex with bisexual male 234 2 5162 3Sex with person with hemophilia 11 0 502 0Sex with HIV-infected transfusion recipient 21 0 793 0Sex with HIV-infected person risk factor not specified 3867 37 52656 27

Receipt of blood transfusion blood components or tissue 68 1 4176 2Otherrisk factor not reported or identified 3793 36 34311 18

Total 10537c 100 191714d 100a From the beginning of the epidemic through 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 104 females of unknown race or multiple racesd Includes 1419 females of unknown race or multiple races

44 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 690 26 4260 26Hemophiliacoagulation disorder 3 0 24 0

bHigh-risk heterosexual contact 1132 42 7593 46Sex with injection drug user 205 8 1876 11Sex with bisexual male 98 4 659 4Sex with person with hemophilia 10 0 115 1Sex with HIV-infected transfusion recipient 7 0 64 0Sex with HIV-infected person risk factor not specified 812 30 4879 29

Receipt of blood transfusion blood components or tissue 12 0 146 1Otherrisk factor not reported or identified 850 32 4567 28

Total 2687 100 16590 100

Black not HispanicInjection drug use 1034 13 7105 14Hemophiliacoagulation disorder 1 0 35 0

bHigh-risk heterosexual contact 3451 44 23732 46Sex with injection drug user 313 4 3473 7Sex with bisexual male 155 2 1294 3Sex with person with hemophilia 5 0 71 0Sex with HIV-infected transfusion recipient 14 0 120 0Sex with HIV-infected person risk factor not specified 2964 38 18774 36

Receipt of blood transfusion blood components or tissue 26 0 324 1Otherrisk factor not reported or identified 3370 43 20244 39

Total 7882 100 51440 100

HispanicInjection drug use 339 15 2280 18Hemophiliacoagulation disorder 2 0 11 0

bHigh-risk heterosexual contact 1198 52 6264 50Sex with injection drug user 218 9 1324 11Sex with bisexual male 62 3 266 2Sex with person with hemophilia 1 0 11 0Sex with HIV-infected transfusion recipient 7 0 39 0Sex with HIV-infected person risk factor not specified 910 39 4624 37

Receipt of blood transfusion blood components or tissue 12 1 58 0Otherrisk factor not reported or identified 767 33 3843 31

Total 2318 100 12456 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 45

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 8: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS

Persons living with HIVAIDSFrom 2003 through 2006 the estimated number of

persons living with HIVAIDS increased steadily in the 33 states with confidential name-based HIV infec-tion reporting (Table 8) At the end of 2006 an esti-mated 491727 persons in these states were living with HIVAIDS

bull By age group most (21) were aged 40ndash44 years

bull By raceethnicity 47 were black 34 white 17 Hispanic and less than 1 each were American IndianAlaska Native or AsianPacific Islander

bull By sex 73 of adults and adolescents living with HIVAIDS were male

bull Of the estimated 353825 male adults and adolescents living with HIVAIDS 62 had been exposed through male-to-male sexual contact 17 had been exposed through injection drug use 13 had been exposed through high-risk heterosexual contact and 7 had been exposed through both male-to-male sexual contact and injection drug use Of the estimated 131195 female adults and adolescents living with HIVAIDS 73 had been exposed through high-risk heterosexual contact and 26 had been exposed through injection drug use Of the estimated 6703 children living with HIVAIDS 92 had been exposed perinatally

Prevalence rates of HIV infection (not AIDS)At the end of 2006 in the 38 areas with confidential

name-based HIV infection reporting since at least 2003 the prevalence rate of HIV infection (not AIDS) among adults and adolescents was estimated at 1437 per 100000 (Map 1) The rate for adults and adoles-cents living with HIV infection (not AIDS) ranged from an estimated 49 per 100000 (American Samoa) to an estimated 2617 per 100000 (New York) The prevalence rate of HIV infection (not AIDS) among children residing in the 38 areas was an estimated 65 per 100000 (Map 2) The rate for children living with HIV infection (not AIDS) ranged from an estimated zero per 100000 in Idaho New Mexico American Samoa Guam and the Northern Mariana Islands to an estimated 253 per 100000 in New York

8 Comm

Persons living with AIDSAIDS prevalence also increased steadily from 2002

through 2006 (Table 10) At the end of 2006 an esti-mated 436693 persons in the 50 states and the District of Columbia were living with AIDS

bull By age group most (22) were aged 40ndash44 years

bull By raceethnicity 44 were black 35 white 19 Hispanic 1 AsianPacific Islander and less than 1 were American IndianAlaska Native

bull By sex 77 of adults and adolescents living with AIDS were male

bull Of the estimated 333244 male adults and adolescents living with AIDS 60 had been exposed through male-to-male sexual contact 19 had been exposed through injection drug use 12 had been exposed through high-risk heterosexual contact and 8 had been exposed through both male-to-male sexual contact and injection drug use Of the estimated 99671 female adults and adolescents living with AIDS 66 had been exposed through high-risk heterosexual contact and 32 had been exposed through injection drug use

bull By region 41 resided in the South 29 in the Northeast 20 in the West and 11 in the Midwest

AIDS prevalence ratesAt the end of 2006 the prevalence rate of AIDS

among adults and adolescents in the United States was estimated at 1786 per 100000 (Map 1) The rate for adults and adolescents living with AIDS ranged from an estimated 25 per 100000 (American Samoa) to an estimated 20165 per 100000 (District of Columbia) The prevalence rate of AIDS among children in the United States was estimated at 22 per 100000 at the end of 2006 (Map 2) The rate for children living with AIDS ranged from an estimated zero per 100000 in Idaho Montana Utah American Samoa Guam and the Northern Mariana Islands to an estimated 365 per 100000 in the District of Columbia

Survival after AIDS DiagnosisTable 13 is limited to data on AIDS cases diagnosed

in 2002 in order to describe the survival of persons whose diagnosis was made relatively recently but far enough in the past to permit a meaningful measure of

entary

survival Figures 2 3 and 4 illustrate the proportion of surviving persons among persons whose diagnoses were made over a longer period 1998 through 2005

bull Survival (the estimated proportion of persons surviving a given length of time after diagnosis) increased with the year of diagnosis for diagnoses made during 1998ndash2000 Year-to-year differences were small during 2001ndash2005 (Figure 2)

bull Survival decreased as age at diagnosis increased among persons at least 35 years old at diagnosis and in comparison with persons younger than 35 Survival was similar for the age groups 13ndash24 and 25ndash34 (Figure 3)

bull Survival was greatest among MSM and among children with perinatally acquired HIV infection (Table 13) Survival was intermediate among male and female adults and adolescents who had heterosexual contact with someone known to be HIV infected or at high risk for HIV infection as well as among MSM who also were IDUs Survival was lowest among male and female adults and adolescents who were IDUs

bull Survival particularly at more than 48 months after diagnosis was greater among AsiansPacific Islanders whites and Hispanics than among blacks (Figure 4) Results were unstable or inconsistent for American IndiansAlaska Natives because the numbers of persons in this racialethnic category were small

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Tables 14ndash23 describe reports of cases of HIVAIDS AIDS and HIV infection (not AIDS) Tables 16 18 20 and 22 are based on reports of cases of HIV infection (not AIDS) through 2006 from the 50 areas that had implemented name-based HIV infection reporting Note that not all cases of HIV infection (not AIDS) or AIDS reported in 2006 reflect diagnoses made during 2006 rather the reported cases include cases diagnosed during earlier years

Reports of cases of HIV infection (not AIDS)Through 2006 a total of 287954 persons were

reported as having HIV infection (not AIDS) in the 50 areas with confidential name-based HIV infection reporting (Table 16) (see Technical Notes for discus-sion of surveillance of HIV infection [not AIDS])

Comm

Five states (Florida New Jersey New York North Carolina and Texas) reported 137507 (48) of the 287954 cumulative cases of HIV infection (not AIDS) reported to CDC In 2006 4 states (California Illinois New York and Pennsylvania) reported 22417 (42) of the 52878 cases of HIV infection (not AIDS)

bull In 2006 of the 52312 reported cases among adults and adolescents 75 were in males and 25 were in females (Table 18)

bull In 2006 566 cases in children were reported

Reports of AIDS casesThrough 2006 a total of 992865 persons in the

United States had been reported as having AIDS (Table 14) Three states (California Florida and New York) reported 43 of the cumulative AIDS cases and 37 of AIDS cases reported to CDC in 2006 In the United States the rate of reported AIDS cases in 2006 was 129 per 100000 population When the US dependent areas were included the rate of reported AIDS cases ranged from zero per 100000 (American Samoa Guam and the Northern Mariana Islands) to 1467 per 100000 (District of Columbia)

bull In 2006 males accounted for 73 and females for 27 of 38916 reported AIDS cases among adults and adolescents (Table 17)

bull In 2006 86 AIDS cases in children were reported

ADDITIONAL RESOURCES

The following were prepared by using HIVAIDS surveillance data

bull Selected MMWR articles at httpwwwcdcgovhivresourcesreportsmmwr

bull Public-use slides at httpwwwcdcgovhivtopicssurveillanceresourcesslides

bull Other surveillance reports at httpwwwcdcgovhivtopicssurveillanceresourcesreports

bull Public-use version of the AIDS surveillance data set (AIDS Public Information Data Set [APIDS]) at httpwwwcdcgovhivsoftwareapidshtm

SUGGESTED READINGS

CDC Advancing HIV Prevention New Strategies for a Changing EpidemicmdashUnited States 2003 MMWR 200352(15)329ndash332

entary 9

CDC Dear colleague letter CDC recommends that all states and territories adopt confidential name-based surveillance systems to report HIV infec-tions httpwwwcdcgovhivpubs070505_dearcolleague_gerberdingpdf Pub-lished July 5 2005 Accessed March 11 2008

1981ndash2005 CDC Epidemiology of HIVAIDSmdashUnited States

MMWR 200655(21)589ndash592CDC Guidelines for national HIV case surveil-

lance including monitoring for HIV infection and AIDS MMWR 199948(RR-13)1ndash31

CDC HIV prevention strategic plan extended through 2010 httpwwwcdcgovhivresourcesreportspsp Published October 2007 Accessed March 11 2008

CDC Revised recommendations for HIV testing of adults adolescents and pregnant women in health-care settings MMWR 200655(RR-14)1ndash17

CDC Twenty-five years of HIVAIDSmdashUnited States 1981ndash2006 MMWR 200655(21)585ndash589

Glynn MK Lee LM McKenna MT The status of national HIV case surveillance United States 2006 Public Health Rep 2007122(suppl 1)63ndash71

Janssen RS Satten GA Stramer SL et al New test-ing strategy to detect early HIV-1 infection for use in incidence estimates and for clinical and prevention purposes JAMA 1998280(1)42ndash48

Lee LM McKenna MT Monitoring the incidence of HIV infection in the United States Public Health Rep 2007122(suppl 1)72ndash79

10 Comm

entary

Cases of HIVAIDS and AIDS

Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003ndash2006mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

Year of diagnosis

2003 2004 2005 2006

Data for 33 statesAge at diagnosis (yrs)lt13 211 183 169 13513ndash14 53 36 40 4115ndash19 993 993 1126 133220ndash24 3163 3368 3592 388625ndash29 4023 4057 4236 460330ndash34 5189 4820 4676 446635ndash39 6369 5807 5535 544240ndash44 5786 5429 5529 571845ndash49 4028 3877 4028 420450ndash54 2451 2401 2547 271855ndash59 1279 1363 1455 143860ndash64 655 702 692 714gt65 570 624 613 618

RaceethnicityWhite not Hispanic 10033 10181 10528 10758Black not Hispanic 17668 16718 16629 17356Hispanic 6355 6010 6217 6481AsianPacific Islander 338 339 373 397American IndianAlaska Native 179 171 182 166

Transmission categoryMale adult or adolescentMale-to-male sexual contact 15409 15880 16833 17465Injection drug use 3514 3083 2978 3016Male-to-male sexual contact and injection drug use 1349 1299 1247 1180High-risk heterosexual contacta 4269 3959 3871 4152Otherb 125 110 107 114Subtotal 24666 24331 25036 25928

Female adult or adolescentInjection drug use 2027 1856 1720 1712High-risk heterosexual contacta 7731 7182 7216 7432Otherb 134 107 97 109Subtotal 9892 9145 9033 9252

Child (lt13 yrs at diagnosis)Perinatal 190 157 147 115Otherc 23 27 23 20Subtotal 213 184 170 135

Subtotal for 33 states 34770 33659 34239 35314

Data for US dependent areas 1331 1234 1395 1503

Totald 36102 34894 35634 36817Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

Cases of HIVAIDS and AIDS 11

Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

gt12 Months after diagnosis aof HIV infection

lt12 Months after diagnosis of HIV infectionb Total

No ()c No ()c No

Data for 33 statesAge at diagnosis (yrs)lt13 148 88 21 12 16913ndash14 22 54 18 46 4015ndash19 912 81 215 19 112620ndash24 2874 80 714 20 358925ndash29 3077 73 1157 27 423430ndash34 3016 65 1655 35 467135ndash39 3353 61 2176 39 553040ndash44 3181 58 2338 42 551945ndash49 2145 53 1874 47 401950ndash54 1307 51 1239 49 254655ndash59 725 50 728 50 145360ndash64 316 46 376 54 692gt65 266 44 346 56 612RaceethnicityWhite not Hispanic 6839 65 3677 35 10516Black not Hispanic 10372 62 6242 38 16614Hispanic 3593 58 2614 42 6206AsianPacific Islander 232 62 139 38 371American IndianAlaska Native 110 61 72 39 182Transmission category

Male adult or adolescentMale-to-male sexual contact 10917 65 5902 35 16819Injection drug use 1544 52 1427 48 2971Male-to-male sexual contact and injection drug use 733 59 512 41 1245High-risk heterosexual contactd 2091 54 1773 46 3864Othere 45 42 61 58 107Subtotal 15331 61 9675 39 25006Female adult or adolescentInjection drug use 1056 62 660 38 1716High-risk heterosexual contactd 4761 66 2450 34 7210Othere 47 48 50 52 97Subtotal 5864 65 3160 35 9023Child (lt13 yrs at diagnosis)Perinatal 126 86 21 14 147Otherf 22 94 2 6 23Subtotal 148 87 22 13 170

Subtotal for 33 states 21343 62 12857 38 34200Data for US dependent areas 855 61 541 39 1395

Totalg 22197 62 13398 38 35595h

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003Data exclude 39 persons whose month of diagnosis of HIV infection is unknowna Includes persons in whom AIDS has not developedb Includes persons whose diagnoses of HIV infection and AIDS were made at the same timec Percentages represent proportions of the total number of diagnoses of HIVAIDS made during 2005 for the corresponding group (see row

entries)d Heterosexual contact with a person known to have or to be at high risk for HIV infectione Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedf Includes hemophilia blood transfusion and risk factor not reported or not identifiedg Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the

column totalh Includes 310 persons of unknown race or multiple races

12 Cases of HIVAIDS and AIDS

Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas

Year of diagnosis2002 2003 2004 2005 2006 Cumulativea

Data for 50 states and the District of ColumbiaAge at diagnosis (yrs)lt13 106 70 53 53 38 915613ndash14 62 74 70 66 73 107815ndash19 316 302 334 410 401 562620ndash24 1399 1568 1624 1675 1669 3622525ndash29 3137 3059 3196 3110 3423 11709930ndash34 5701 5521 5144 4668 4349 19753035ndash39 8217 8017 7072 6479 6402 21357340ndash44 7404 7626 7703 7378 7298 17053145ndash49 5358 5617 5498 5727 5628 10720750ndash54 3271 3364 3491 3527 3687 5990755ndash59 1607 1693 1836 1861 2071 3219060ndash64 872 864 913 872 955 17303gt65 682 763 791 727 835 15074

RaceethnicityWhite not Hispanic 11233 10948 11066 10676 10929 394024Black not Hispanic 19246 19512 18909 18081 17960 409982Hispanic 6712 7102 6771 6823 6907 161505AsianPacific Islander 425 450 444 450 519 7951American IndianAlaska Native 177 176 182 170 155 3345

Transmission categoryMale adult or adolescentMale-to-male sexual contact 15709 16078 16054 15711 16001 465965Injection drug use 5483 5275 4818 4603 4410 170171Male-to-male sexual contact and injection drug use 2075 2029 1925 1930 1803 68516High-risk heterosexual contactb 4547 4471 4506 4306 4558 65241Otherc 253 226 228 237 217 13893Subtotal 28067 28079 27532 26787 26989 783786

Female adult or adolescentInjection drug use 2897 2836 2810 2586 2385 74718High-risk heterosexual contactb 6855 7336 7113 6922 7196 108252Otherc 207 217 217 205 220 6596Subtotal 9959 10389 10141 9713 9801 189566

Child (lt13 yrs at diagnosis)Perinatal 104 70 53 52 37 8508Otherd 2 0 0 0 0 636Subtotal 106 70 53 53 38 9144

Region of residenceNortheast 10092 10342 9412 9396 9486 306241Midwest 4125 4226 4089 4371 4164 101479South 17198 17630 18225 16894 17104 374800West 6718 6339 6000 5891 6074 199978Subtotal for 50 states and the District of Columbia 38132 38538 37726 36552 36828 982498

Data for US dependent areas 1058 1060 921 955 833 31217

Totale 39250 39690 38807 37662 37852 1014797Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes persons of unknown race or multiple races and persons of unknown sex Cumulative total includes 5691 persons of unknown race or multiple

races 3 persons of unknown sex 1079 persons of unknown state of residence and 3 persons who were residents of other areas Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Cases of HIVAIDS and AIDS 13

Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002ndash2006 and cumulativemdash50 states and the District of Columbia

Year of diagnosisCumulativea2002 2003 2004 2005 2006

RaceethnicityWhite not Hispanic 14 12 7 4 4 1599Black not Hispanic 70 46 33 38 30 5654Hispanic 18 10 9 8 3 1748AsianPacific Islander 1 0 1 1 1 54American IndianAlaska Native 1 0 1 0 0 31

Transmission categoryHemophiliacoagulation disorder 0 0 0 0 0 226Mother with documented HIV infection or 1 of the following risk factors 104 70 53 52 37 8508

Injection drug use 12 8 5 3 4 3220Sex with injection drug user 4 6 3 2 1 1397Sex with bisexual male 2 0 3 1 1 209Sex with person with hemophilia 0 0 0 0 0 35Sex with HIV-infected transfusion recipient 0 0 0 0 0 22Sex with HIV-infected person risk factor not specified 36 20 20 25 13 1530Receipt of blood transfusion blood components or tissue 2 1 0 0 0 144Has HIV infection risk factor not specified 47 34 21 21 17 1951

Receipt of blood transfusion blood components or tissue 2 0 0 0 0 374Otherrisk factor not reported or identified 0 0 0 0 0 36

Totalb 106 70 53 53 38 9144

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga From the beginning of the epidemic through 2006b Includes children of unknown race or multiple races Cumulative total includes 58 children of unknown race or multiple races Because column totals

were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992ndash2006mdash50 states and the District of Columbia

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reporting

14 Cases of HIVAIDS and AIDS

Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006mdash50 states and the District of Columbia

Raceethnicity

Adults or adolescents

Children (lt13 yrs) TotalaMales Females Totala

No Rate No Rate No Rate No Rate No Rate

White not Hispanic 9267 112 1659 19 10926 64 4 00 10929 54Black not Hispanic 11540 829 6391 404 17930 603 30 04 17960 476Hispanic 5388 313 1516 95 6903 208 3 00 6907 156AsianPacific Islander 423 75 95 16 518 44 1 00 519 37American IndianAlaska Native 118 122 37 36 155 78 0 00 155 62

Totalb 26989 224 9801 78 36790 149 38 01 36828c 123

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reportingData exclude cases in persons whose state or area of residence is unknown as well as cases from US dependent areas for which census information about race and age categories is lackinga Because row totals were calculated independently of the values for the subpopulations the values in each row may not sum to the row totalb Includes person of unknown race or multiple races Because column totals were calculated independently of the values for the subpopulations the

values in each column may not sum to the column totalc Includes 358 persons of unknown race or multiple races

Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006mdash33 states with confidential name-based HIV infection reporting

Raceethnicity

Adults or adolescents

Children (lt13 yrs) TotalaMales Females Totala

No Rate No Rate No Rate No Rate No Rate

White not Hispanic 9078 167 1664 29 10742 96 16 01 10758 82Black not Hispanic 11230 1191 6033 562 17263 856 93 17 17356 677Hispanic 5058 509 1400 151 6458 337 23 04 6481 255AsianPacific Islander 318 135 79 32 397 82 0 00 397 67American IndianAlaska Native 129 177 35 46 164 110 2 06 166 88

Totalb 25928 338 9252 115 35180 224 135 04 35314c 185

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Because row totals were calculated independently of the values for the subpopulations the values in each row may not sum to the row totalb Includes persons of unknown race or multiple races Because column totals were calculated independently of the values for the subpopulations the

values in each column may not sum to the column totalc Includes 156 persons of unknown race or multiple races

Cases of HIVAIDS and AIDS 15

Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006mdashUnited States and dependent areas

Transmission category

Place of birth

United StatesCentralSouth

America Cuba Mexico Puerto Rico Totala

No No No No No No

Male-to-male sexual contact 1172 45 402 49 89 62 790 59 249 18 3337 43Injection drug use 569 22 83 10 13 9 133 10 533 40 1650 21Male-to-male sexual contact

and injection drug use 158 6 25 3 6 4 59 4 63 5 357 5High-risk heterosexual

contactb 661 25 296 36 35 24 342 26 487 36 2282 30Otherc 47 2 8 1 0 0 9 1 14 1 103 1

Totald 2608 100 814 100 145 100 1334 100 1346 100 7728 100Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Includes 222 persons whose place of birth is not among those listed and 1260 persons whose place of birth is unknownb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the

column total

16 Cases of HIVAIDS and AIDS

Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas

Year of death

Cumulativea2002 2003 2004 2005 2006

Data for 50 states and the District of ColumbiaAge at death (yrs)lt13 25 22 15 7 13 4889

13ndash14 10 6 15 12 5 276

15ndash19 39 36 36 38 44 1104

20ndash24 151 157 175 147 162 8716

25ndash29 553 512 482 458 405 43671

30ndash34 1480 1272 1128 1069 785 95351

35ndash39 2967 2763 2425 2096 1682 116746

40ndash44 3595 3516 3393 3317 2636 104133

45ndash49 3294 3234 3251 3275 2886 72831

50ndash54 2318 2373 2502 2645 2343 44255

55ndash59 1209 1322 1425 1543 1480 25123

60ndash64 616 705 741 797 771 14315

gt65 691 773 807 865 805 14393

RaceethnicityWhite not Hispanic 5214 5097 4836 4758 3860 239529

Black not Hispanic 9037 8675 8581 8679 7426 218392

Hispanic 2429 2632 2641 2513 2425 80690

AsianPacific Islander 97 84 111 87 114 3426

American IndianAlaska Native 83 73 80 65 66 1693

Transmission categoryMale adult or adolescentMale-to-male sexual contact 5960 5937 5735 5641 4930 266272

Injection drug use 3738 3547 3315 3314 2641 107173

Male-to-male sexual contact and injection drug use 1278 1299 1237 1289 1064 40993

High-risk heterosexual contactb 1465 1501 1625 1571 1470 26236

Otherc 160 149 125 117 80 9867

Subtotal 12601 12431 12038 11932 10184 450541

Female adult or adolescentInjection drug use 1923 1825 1855 1768 1456 43143

High-risk heterosexual contactb 2281 2292 2373 2458 2258 42620

Otherc 84 87 72 68 70 4131

Subtotal 4289 4204 4300 4295 3784 89895

Child (lt13 yrs at diagnosis)Perinatal 53 49 56 39 42 4848

Otherd 4 5 1 2 7 521

Subtotal 57 54 57 41 48 5369

Deaths 17

Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas (cont)

Year of death

Cumulativea2002 2003 2004 2005 2006

Region of residenceNortheast 5313 5012 4779 4750 4074 180623

Midwest 1726 1666 1482 1378 1325 54468

South 7337 7427 7535 7907 6475 197209

West 2571 2585 2600 2234 2141 113506

Subtotal for 50 states and the District of Columbia 16948 16690 16395 16268 14016 545805

Data for US dependent areas 667 575 572 562 580 19858

Totale 17628 17283 16982 16865 14627 565927f

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column totalf Includes 2082 persons of unknown race or multiple races 261 persons of unknown state of residence and 2 persons who were residents

of other areas

18 Deaths

Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003ndash2006mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

2003 2004 2005 2006Data for 33 states

Age at end of year (yrs)lt13 4154 3700 3294 286713ndash14 1130 1238 1212 113915ndash19 3298 3627 4024 453920ndash24 12389 12826 13411 1430125ndash29 26167 26924 28164 2960030ndash34 49602 47577 45109 4418935ndash39 80703 77871 75842 7363440ndash44 92040 97109 100102 10176445ndash49 71345 77490 83816 9028350ndash54 45133 51033 56640 6319555ndash59 22793 26610 31186 3600860ndash64 10820 12642 14422 16658gt65 8531 9959 11657 13551

RaceethnicityWhite not Hispanic 145081 151694 158375 166000Black not Hispanic 202951 212425 221439 231957Hispanic 72612 76503 80491 84720AsianPacific Islander 2234 2529 2858 3187American IndianAlaska Native 1788 1889 2008 2119

Transmission categoryMale adult or adolescentMale-to-male sexual contact 181771 193245 205423 218676Injection drug use 57651 58149 58369 59077Male-to-male sexual contact and injection drug use 23965 24434 24725 25085High-risk heterosexual contacta 40084 42559 44915 47562Otherb 3218 3278 3325 3424Subtotal 306689 321665 336756 353825

Female adult or adolescentInjection drug use 32346 32735 32973 33470High-risk heterosexual contacta 80324 85348 90185 95403Otherb 2036 2123 2212 2321Subtotal 114705 120206 125370 131195

Child (lt13 yrs at diagnosis)Perinatal 6137 6154 6178 6143Otherc 570 575 571 560Subtotal 6707 6730 6748 6703

Subtotal for 33 states 428107 448605 468879 491727Data for US dependent areas 15809 16399 17150 17955

Totald 443916 465005 486028 509681Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 19

Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission categorymdash33 states with confidential name-based HIV infection reporting

Transmission category

White not Hispanic

Black not Hispanic Hispanic

AsianPacific Islander

American IndianAlaska

Native Totala

No No No No No No

Male adult or adolescentMale-to-male sexual contact 108259 77 70242 49 36043 57 1669 68 938 62 218676 62Injection drug use 12328 9 31339 22 14472 23 264 11 216 14 59077 17Male-to-male sexual contact

and injection drug use 11283 8 9587 7 3720 6 93 4 205 13 25085 7High-risk heterosexual contactb 6667 5 31140 22 8788 14 395 16 143 9 47562 13Otherc 1458 1 1492 1 404 1 30 1 17 1 3424 1Subtotal 139994 100 143799 100 63427 100 2450 100 1519 100 353825 100

Female adult or adolescentInjection drug use 8262 33 19136 23 5528 28 106 15 175 30 33470 26High-risk heterosexual contactb 16338 65 63204 75 14132 71 573 82 392 68 95403 73Otherc 450 2 1469 2 344 2 24 3 12 2 2321 2Subtotal 25050 100 83809 100 20004 100 703 100 578 100 131195 100

Child (lt13 yrs at diagnosis)Perinatal 801 84 4064 93 1183 92 28 82 20 95 6143 92Otherd 154 16 283 7 107 8 6 18 1 5 560 8Subtotal 955 100 4347 100 1290 100 34 100 21 100 6703 100

Totale 166000 231957 84720 3187 2119 491727Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of 33 states that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Includes 3745 persons of unknown race or multiple racesb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes 5 persons of unknown sex Because column totals were calculated independently of the values for the subpopulations the values

in each column may not sum to the column total

20 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Map 1 Estimated rates (per 100000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

Note Rates adjusted for reporting delays Rates of HIV infection include only persons living with HIV infection that has not progressed to AIDSSince 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 Islandsa Includes persons whose area of residence is unknown

Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

Note Rates adjusted for reporting delays Rates of HIV infection include only persons living with HIV infection that has not progressed to AIDSSince 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 Islandsa Includes persons whose area of residence is unknown

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 21

Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002ndash2006mdashUnited States and dependent areas

2002 2003 2004 2005 2006Data for 50 states and the District of Columbia

Age at end of year (yrs)lt13 2308 2006 1684 1394 111513ndash14 685 747 784 762 71115ndash19 1465 1694 1974 2243 248720ndash24 3910 4292 4629 5033 536725ndash29 12725 12743 13045 13505 1435930ndash34 35558 33870 32057 29949 2882435ndash39 70107 68106 65076 62235 5964940ndash44 80377 86294 91335 94021 9517445ndash49 64702 71276 77417 84153 9077550ndash54 41270 46855 53333 59256 6647655ndash59 20113 24145 28356 33522 3901460ndash64 9681 11293 13305 15380 18072gt65 7520 8946 10604 12430 14669

RaceethnicityWhite not Hispanic 129426 135278 141508 147426 154495Black not Hispanic 150488 161326 171654 181056 191590Hispanic 63424 67895 72024 76334 80815AsianPacific Islander 3060 3426 3759 4121 4526American IndianAlaska Native 1254 1356 1458 1562 1651

Transmission categoryMale adult or adolescentMale-to-male sexual contact 158092 168233 178551 188622 199693Injection drug use 56708 58436 59940 61229 62998Male-to-male sexual contact and injection drug use 24726 25457 26144 26785 27523High-risk heterosexual contacta 27329 30300 33181 35916 39004Otherb 3588 3665 3769 3888 4026Subtotal 270444 286091 301585 316440 333244

Female adult or adolescentInjection drug use 27863 28874 29828 30646 31575High-risk heterosexual contacta 46445 51489 56229 60693 65631Otherb 1903 2033 2178 2315 2465Subtotal 76210 82395 88236 93653 99671

Child (lt13 yrs at diagnosis)Perinatal 3633 3654 3651 3664 3660Otherc 129 124 123 122 115Subtotal 3762 3778 3774 3786 3775

Region of residenceNortheast 105599 110929 115562 120208 125620Midwest 36011 38571 41178 44171 47010South 137081 147284 157975 166962 177591West 71729 75483 78883 82540 86473

Subtotal for 50 states and the District of Columbia 350419 372267 393598 413882 436693

Data for US dependent areas 9880 10365 10713 11106 11359

Totald 360617 383024 404849 425646 448871Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

22 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission categorymdash50 states and the District of Columbia

Transmission category

White not Hispanic

Black not Hispanic Hispanic

AsianPacific Islander

American IndianAlaska

Native Totala

No No No No No No

Male adult or adolescentMale-to-male sexual contact 101299 75 57520 45 36087 57 2715 72 704 57 199693 60Injection drug use 13168 10 33911 27 14795 23 325 9 201 16 62998 19Male-to-male sexual contact and

injection drug use 12393 9 10121 8 4352 7 198 5 220 18 27523 8High-risk heterosexual contactb 6081 5 24205 19 7816 12 444 12 105 8 39004 12Otherc 1743 1 1602 1 574 1 69 2 16 1 4026 1Subtotal 134683 100 127359 100 63623 100 3752 100 1246 100 333244 100

Female adult or adolescentInjection drug use 7407 38 18531 30 5025 30 115 15 153 39 31575 32High-risk heterosexual contactb 11350 59 41741 68 11092 67 588 78 227 58 65631 66Otherc 508 3 1456 2 413 2 51 7 13 3 2465 2Subtotal 19264 100 61728 100 16531 100 753 100 393 100 99671 100

Child (lt13 yrs at diagnosis)Perinatal 500 92 2468 99 629 95 20 94 12 100 3660 97Otherd 46 8 34 1 33 5 1 6 0 0 115 3Subtotal 546 100 2503 100 662 100 21 100 12 100 3775 100

Totale 154495 191590 80815 4526 1651 436693

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Includes 3616 persons of unknown race or multiple racesb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes 3 person of unknown sex Because column totals were calculated independently of the values for the subpopulations the values in each column

may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 23

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by

area of residence and age categorymdashUnited States and dependent areas

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

Alabama 5469 17 5486 3744 11 3755Alaska 272 1 273 330 1 331Arizona 5744 49 5793 4922 7 4929Arkansas 2291 7 2298 2139 6 2145California mdash mdash mdash 61451 105 61555Colorado 5855 13 5869 4083 2 4085Connecticut mdash mdash mdash 7406 15 7421Delaware mdash mdash mdash 1753 7 1760District of Columbia mdash mdash mdash 10059 30 10089Floridab 35461 263 35723 46469 194 46663Georgia mdash mdash mdash 17336 47 17383Hawaii mdash mdash mdash 1234 3 1237Idaho 356 0 356 313 0 313Illinois mdash mdash mdash 16139 46 16185Indiana 3849 21 3870 3996 14 4010Iowa 588 2 590 869 3 872Kansas 1230 7 1237 1272 2 1274Kentucky mdash mdash mdash 2589 13 2602Louisiana 7361 101 7462 8052 21 8074Maine mdash mdash mdash 512 2 514Maryland mdash mdash mdash 14540 41 14581Massachusetts mdash mdash mdash 8806 20 8826Michigan 6118 55 6173 6615 12 6627Minnesota 3227 21 3248 2314 9 2323Mississippi 4200 32 4232 3155 13 3168Missouri 4999 33 5033 5479 7 5486Montana mdash mdash mdash 205 0 205Nebraska 688 12 700 771 2 773Nevada 3402 13 3415 2969 3 2972New Hampshire mdash mdash mdash 556 3 559New Jersey 16059 153 16212 17168 57 17226New Mexico 910 0 909 1252 3 1255New York 42220 801 43021 70697 148 70845North Carolina 11700 60 11760 8451 12 8463North Dakota 87 2 89 73 1 74Ohio 8266 57 8323 7054 30 7084Oklahoma 2191 17 2208 2191 3 2194Oregon mdash mdash mdash 2840 4 2844Pennsylvania mdash mdash mdash 18633 71 18703Rhode Island mdash mdash mdash 1296 7 1303South Carolina 6349 45 6394 7035 23 7058South Dakota 195 4 199 139 1 140Tennessee 6579 51 6631 6403 11 6414Texas 24741 262 25003 34010 53 34063Utah 893 10 903 1164 0 1164Vermont mdash mdash mdash 238 2 240Virginia 9937 41 9978 8423 24 8447Washington mdash mdash mdash 5471 5 5476West Virginia 660 5 665 749 5 754Wisconsin 2322 15 2337 2153 12 2165Wyoming 86 2 88 102 1 103

Subtotal 224303 2174 226477 435621 1115 436736

24 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age categorymdashUnited States and dependent areas (cont)

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

US dependent areasAmerican Samoa 2 0 2 1 0 1Guam 63 0 63 36 0 36Northern Mariana Islands 7 0 7 3 0 3Puerto Rico 6269 31 6300 10971 26 10997US Virgin Islands 228 2 230 312 2 314Otherc mdash mdash mdash 1 0 1

Totald 230872 2207 233079 447724 1147 448871

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reporting a See Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at

least 2003b Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterc Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasd Total number of persons living with HIV infection (not AIDS) includes persons reported from areas with confidential name-based HIV

infection reporting who were residents of other states or whose area of residence is unknown Total number of persons living with AIDS includes persons whose area of residence is unknown Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 25

Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristicsmdashUnited States and dependent areas

No of persons

Survival in months

gt12 gt24 gt36Data for 50 states and the District of Columbia

Age at diagnosis (yrs)lt13 101 096 094 09413ndash14 60 098 098 09515ndash19 305 098 096 09520ndash24 1351 096 093 09225ndash29 3034 095 092 09130ndash34 5499 094 091 08935ndash39 7888 093 090 08740ndash44 7085 092 088 08545ndash49 5090 089 085 08250ndash54 3067 086 081 07855ndash59 1505 083 078 07460ndash64 806 080 073 069gt65 614 073 068 065

RaceethnicityWhite not Hispanic 10706 092 089 087Black not Hispanic 18406 090 086 082Hispanic 6398 092 090 088AsianPacific Islander 404 094 092 090American IndianAlaska Native 167 084 081 075

Transmission categoryMale adult or adolescentMale-to-male sexual contact 12830 093 090 088Injection drug use 4048 089 084 081Male-to-male sexual contact and injection drug use 1701 093 089 086High-risk heterosexual contacta 3170 091 088 085Otherb 5019 086 083 080Subtotal 26768 091 088 085

Female adult or adolescentInjection drug use 2101 089 083 078High-risk heterosexual contacta 4686 093 089 086Otherb 2749 090 085 083Subtotal 9536 091 087 083

Child (lt13 yrs at diagnosis)Perinatal 98 096 095 095Otherc 3 100 067 067Subtotal 101 096 094 094

Subtotal for 50 states and the District of Columbia 36405 091 087 085

Data for US dependent areas 891 083 078 075

Total 37352d 091 087 084Note Excludes persons whose date of death was before or in the same month as date of diagnosis Excludes persons whose month of diagnosis or month of death is unknowna Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes 325 persons of unknown race or multiple races

26 Survival after AIDS Diagnosis

Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by year of diagnosismdashUnited States and dependent areas

Months after AIDS diagnosis

Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by age groupmdashUnited States and dependent areas

Months after AIDS diagnosis

Survival after AIDS Diagnosis 27

Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by raceethnicitymdashUnited States and dependent areas

Months after AIDS diagnosis

28 Survival after AIDS Diagnosis

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006

and cumulativemdashUnited States and dependent areas

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Alabama 510 112 462 100 8626 76 8702Alaska 24 36 38 57 648 7 655Arizona 626 105 539 87 10396 46 10442Arkansas 237 85 252 90 3891 36 3927California 4069 113 3960 109 142254 664 142918Colorado 351 75 322 68 8742 31 8773Connecticut 658 188 422 120 14716 183 14899Delaware 177 210 116 136 3547 26 3573District of Columbia 672 1155 853 1467 17372 189 17561Florida 4921 277 4932 273 104084 1530 105614Georgia 2325 255 1605 171 31734 231 31965Hawaii 105 82 93 72 2927 17 2944Idaho 24 17 26 18 604 2 606Illinois 1886 148 1382 108 33620 282 33902Indiana 407 65 346 55 8239 56 8295Iowa 93 31 86 29 1727 13 1740Kansas 105 38 120 43 2781 14 2795Kentucky 249 60 207 49 4600 32 4632Louisiana 936 208 824 192 17612 128 17740Maine 21 16 68 51 1110 8 1118Maryland 1558 279 1626 290 30252 319 30571Massachusetts 666 104 533 83 19181 214 19395Michigan 821 81 672 67 14941 113 15054Minnesota 226 44 212 41 4817 28 4845Mississippi 368 127 365 125 6642 56 6698Missouri 385 66 469 80 11016 61 11077Montana 21 22 7 07 373 3 376Nebraska 53 30 118 67 1479 11 1490Nevada 293 121 294 118 5733 29 5762New Hampshire 33 25 55 42 1074 10 1084New Jersey 1262 145 1065 122 48750 778 49528New Mexico 134 70 93 48 2603 7 2610New York 6201 321 5495 285 174908 2354 177262North Carolina 916 106 1229 139 15954 118 16072North Dakota 10 16 6 09 144 1 145Ohio 753 66 767 67 14957 138 15095Oklahoma 281 79 205 57 4836 26 4862Oregon 217 60 281 76 5995 20 6015Pennsylvania 1486 120 1893 152 33417 365 33782Rhode Island 87 81 111 104 2580 28 2608South Carolina 682 161 705 163 13301 105 13406South Dakota 18 23 18 23 255 5 260Tennessee 818 137 680 113 12457 59 12516Texas 3045 133 2998 128 69735 392 70127Utah 63 25 57 22 2295 20 2315Vermont 5 08 18 29 461 6 467Virginia 638 84 605 79 16802 177 16979Washington 485 77 389 61 11792 34 11826West Virginia 74 41 67 37 1500 11 1511Wisconsin 122 22 217 39 4513 33 4546Wyoming 6 12 8 16 228 2 230

Subtotal 40123 135 37911 127 952221 9094 961315

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 29

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulativemdashUnited States and dependent areas (cont)

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

US dependent areasAmerican Samoa 0 0 0 0 1 0 1Guam 0 0 0 0 68 1 69Northern Mariana Islands 0 0 0 0 3 0 3Puerto Rico 1029 263 850 216 29511 400 29911US Virgin Islands 17 156 32 295 629 18 647Otherb 0 0 0 0 3 0 3

Totalc 41357 138 39002 129 983343 9522 992865d

a From the beginning of the epidemic through 2006b Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasc Includes persons whose state or area of residence is unknownd Includes 916 persons whose state or area of residence is unknown

30 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

MSA (population gt 500000)

Akron Ohio 66 94 32 46 762 1 763

AlbanyndashSchenectadyndashTroy NY 97 114 105 123 2253 24 2277

Albuquerque N Mex 70 88 50 61 1404 2 1406

AllentownndashBethlehemndashEaston PandashNJ 72 91 119 149 1352 17 1369

AtlantandashSandy SpringsndashMarietta Ga 1586 319 1006 196 21896 128 22024

AugustandashRichmond County GandashSC 106 205 32 61 1851 24 1875

AustinndashRound Rock Tex 227 156 186 123 4830 26 4856

Bakersfield Calif 76 100 122 156 1528 8 1536

BaltimorendashTowson Md 1064 401 1001 377 20352 218 20570

Baton Rouge La 222 304 231 301 3732 20 3752

BirminghamndashHoover Ala 151 139 110 100 2614 25 2639

Boise CityndashNampa Idaho 14 26 14 25 281 0 281

Boston MassndashNHa 441 99 355 80 13476 147 13623

Boston Division 269 146 185 101 8451 91 8542

Cambridge Division 108 74 102 70 3126 35 3161

Essex Division 52 71 51 69 1577 20 1597

BridgeportndashStamfordndashNorwalk Conn 181 201 135 150 3733 57 3790

BuffalondashNiagara Falls NY 117 102 96 84 2476 20 2496

Cape CoralndashFort Myers Fla 44 81 91 159 1692 24 1716

CharlestonndashNorth Charleston SC 92 155 91 151 2034 18 2052

CharlottendashGastoniandashConcord NCndashSC 214 141 285 180 3242 22 3264

Chicago IllndashIndndashWis 1716 182 1159 122 30118 261 30379

Chicago Division 1604 203 1073 135 28300 248 28548

Gary Division 61 88 50 71 1038 8 1046

Lake Division 51 59 36 41 780 5 785

CincinnatindashMiddletown OhiondashKyndashInd 111 53 199 95 2735 17 2752

ClevelandndashElyriandashMentor Ohio 228 107 170 80 4226 48 4274

Colorado Springs Colo 19 32 21 35 576 5 581

Columbia SC 177 256 197 280 3274 24 3298

Columbus Ohio 166 97 165 96 3112 15 3127

Dallas Tex 874 150 929 155 20238 63 20301

Dallas Division 681 175 714 178 16038 37 16075

Fort Worth Division 193 100 215 108 4200 26 4226

Dayton Ohio 58 69 54 64 1217 15 1232

DenverndashAurora Colo 274 116 236 98 6899 22 6921

Des Moines Iowa 30 57 23 43 530 4 534

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 31

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Detroit Mich 570 127 445 100 10373 73 10446

Detroit Division 443 223 330 167 8268 57 8325

Warren Division 127 51 115 46 2105 16 2121

El Paso Tex 56 78 40 54 1476 10 1486

Fresno Calif 52 59 64 72 1430 11 1441

Grand RapidsndashWyoming Mich 46 60 51 66 816 6 822

GreensborondashHigh Point NC 52 77 66 96 1265 14 1279

Greenville SC 70 119 67 111 1292 4 1296

HarrisburgndashCarlisle Pa 23 44 67 128 1224 8 1232

HartfordndashWest HartfordndashEast Hartford Conn 256 216 135 114 5126 46 5172

Honolulu Hawaii 54 60 69 76 2121 14 2135

HoustonndashBaytownndashSugar Land Tex 1017 190 1092 197 25821 172 25993

Indianapolis Ind 191 116 150 90 3824 25 3849

Jackson Miss 134 257 117 221 2419 30 2449

Jacksonville Fla 309 248 315 246 6020 75 6095

Kansas City MondashKans 183 94 160 81 4669 15 4684

Knoxville Tenn 47 72 35 52 882 5 887

Lakeland Fla 103 190 112 199 1811 21 1832

Las VegasndashParadise Nev 245 143 258 145 4616 28 4644

Little RockndashNorth Little Rock Ark 87 135 75 115 1383 14 1397

Los Angeles Calif 1529 118 1684 130 57953 293 58246

Los Angeles Division 1339 135 1435 144 51098 250 51348

Santa Anna Division 190 63 249 83 6855 43 6898

Louisville KyndashInd 123 102 97 79 2286 22 2308

Madison Wis 10 19 29 53 520 4 524

McAllenndashEdinburgndashPharr Tex 57 84 45 64 630 11 641

Memphis TennndashMissndashArk 402 320 346 271 5128 19 5147

Miami Fla 2420 446 2289 419 55807 997 56804

Fort Lauderdale Division 810 455 769 430 16412 262 16674

Miami Division 1243 523 1165 485 29703 512 30215

West Palm Beach Division 367 290 355 279 9692 223 9915

MilwaukeendashWaukeshandashWest Allis Wis 68 45 109 72 2507 18 2525

MinneapolisndashSt PaulndashBloomington MinnndashWis 186 59 184 58 4259 22 4281

Modesto Calif 36 71 22 43 671 6 677

NashvillendashDavidsonndashMurfreesboro Tenn 224 158 172 118 3848 20 3868

New HavenndashMilford Conn 169 200 107 127 4573 73 4646

New OrleansndashMetairiendashKenner La 393 299 271 264 8835 67 8902

32 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

New York NYndashNJndashPa 6215 330 5500 292 195177 2906 198083

Edison Division 191 83 130 56 6709 139 6848

Nassau Division 262 93 246 88 8141 110 8251

New York Division 5266 456 4716 408 160408 2323 162731

Newark Division 496 231 408 190 19919 334 20253

Oklahoma City Okla 125 108 88 75 2255 5 2260

OmahandashCouncil Bluffs NebndashIowa 37 46 80 97 1035 3 1038

Orlando Fla 544 282 517 260 8653 92 8745

OxnardndashThousand OaksndashVentura Calif 49 62 21 26 1008 3 1011

Palm BayndashMelbournendashTitusville Fla 68 129 61 114 1512 11 1523

Philadelphia PandashNJndashDelndashMd 1261 217 1348 231 28221 313 28534

Camden Division 108 87 111 89 3118 42 3160

Philadelphia Division 1022 263 1144 294 22112 250 22362

Wilmington Division 131 191 93 134 2991 21 3012

PhoenixndashMesandashScottsdale Ariz 460 119 376 93 7459 31 7490

Pittsburgh Pa 143 60 135 57 3182 19 3201

PortlandndashSouth Portland Maine 9 18 34 66 562 1 563

PortlandndashVancouverndashBeaverton OrendashWash 170 81 215 101 4825 10 4835

PoughkeepsiendashNewburghndashMiddletown NY 136 204 113 168 3162 24 3186

ProvidencendashNew BedfordndashFall River RIndashMass 132 82 155 96 3900 44 3944

RaleighndashCary NC 138 145 201 202 1987 13 2000

Richmond Va 119 101 122 102 3371 35 3406

RiversidendashSan BernardinondashOntario Calif 361 92 306 76 8568 60 8628

Rochester NY 165 159 124 120 3134 13 3147

SacramentondashArden-ArcadendashRoseville Calif 154 75 169 82 4000 26 4026

St Louis MondashIll 192 69 366 131 5965 40 6005

Salt Lake City Utah 46 44 40 37 1743 10 1753

San Antonio Tex 215 114 247 127 4987 30 5017

San DiegondashCarlsbadndashSan Marcos Calif 491 167 384 131 12934 61 12995

San Francisco Calif 867 209 690 165 40152 96 40248

Oakland Division 312 126 246 99 9546 48 9594

San Francisco Division 555 329 444 261 30606 48 30654

San JosendashSunnyvalendashSanta Clara Calif 88 50 145 81 3747 15 3762

San JuanndashCaguasndashGuaynabo PR 745 289 578 223 21402 277 21679

SarasotandashBradentonndashVenice Fla 82 122 104 152 1978 27 2005

ScrantonndashWilkes-Barre Pa 27 49 47 85 572 6 578

Seattle Wash 353 110 280 86 9172 27 9199

Seattle Division 316 129 255 102 8161 18 8179

Tacoma Division 37 49 25 33 1011 9 1020

Springfield Mass 88 128 45 66 2075 26 2101

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 33

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Stockton Calif 52 78 52 77 1076 15 1091

Syracuse NY 52 80 49 75 1317 8 1325

TampandashSt PetersburgndashClearwater Fla 559 211 605 224 11174 112 11286

Toledo Ohio 25 38 66 101 812 14 826

Tucson Ariz 103 111 100 106 2010 10 2020

Tulsa Okla 83 94 65 72 1494 10 1504

Virginia BeachndashNorfolkndashNewport News VandashNC 183 111 132 80 4711 63 4774

Washington DCndashVandashMdndashWV 1322 252 1684 318 31130 315 31445

Bethesda Division 135 118 173 150 2774 23 2797

Washington Division 1187 289 1511 365 28356 292 28648

Wichita Kans 35 60 38 64 851 2 853

Worcester Mass 76 97 79 101 1783 20 1803

YoungstownndashWarrenndashBoardman OhiondashPa 27 46 26 44 519 0 519

Subtotal for MSAs (population gt500000) 33602 173 31274 159 829633 8171 837804

Metropolitan areas (population of 50000 to 499999) 4477 80 4466 79 94829 847 95676

Nonmetropolitan areas 2666 54 2732 55 52063 445 52508

Totalb 41144 137 38749 128 981708 9494 991202

Note Because of the lack of census information for all US dependent areas includes data for only the 50 states the District of Columbia and Puerto RicoMSA metropolitan statistical areaMSA definitions for this report can be found at httpwwwcensusgovpopulationwwwestimatesmetrodefhtmla Reported case counts for the metropolitan divisions do not sum to the MSA total MSA total includes data from 1 metropolitan division with

population of lt500000b Includes persons whose county of residence is unknown

34 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Alabama (January 1988) 502 6041 48 6089

Alaska (February 1999) 38 285 2 287

Arizona (January 1987) 617 5877 80 5957

Arkansas (July 1989) 206 2349 20 2369

California (April 2006) 6581 7056 92 7148

Colorado (November 1985) 319 6084 31 6115

Connecticut (January 2005)b 826 2500 101 2601

Delaware (February 2006) 788 801 18 819

Florida (July 1997)c 4163 36386 397 36783

Georgia (December 2003) 2245 8197 194 8391

Idaho (June 1986) 35 340 4 344

Illinois (January 2006) 6241 6661 162 6823

Indiana (July 1988) 399 4027 43 4070

Iowa (July 1998) 69 586 5 591

Kansas (July 1999) 142 1225 15 1240

Kentucky (October 2004) 333 1303 13 1316

Louisiana (February 1993) 728 8149 166 8315

Maine (January 2006) 386 393 3 396

Michigan (April 1992) 635 6702 134 6836

Minnesota (October 1985) 309 3356 40 3396

Mississippi (August 1988) 352 4549 59 4608

Missouri (October 1987) 502 5086 55 5141

Nebraska (September 1995) 91 672 14 686

Nevada (February 1992) 339 3532 24 3556

New Hampshire (January 2005) 59 466 9 475

New Jersey (January 1992) 1477 17513 325 17838

New Mexico (January 1998) 114 949 4 953

New York (June 2000) 5326 42345 1820 44165

North Carolina (February 1990) 1615 13879 143 14022

North Dakota (January 1988) 4 82 1 83

Ohio (June 1990) 867 8222 101 8323

Oklahoma (June 1988) 229 2401 30 2431

Oregon (April 2006) 49 95 19 114

Pennsylvania (October 2002)d 4269 9537 179 9716

Rhode Island (July 2006) 14 21 0 21

South Carolina (February 1986) 493 6970 93 7063

South Dakota (January 1988) 18 215 6 221

Tennessee (January 1992) 732 7115 90 7205

Texas (January 1999)e 3370 24282 417 24699

Utah (April 1989) 106 893 14 907

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 35

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Virginia (July 1989) 864 10257 95 10352

Washington (March 2006) 4048 4157 40 4197

West Virginia (January 1989) 66 673 8 681

Wisconsin (November 1985) 261 2500 31 2531

Wyoming (June 1989) 7 93 1 94

Subtotal 50834 274822 5146 279968

US dependent areas

American Samoa (August 2001) 0 1 0 1

Guam (March 2000) 2 66 0 66

Northern Mariana Islands (October 2001) 2 7 0 7

Puerto Rico (January 2003) 1471 5610 91 5701

US Virgin Islands (December 1998) 22 247 6 253

Persons reported from areas with confidential name-based HIV infection reporting but who were residents of other areas 132 685 21 706

Totalf 52878 282640 5314 287954

Note Includes data from 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through 2006b Beginning in 1992 Connecticut had name-based HIV reporting for cases in children only From January 2002 through December 2004

Connecticut had name- or code-based HIV reporting for cases in adolescents and adults As of January 2005 Connecticut has name-based reporting of all cases of HIV infection

c Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterd On October 18 2002 Pennsylvania initiated confidential name-based HIV infection reporting in all areas except Philadelphia Code-based

reporting was implemented in Philadelphia in March 2004 and the switch to name-based reporting was made in October 2005e From February 1994 through December 1998 Texas reported HIV infection in children onlyf Includes 1252 persons reported from areas with confidential name-based HIV infection reporting but whose area of residence is unknown

36 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulativemdashUnited States and dependent areas

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No Adult or adolescentMale-to-male sexual contact 13775 49 429897 54 mdash mdash mdash mdash 13775 35 429897 44Injection drug use 3413 12 163070 21 1826 17 67693 35 5239 13 230763 23Male-to-male sexual contact and

injection drug use 1603 6 65524 8 mdash mdash mdash mdash 1603 4 65524 7Hemophiliacoagulation disorder 43 0 5176 1 11 0 348 0 54 0 5524 1High-risk heterosexual contactc 2997 11 49610 6 4839 46 85186 44 7836 20 134796 14

Sex with injection drug user 330 1 11683 1 706 7 26073 14 1036 3 37756 4Sex with bisexual male mdash mdash mdash mdash 234 2 5162 3 234 1 5162 1Sex with person with hemophilia 1 0 84 0 11 0 502 0 12 0 586 0Sex with HIV-infected transfusion

recipient 22 0 553 0 21 0 793 0 43 0 1346 0Sex with HIV-infected person risk

factor not specified 2644 9 37290 5 3867 37 52656 27 6511 17 89946 9Receipt of blood transfusion blood

d components or tissue 63 0 5213 1 68 1 4176 2 131 0 9389 1Otherrisk factor not reported or

identifiede 6484 23 73136 9 3793 36 34311 18 10278 26 107450 11Subtotal 28378 100 791626 100 10537 100 191714 100 38916 100 983343 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 0 0 222 5 0 0 7 0 0 0 229 2Mother with documented HIV infection or

1 of the following risk factors 24 75 4315 89 50 93 4423 95 74 86 8738 92Injection drug use 4 13 1676 35 4 7 1665 36 8 9 3341 35Sex with injection drug user 4 13 789 16 4 7 750 16 8 9 1539 16Sex with bisexual male 1 3 101 2 2 4 110 2 3 3 211 2Sex with person with hemophilia 0 0 20 0 0 0 16 0 0 0 36 0Sex with HIV-infected transfusion

recipient 0 0 11 0 0 0 15 0 0 0 26 0Sex with HIV-infected person risk

factor not specified 6 19 742 15 17 31 790 17 23 27 1532 16Receipt of blood transfusion blood

components or tissue 0 0 70 1 0 0 82 2 0 0 152 2Has HIV infection risk factor not

specified 9 28 906 19 23 43 995 21 32 37 1901 20Receipt of blood transfusion blood

fcomponents or tissue 1 3 243 5 0 0 144 3 1 1 387 4Otherrisk factor not reported or

identifiedg 7 22 75 2 4 7 93 2 11 13 168 2Subtotal 32 100 4855 100 54 100 4667 100 86 100 9522 100

Total 28410 100 796481 100 10591 100 196381 100 39002 100 992865 100a From the beginning of the epidemic through 2006b From the beginning of the epidemic through 2006 Includes 3 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infectiond AIDS developed in 47 adultsadolescents after they received blood that had tested negative for HIV antibodies AIDS developed in 14 additional adults

after they received tissue organs or artificial insemination from HIV-infected donors Four of the 14 received tissue or organs from a donor who was negative for HIV antibody at the time of donation

e Includes 37 adultsadolescents who were exposed to HIV-infected blood body fluids or concentrated virus in health care laboratory or household settings as supported by seroconversion epidemiologic andor laboratory evidence One person was infected after intentional inoculation with HIV-infected blood Includes an additional 740 persons who acquired HIV infection perinatally but who were more than 12 years of age when AIDS was diagnosed These 740 persons are not counted in the values for the pediatric transmission category

f AIDS developed in 3 children after they received blood that had tested negative for HIV antibodiesg Includes 5 children who were exposed to HIV-infected blood as supported by seroconversion epidemiologic andor laboratory evidence 1 child was

infected after intentional inoculation with HIV-infected blood and 5 children were exposed to HIV-infected blood in a household setting Of the 168 children 26 had sexual contact with an adult with or at high risk for HIV infection

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 37

Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No

Adult or adolescentMale-to-male sexual contact 22912 59 103679 52 mdash mdash mdash mdash 22912 44 103679 37

Injection drug use 3503 9 24255 12 2124 16 13925 17 5627 11 38181 14

Male-to-male sexual contact and injection drug use 1946 5 10704 5 mdash mdash mdash mdash 1946 4 10704 4

Hemophiliacoagulation disorder 43 0 495 0 6 0 73 0 49 0 568 0

High-risk heterosexual contactc 2874 7 16830 8 5939 45 38315 47 8813 17 55145 20

Sex with injection drug user 308 1 2601 1 757 6 6791 8 1065 2 9392 3

Sex with bisexual male mdash mdash mdash mdash 328 2 2265 3 328 1 2265 1

Sex with person with hemophilia 4 0 31 0 16 0 201 0 20 0 232 0

Sex with HIV-infected transfusion recipient 13 0 131 0 28 0 223 0 41 0 354 0

Sex with HIV-infected person risk factor not specified 2549 7 14067 7 4810 36 28835 35 7359 14 42902 15

Receipt of blood transfusion blood components or tissue 61 0 489 0 50 0 536 1 111 0 1025 0

Otherrisk factor not reported or identified 7748 20 44021 22 5106 39 29312 36 12854 25 73338 26

Subtotal 39087 100 200473 100 13225 100 82161 100 52312 100 282640 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 8 3 106 4 0 0 1 0 8 1 107 2

Mother with documented HIV infection or 1 of the following risk factors 197 74 2195 85 254 85 2417 89 451 80 4612 87

Injection drug use 34 13 532 21 53 18 561 21 87 15 1093 21

Sex with injection drug user 12 5 208 8 21 7 213 8 33 6 421 8

Sex with bisexual male 5 2 37 1 4 1 32 1 9 2 69 1

Sex with person with hemophilia 0 0 3 0 1 0 7 0 1 0 10 0

Sex with HIV-infected transfusion recipient 0 0 4 0 0 0 4 0 0 0 8 0

Sex with HIV-infected person risk factor not specified 54 20 534 21 76 25 629 23 130 23 1163 22

Receipt of blood transfusion blood components or tissue 0 0 17 1 2 1 20 1 2 0 37 1

Has HIV infection risk factor not specified 92 35 860 33 97 32 951 35 189 33 1811 34

Receipt of blood transfusion blood components or tissue 6 2 28 1 3 1 24 1 9 2 52 1

Otherrisk factor not reported or identified 55 21 260 10 43 14 283 10 98 17 543 10

Subtotal 266 100 2589 100 300 100 2725 100 566 100 5314 100

Total 39353 100 203062 100 13525 100 84886 100 52878 100 287954 100

Note See Table 16 for the list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006b From the beginning of the epidemic through December 2006 Includes 6 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infection

38 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity

2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 6251 65 253927 73Injection drug use 733 8 31737 9Male-to-male sexual contact and injection drug use 732 8 31434 9Hemophiliacoagulation disorder 26 0 3989 1High-risk heterosexual contactb 416 4 7850 2

Sex with injection drug user 74 1 2310 1

Sex with person with hemophilia 0 0 36 0

Sex with HIV-infected transfusion recipient 2 0 176 0

Sex with HIV-infected person risk factor not specified 340 4 5328 2Receipt of blood transfusion blood components or tissue 20 0 3194 1Otherrisk factor not reported or identified 1400 15 16469 5

Total 9578 100 348600 100

Black not HispanicMale-to-male sexual contact 4309 36 103297 37Injection drug use 1635 14 83369 30Male-to-male sexual contact and injection drug use 526 4 22134 8Hemophiliacoagulation disorder 10 0 604 0High-risk heterosexual contactb 1875 16 29952 11

Sex with injection drug user 167 1 6823 2Sex with person with hemophilia 1 0 36 0Sex with HIV-infected transfusion recipient 15 0 237 0Sex with HIV-infected person risk factor not specified 1692 14 22856 8

Receipt of blood transfusion blood components or tissue 24 0 1218 0Otherrisk factor not reported or identified 3579 30 40268 14

Total 11958 100 280842 100

HispanicMale-to-male sexual contact 2816 47 64893 44Injection drug use 965 16 46337 31Male-to-male sexual contact and injection drug use 287 5 10884 7Hemophiliacoagulation disorder 6 0 466 0High-risk heterosexual contactb 638 11 10950 7

Sex with injection drug user 84 1 2409 2Sex with person with hemophilia 0 0 11 0Sex with HIV-infected transfusion recipient 5 0 125 0Sex with HIV-infected person risk factor not specified 549 9 8405 6

Receipt of blood transfusion blood components or tissue 17 0 657 0Otherrisk factor not reported or identified 1326 22 14832 10

Total 6055 100 149019 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 39

a

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulative

No No

AsianPacific IslanderMale-to-male sexual contact 225 54 4475 68Injection drug use 20 5 317 5Male-to-male sexual contact and injection drug use 17 4 284 4Hemophiliacoagulation disorder 1 0 70 1High-risk heterosexual contactb 34 8 376 6

Sex with injection drug user 1 0 54 1Sex with person with hemophilia 0 0 1 0Sex with HIV-infected transfusion recipient 0 0 8 0Sex with HIV-infected person risk factor not specified 33 8 313 5

Receipt of blood transfusion blood components or tissue 2 0 112 2Otherrisk factor not reported or identified 114 28 949 14

Total 413 100 6583 100

American IndianAlaska NativeMale-to-male sexual contact 61 49 1403 55Injection drug use 15 12 395 15Male-to-male sexual contact and injection drug use 23 19 457 18Hemophiliacoagulation disorder 0 0 27 1High-risk heterosexual contactb 9 7 118 5

Sex with injection drug user 1 1 33 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 8 6 82 3

Receipt of blood transfusion blood components or tissue 0 0 8 0Otherrisk factor not reported or identified 16 13 155 6

Total 124 100 2563 100

Total casesMale-to-male sexual contact 13775 49 429897 54Injection drug use 3413 12 163070 21Male-to-male sexual contact and injection drug use 1603 6 65524 8Hemophiliacoagulation disorder 43 0 5176 1High-risk heterosexual contactb 2997 11 49610 6

Sex with injection drug user 330 1 11683 1Sex with person with hemophilia 1 0 84 0Sex with HIV-infected transfusion recipient 22 0 553 0Sex with HIV-infected person risk factor not specified 2644 9 37290 5

Receipt of blood transfusion blood components or tissue 63 0 5213 1Otherrisk factor not reported or identified 6484 23 73136 9

Total 28378c 100 791626d 100a From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 4019 males of unknown race or multiple races

40 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 11963 73 55725 69Injection drug use 858 5 5512 7Male-to-male sexual contact and injection drug use 1092 7 5578 7Hemophiliacoagulation disorder 29 0 355 0High-risk heterosexual contactb 522 3 2658 3

Sex with injection drug user 65 0 544 1Sex with person with hemophilia 0 0 8 0Sex with HIV-infected transfusion recipient 3 0 33 0Sex with HIV-infected person risk factor not specified 454 3 2073 3

Receipt of blood transfusion blood components or tissue 14 0 197 0Otherrisk factor not reported or identified 1956 12 11147 14

Total 16434 100 81172 100

Black not HispanicMale-to-male sexual contact 6203 44 30148 37Injection drug use 1594 11 11997 15Male-to-male sexual contact and injection drug use 483 3 3489 4Hemophiliacoagulation disorder 10 0 109 0High-risk heterosexual contactb 1714 12 10905 13

Sex with injection drug user 169 1 1554 2Sex with person with hemophilia 4 0 17 0Sex with HIV-infected transfusion recipient 6 0 77 0Sex with HIV-infected person risk factor not specified 1535 11 9257 11

Receipt of blood transfusion blood components or tissue 32 0 223 0Otherrisk factor not reported or identified 4151 29 24632 30

Total 14187 100 81503 100

HispanicMale-to-male sexual contact 4094 55 15623 47Injection drug use 993 13 6407 19Male-to-male sexual contact and injection drug use 316 4 1402 4Hemophiliacoagulation disorder 3 0 26 0High-risk heterosexual contactb 582 8 2963 9

Sex with injection drug user 65 1 455 1Sex with person with hemophilia 0 0 6 0Sex with HIV-infected transfusion recipient 4 0 18 0Sex with HIV-infected person risk factor not specified 513 7 2484 7

Receipt of blood transfusion blood components or tissue 11 0 55 0Otherrisk factor not reported or identified 1475 20 6977 21

Total 7474 100 33453 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 41

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderMale-to-male sexual contact 402 70 1006 63Injection drug use 17 3 55 3Male-to-male sexual contact and injection drug use 15 3 38 2Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 25 4 96 6

Sex with injection drug user 3 1 10 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 22 4 83 5

Receipt of blood transfusion blood components or tissue 4 1 7 0Otherrisk factor not reported or identified 109 19 397 25

Total 572 100 1600 100

American IndianAlaska NativeMale-to-male sexual contact 104 61 516 57Injection drug use 13 8 101 11Male-to-male sexual contact and injection drug use 19 11 110 12Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 10 6 53 6

Sex with injection drug user 2 1 14 2Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 8 5 39 4

Receipt of blood transfusion blood components or tissue 0 0 2 0Otherrisk factor not reported or identified 24 14 125 14

Total 170 100 907 100

Total casesMale-to-male sexual contact 22912 59 103679 52Injection drug use 3503 9 24255 12Male-to-male sexual contact and injection drug use 1946 5 10704 5Hemophiliacoagulation disorder 43 0 495 0High-risk heterosexual contactb 2874 7 16830 8

Sex with injection drug user 308 1 2601 1Sex with person with hemophilia 4 0 31 0Sex with HIV-infected transfusion recipient 13 0 131 0Sex with HIV-infected person risk factor not specified 2549 7 14067 7

Receipt of blood transfusion blood components or tissue 61 0 489 0Otherrisk factor not reported or identified 7748 20 44021 22

Total 39087c 100 200473d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 1838 males of unknown race or multiple races

42 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race

ethnicity 2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 482 28 14981 40Hemophiliacoagulation disorder 4 0 123 0High-risk heterosexual contactb 725 42 15799 42

Sex with injection drug user 153 9 5650 15Sex with bisexual male 63 4 1859 5Sex with person with hemophilia 5 0 329 1Sex with HIV-infected transfusion recipient 5 0 338 1Sex with HIV-infected person risk factor not specified 499 29 7623 20

Receipt of blood transfusion blood components or tissue 15 1 1870 5Otherrisk factor not reported or identified 499 29 4801 13

Total 1725 100 37574 100

Black not HispanicInjection drug use 982 15 38914 34Hemophiliacoagulation disorder 3 0 145 0High-risk heterosexual contactb 3103 46 49876 44

Sex with injection drug user 373 6 13530 12Sex with bisexual male 136 2 2352 2Sex with person with hemophilia 4 0 121 0Sex with HIV-infected transfusion recipient 8 0 277 0Sex with HIV-infected person risk factor not specified 2582 38 33596 29

Receipt of blood transfusion blood components or tissue 39 1 1546 1Otherrisk factor not reported or identified 2612 39 23894 21

Total 6739 100 114375 100

HispanicInjection drug use 322 18 12892 35Hemophiliacoagulation disorder 4 0 67 0High-risk heterosexual contactb 894 49 17995 49

Sex with injection drug user 166 9 6522 18Sex with bisexual male 32 2 818 2Sex with person with hemophilia 1 0 45 0Sex with HIV-infected transfusion recipient 7 0 141 0Sex with HIV-infected person risk factor not specified 688 38 10469 29

Receipt of blood transfusion blood components or tissue 12 1 619 2Otherrisk factor not reported or identified 592 32 5023 14

Total 1824 100 36596 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 43

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 8 8 125 12Hemophiliacoagulation disorder 0 0 7 1High-risk heterosexual contactb 49 47 574 53

Sex with injection drug user 4 4 114 11Sex with bisexual male 2 2 80 7Sex with person with hemophilia 0 0 4 0Sex with HIV-infected transfusion recipient 1 1 25 2Sex with HIV-infected person risk factor not specified 42 40 351 33

Receipt of blood transfusion blood components or tissue 1 1 93 9Otherrisk factor not reported or identified 46 44 279 26

Total 104 100 1078 100

American IndianAlaska NativeInjection drug use 13 32 280 42Hemophiliacoagulation disorder 0 0 3 0High-risk heterosexual contactb 15 37 277 41

Sex with injection drug user 4 10 107 16Sex with bisexual male 1 2 27 4Sex with person with hemophilia 0 0 2 0Sex with HIV-infected transfusion recipient 0 0 6 1Sex with HIV-infected person risk factor not specified 10 24 135 20

Receipt of blood transfusion blood components or tissue 1 2 17 3Otherrisk factor not reported or identified 12 29 95 14

Total 41 100 672 100

Total casesInjection drug use 1826 17 67693 35Hemophiliacoagulation disorder 11 0 348 0High-risk heterosexual contactb 4839 46 85186 44

Sex with injection drug user 706 7 26073 14Sex with bisexual male 234 2 5162 3Sex with person with hemophilia 11 0 502 0Sex with HIV-infected transfusion recipient 21 0 793 0Sex with HIV-infected person risk factor not specified 3867 37 52656 27

Receipt of blood transfusion blood components or tissue 68 1 4176 2Otherrisk factor not reported or identified 3793 36 34311 18

Total 10537c 100 191714d 100a From the beginning of the epidemic through 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 104 females of unknown race or multiple racesd Includes 1419 females of unknown race or multiple races

44 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 690 26 4260 26Hemophiliacoagulation disorder 3 0 24 0

bHigh-risk heterosexual contact 1132 42 7593 46Sex with injection drug user 205 8 1876 11Sex with bisexual male 98 4 659 4Sex with person with hemophilia 10 0 115 1Sex with HIV-infected transfusion recipient 7 0 64 0Sex with HIV-infected person risk factor not specified 812 30 4879 29

Receipt of blood transfusion blood components or tissue 12 0 146 1Otherrisk factor not reported or identified 850 32 4567 28

Total 2687 100 16590 100

Black not HispanicInjection drug use 1034 13 7105 14Hemophiliacoagulation disorder 1 0 35 0

bHigh-risk heterosexual contact 3451 44 23732 46Sex with injection drug user 313 4 3473 7Sex with bisexual male 155 2 1294 3Sex with person with hemophilia 5 0 71 0Sex with HIV-infected transfusion recipient 14 0 120 0Sex with HIV-infected person risk factor not specified 2964 38 18774 36

Receipt of blood transfusion blood components or tissue 26 0 324 1Otherrisk factor not reported or identified 3370 43 20244 39

Total 7882 100 51440 100

HispanicInjection drug use 339 15 2280 18Hemophiliacoagulation disorder 2 0 11 0

bHigh-risk heterosexual contact 1198 52 6264 50Sex with injection drug user 218 9 1324 11Sex with bisexual male 62 3 266 2Sex with person with hemophilia 1 0 11 0Sex with HIV-infected transfusion recipient 7 0 39 0Sex with HIV-infected person risk factor not specified 910 39 4624 37

Receipt of blood transfusion blood components or tissue 12 1 58 0Otherrisk factor not reported or identified 767 33 3843 31

Total 2318 100 12456 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 45

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 9: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

survival Figures 2 3 and 4 illustrate the proportion of surviving persons among persons whose diagnoses were made over a longer period 1998 through 2005

bull Survival (the estimated proportion of persons surviving a given length of time after diagnosis) increased with the year of diagnosis for diagnoses made during 1998ndash2000 Year-to-year differences were small during 2001ndash2005 (Figure 2)

bull Survival decreased as age at diagnosis increased among persons at least 35 years old at diagnosis and in comparison with persons younger than 35 Survival was similar for the age groups 13ndash24 and 25ndash34 (Figure 3)

bull Survival was greatest among MSM and among children with perinatally acquired HIV infection (Table 13) Survival was intermediate among male and female adults and adolescents who had heterosexual contact with someone known to be HIV infected or at high risk for HIV infection as well as among MSM who also were IDUs Survival was lowest among male and female adults and adolescents who were IDUs

bull Survival particularly at more than 48 months after diagnosis was greater among AsiansPacific Islanders whites and Hispanics than among blacks (Figure 4) Results were unstable or inconsistent for American IndiansAlaska Natives because the numbers of persons in this racialethnic category were small

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Tables 14ndash23 describe reports of cases of HIVAIDS AIDS and HIV infection (not AIDS) Tables 16 18 20 and 22 are based on reports of cases of HIV infection (not AIDS) through 2006 from the 50 areas that had implemented name-based HIV infection reporting Note that not all cases of HIV infection (not AIDS) or AIDS reported in 2006 reflect diagnoses made during 2006 rather the reported cases include cases diagnosed during earlier years

Reports of cases of HIV infection (not AIDS)Through 2006 a total of 287954 persons were

reported as having HIV infection (not AIDS) in the 50 areas with confidential name-based HIV infection reporting (Table 16) (see Technical Notes for discus-sion of surveillance of HIV infection [not AIDS])

Comm

Five states (Florida New Jersey New York North Carolina and Texas) reported 137507 (48) of the 287954 cumulative cases of HIV infection (not AIDS) reported to CDC In 2006 4 states (California Illinois New York and Pennsylvania) reported 22417 (42) of the 52878 cases of HIV infection (not AIDS)

bull In 2006 of the 52312 reported cases among adults and adolescents 75 were in males and 25 were in females (Table 18)

bull In 2006 566 cases in children were reported

Reports of AIDS casesThrough 2006 a total of 992865 persons in the

United States had been reported as having AIDS (Table 14) Three states (California Florida and New York) reported 43 of the cumulative AIDS cases and 37 of AIDS cases reported to CDC in 2006 In the United States the rate of reported AIDS cases in 2006 was 129 per 100000 population When the US dependent areas were included the rate of reported AIDS cases ranged from zero per 100000 (American Samoa Guam and the Northern Mariana Islands) to 1467 per 100000 (District of Columbia)

bull In 2006 males accounted for 73 and females for 27 of 38916 reported AIDS cases among adults and adolescents (Table 17)

bull In 2006 86 AIDS cases in children were reported

ADDITIONAL RESOURCES

The following were prepared by using HIVAIDS surveillance data

bull Selected MMWR articles at httpwwwcdcgovhivresourcesreportsmmwr

bull Public-use slides at httpwwwcdcgovhivtopicssurveillanceresourcesslides

bull Other surveillance reports at httpwwwcdcgovhivtopicssurveillanceresourcesreports

bull Public-use version of the AIDS surveillance data set (AIDS Public Information Data Set [APIDS]) at httpwwwcdcgovhivsoftwareapidshtm

SUGGESTED READINGS

CDC Advancing HIV Prevention New Strategies for a Changing EpidemicmdashUnited States 2003 MMWR 200352(15)329ndash332

entary 9

CDC Dear colleague letter CDC recommends that all states and territories adopt confidential name-based surveillance systems to report HIV infec-tions httpwwwcdcgovhivpubs070505_dearcolleague_gerberdingpdf Pub-lished July 5 2005 Accessed March 11 2008

1981ndash2005 CDC Epidemiology of HIVAIDSmdashUnited States

MMWR 200655(21)589ndash592CDC Guidelines for national HIV case surveil-

lance including monitoring for HIV infection and AIDS MMWR 199948(RR-13)1ndash31

CDC HIV prevention strategic plan extended through 2010 httpwwwcdcgovhivresourcesreportspsp Published October 2007 Accessed March 11 2008

CDC Revised recommendations for HIV testing of adults adolescents and pregnant women in health-care settings MMWR 200655(RR-14)1ndash17

CDC Twenty-five years of HIVAIDSmdashUnited States 1981ndash2006 MMWR 200655(21)585ndash589

Glynn MK Lee LM McKenna MT The status of national HIV case surveillance United States 2006 Public Health Rep 2007122(suppl 1)63ndash71

Janssen RS Satten GA Stramer SL et al New test-ing strategy to detect early HIV-1 infection for use in incidence estimates and for clinical and prevention purposes JAMA 1998280(1)42ndash48

Lee LM McKenna MT Monitoring the incidence of HIV infection in the United States Public Health Rep 2007122(suppl 1)72ndash79

10 Comm

entary

Cases of HIVAIDS and AIDS

Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003ndash2006mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

Year of diagnosis

2003 2004 2005 2006

Data for 33 statesAge at diagnosis (yrs)lt13 211 183 169 13513ndash14 53 36 40 4115ndash19 993 993 1126 133220ndash24 3163 3368 3592 388625ndash29 4023 4057 4236 460330ndash34 5189 4820 4676 446635ndash39 6369 5807 5535 544240ndash44 5786 5429 5529 571845ndash49 4028 3877 4028 420450ndash54 2451 2401 2547 271855ndash59 1279 1363 1455 143860ndash64 655 702 692 714gt65 570 624 613 618

RaceethnicityWhite not Hispanic 10033 10181 10528 10758Black not Hispanic 17668 16718 16629 17356Hispanic 6355 6010 6217 6481AsianPacific Islander 338 339 373 397American IndianAlaska Native 179 171 182 166

Transmission categoryMale adult or adolescentMale-to-male sexual contact 15409 15880 16833 17465Injection drug use 3514 3083 2978 3016Male-to-male sexual contact and injection drug use 1349 1299 1247 1180High-risk heterosexual contacta 4269 3959 3871 4152Otherb 125 110 107 114Subtotal 24666 24331 25036 25928

Female adult or adolescentInjection drug use 2027 1856 1720 1712High-risk heterosexual contacta 7731 7182 7216 7432Otherb 134 107 97 109Subtotal 9892 9145 9033 9252

Child (lt13 yrs at diagnosis)Perinatal 190 157 147 115Otherc 23 27 23 20Subtotal 213 184 170 135

Subtotal for 33 states 34770 33659 34239 35314

Data for US dependent areas 1331 1234 1395 1503

Totald 36102 34894 35634 36817Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

Cases of HIVAIDS and AIDS 11

Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

gt12 Months after diagnosis aof HIV infection

lt12 Months after diagnosis of HIV infectionb Total

No ()c No ()c No

Data for 33 statesAge at diagnosis (yrs)lt13 148 88 21 12 16913ndash14 22 54 18 46 4015ndash19 912 81 215 19 112620ndash24 2874 80 714 20 358925ndash29 3077 73 1157 27 423430ndash34 3016 65 1655 35 467135ndash39 3353 61 2176 39 553040ndash44 3181 58 2338 42 551945ndash49 2145 53 1874 47 401950ndash54 1307 51 1239 49 254655ndash59 725 50 728 50 145360ndash64 316 46 376 54 692gt65 266 44 346 56 612RaceethnicityWhite not Hispanic 6839 65 3677 35 10516Black not Hispanic 10372 62 6242 38 16614Hispanic 3593 58 2614 42 6206AsianPacific Islander 232 62 139 38 371American IndianAlaska Native 110 61 72 39 182Transmission category

Male adult or adolescentMale-to-male sexual contact 10917 65 5902 35 16819Injection drug use 1544 52 1427 48 2971Male-to-male sexual contact and injection drug use 733 59 512 41 1245High-risk heterosexual contactd 2091 54 1773 46 3864Othere 45 42 61 58 107Subtotal 15331 61 9675 39 25006Female adult or adolescentInjection drug use 1056 62 660 38 1716High-risk heterosexual contactd 4761 66 2450 34 7210Othere 47 48 50 52 97Subtotal 5864 65 3160 35 9023Child (lt13 yrs at diagnosis)Perinatal 126 86 21 14 147Otherf 22 94 2 6 23Subtotal 148 87 22 13 170

Subtotal for 33 states 21343 62 12857 38 34200Data for US dependent areas 855 61 541 39 1395

Totalg 22197 62 13398 38 35595h

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003Data exclude 39 persons whose month of diagnosis of HIV infection is unknowna Includes persons in whom AIDS has not developedb Includes persons whose diagnoses of HIV infection and AIDS were made at the same timec Percentages represent proportions of the total number of diagnoses of HIVAIDS made during 2005 for the corresponding group (see row

entries)d Heterosexual contact with a person known to have or to be at high risk for HIV infectione Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedf Includes hemophilia blood transfusion and risk factor not reported or not identifiedg Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the

column totalh Includes 310 persons of unknown race or multiple races

12 Cases of HIVAIDS and AIDS

Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas

Year of diagnosis2002 2003 2004 2005 2006 Cumulativea

Data for 50 states and the District of ColumbiaAge at diagnosis (yrs)lt13 106 70 53 53 38 915613ndash14 62 74 70 66 73 107815ndash19 316 302 334 410 401 562620ndash24 1399 1568 1624 1675 1669 3622525ndash29 3137 3059 3196 3110 3423 11709930ndash34 5701 5521 5144 4668 4349 19753035ndash39 8217 8017 7072 6479 6402 21357340ndash44 7404 7626 7703 7378 7298 17053145ndash49 5358 5617 5498 5727 5628 10720750ndash54 3271 3364 3491 3527 3687 5990755ndash59 1607 1693 1836 1861 2071 3219060ndash64 872 864 913 872 955 17303gt65 682 763 791 727 835 15074

RaceethnicityWhite not Hispanic 11233 10948 11066 10676 10929 394024Black not Hispanic 19246 19512 18909 18081 17960 409982Hispanic 6712 7102 6771 6823 6907 161505AsianPacific Islander 425 450 444 450 519 7951American IndianAlaska Native 177 176 182 170 155 3345

Transmission categoryMale adult or adolescentMale-to-male sexual contact 15709 16078 16054 15711 16001 465965Injection drug use 5483 5275 4818 4603 4410 170171Male-to-male sexual contact and injection drug use 2075 2029 1925 1930 1803 68516High-risk heterosexual contactb 4547 4471 4506 4306 4558 65241Otherc 253 226 228 237 217 13893Subtotal 28067 28079 27532 26787 26989 783786

Female adult or adolescentInjection drug use 2897 2836 2810 2586 2385 74718High-risk heterosexual contactb 6855 7336 7113 6922 7196 108252Otherc 207 217 217 205 220 6596Subtotal 9959 10389 10141 9713 9801 189566

Child (lt13 yrs at diagnosis)Perinatal 104 70 53 52 37 8508Otherd 2 0 0 0 0 636Subtotal 106 70 53 53 38 9144

Region of residenceNortheast 10092 10342 9412 9396 9486 306241Midwest 4125 4226 4089 4371 4164 101479South 17198 17630 18225 16894 17104 374800West 6718 6339 6000 5891 6074 199978Subtotal for 50 states and the District of Columbia 38132 38538 37726 36552 36828 982498

Data for US dependent areas 1058 1060 921 955 833 31217

Totale 39250 39690 38807 37662 37852 1014797Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes persons of unknown race or multiple races and persons of unknown sex Cumulative total includes 5691 persons of unknown race or multiple

races 3 persons of unknown sex 1079 persons of unknown state of residence and 3 persons who were residents of other areas Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Cases of HIVAIDS and AIDS 13

Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002ndash2006 and cumulativemdash50 states and the District of Columbia

Year of diagnosisCumulativea2002 2003 2004 2005 2006

RaceethnicityWhite not Hispanic 14 12 7 4 4 1599Black not Hispanic 70 46 33 38 30 5654Hispanic 18 10 9 8 3 1748AsianPacific Islander 1 0 1 1 1 54American IndianAlaska Native 1 0 1 0 0 31

Transmission categoryHemophiliacoagulation disorder 0 0 0 0 0 226Mother with documented HIV infection or 1 of the following risk factors 104 70 53 52 37 8508

Injection drug use 12 8 5 3 4 3220Sex with injection drug user 4 6 3 2 1 1397Sex with bisexual male 2 0 3 1 1 209Sex with person with hemophilia 0 0 0 0 0 35Sex with HIV-infected transfusion recipient 0 0 0 0 0 22Sex with HIV-infected person risk factor not specified 36 20 20 25 13 1530Receipt of blood transfusion blood components or tissue 2 1 0 0 0 144Has HIV infection risk factor not specified 47 34 21 21 17 1951

Receipt of blood transfusion blood components or tissue 2 0 0 0 0 374Otherrisk factor not reported or identified 0 0 0 0 0 36

Totalb 106 70 53 53 38 9144

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga From the beginning of the epidemic through 2006b Includes children of unknown race or multiple races Cumulative total includes 58 children of unknown race or multiple races Because column totals

were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992ndash2006mdash50 states and the District of Columbia

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reporting

14 Cases of HIVAIDS and AIDS

Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006mdash50 states and the District of Columbia

Raceethnicity

Adults or adolescents

Children (lt13 yrs) TotalaMales Females Totala

No Rate No Rate No Rate No Rate No Rate

White not Hispanic 9267 112 1659 19 10926 64 4 00 10929 54Black not Hispanic 11540 829 6391 404 17930 603 30 04 17960 476Hispanic 5388 313 1516 95 6903 208 3 00 6907 156AsianPacific Islander 423 75 95 16 518 44 1 00 519 37American IndianAlaska Native 118 122 37 36 155 78 0 00 155 62

Totalb 26989 224 9801 78 36790 149 38 01 36828c 123

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reportingData exclude cases in persons whose state or area of residence is unknown as well as cases from US dependent areas for which census information about race and age categories is lackinga Because row totals were calculated independently of the values for the subpopulations the values in each row may not sum to the row totalb Includes person of unknown race or multiple races Because column totals were calculated independently of the values for the subpopulations the

values in each column may not sum to the column totalc Includes 358 persons of unknown race or multiple races

Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006mdash33 states with confidential name-based HIV infection reporting

Raceethnicity

Adults or adolescents

Children (lt13 yrs) TotalaMales Females Totala

No Rate No Rate No Rate No Rate No Rate

White not Hispanic 9078 167 1664 29 10742 96 16 01 10758 82Black not Hispanic 11230 1191 6033 562 17263 856 93 17 17356 677Hispanic 5058 509 1400 151 6458 337 23 04 6481 255AsianPacific Islander 318 135 79 32 397 82 0 00 397 67American IndianAlaska Native 129 177 35 46 164 110 2 06 166 88

Totalb 25928 338 9252 115 35180 224 135 04 35314c 185

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Because row totals were calculated independently of the values for the subpopulations the values in each row may not sum to the row totalb Includes persons of unknown race or multiple races Because column totals were calculated independently of the values for the subpopulations the

values in each column may not sum to the column totalc Includes 156 persons of unknown race or multiple races

Cases of HIVAIDS and AIDS 15

Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006mdashUnited States and dependent areas

Transmission category

Place of birth

United StatesCentralSouth

America Cuba Mexico Puerto Rico Totala

No No No No No No

Male-to-male sexual contact 1172 45 402 49 89 62 790 59 249 18 3337 43Injection drug use 569 22 83 10 13 9 133 10 533 40 1650 21Male-to-male sexual contact

and injection drug use 158 6 25 3 6 4 59 4 63 5 357 5High-risk heterosexual

contactb 661 25 296 36 35 24 342 26 487 36 2282 30Otherc 47 2 8 1 0 0 9 1 14 1 103 1

Totald 2608 100 814 100 145 100 1334 100 1346 100 7728 100Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Includes 222 persons whose place of birth is not among those listed and 1260 persons whose place of birth is unknownb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the

column total

16 Cases of HIVAIDS and AIDS

Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas

Year of death

Cumulativea2002 2003 2004 2005 2006

Data for 50 states and the District of ColumbiaAge at death (yrs)lt13 25 22 15 7 13 4889

13ndash14 10 6 15 12 5 276

15ndash19 39 36 36 38 44 1104

20ndash24 151 157 175 147 162 8716

25ndash29 553 512 482 458 405 43671

30ndash34 1480 1272 1128 1069 785 95351

35ndash39 2967 2763 2425 2096 1682 116746

40ndash44 3595 3516 3393 3317 2636 104133

45ndash49 3294 3234 3251 3275 2886 72831

50ndash54 2318 2373 2502 2645 2343 44255

55ndash59 1209 1322 1425 1543 1480 25123

60ndash64 616 705 741 797 771 14315

gt65 691 773 807 865 805 14393

RaceethnicityWhite not Hispanic 5214 5097 4836 4758 3860 239529

Black not Hispanic 9037 8675 8581 8679 7426 218392

Hispanic 2429 2632 2641 2513 2425 80690

AsianPacific Islander 97 84 111 87 114 3426

American IndianAlaska Native 83 73 80 65 66 1693

Transmission categoryMale adult or adolescentMale-to-male sexual contact 5960 5937 5735 5641 4930 266272

Injection drug use 3738 3547 3315 3314 2641 107173

Male-to-male sexual contact and injection drug use 1278 1299 1237 1289 1064 40993

High-risk heterosexual contactb 1465 1501 1625 1571 1470 26236

Otherc 160 149 125 117 80 9867

Subtotal 12601 12431 12038 11932 10184 450541

Female adult or adolescentInjection drug use 1923 1825 1855 1768 1456 43143

High-risk heterosexual contactb 2281 2292 2373 2458 2258 42620

Otherc 84 87 72 68 70 4131

Subtotal 4289 4204 4300 4295 3784 89895

Child (lt13 yrs at diagnosis)Perinatal 53 49 56 39 42 4848

Otherd 4 5 1 2 7 521

Subtotal 57 54 57 41 48 5369

Deaths 17

Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas (cont)

Year of death

Cumulativea2002 2003 2004 2005 2006

Region of residenceNortheast 5313 5012 4779 4750 4074 180623

Midwest 1726 1666 1482 1378 1325 54468

South 7337 7427 7535 7907 6475 197209

West 2571 2585 2600 2234 2141 113506

Subtotal for 50 states and the District of Columbia 16948 16690 16395 16268 14016 545805

Data for US dependent areas 667 575 572 562 580 19858

Totale 17628 17283 16982 16865 14627 565927f

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column totalf Includes 2082 persons of unknown race or multiple races 261 persons of unknown state of residence and 2 persons who were residents

of other areas

18 Deaths

Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003ndash2006mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

2003 2004 2005 2006Data for 33 states

Age at end of year (yrs)lt13 4154 3700 3294 286713ndash14 1130 1238 1212 113915ndash19 3298 3627 4024 453920ndash24 12389 12826 13411 1430125ndash29 26167 26924 28164 2960030ndash34 49602 47577 45109 4418935ndash39 80703 77871 75842 7363440ndash44 92040 97109 100102 10176445ndash49 71345 77490 83816 9028350ndash54 45133 51033 56640 6319555ndash59 22793 26610 31186 3600860ndash64 10820 12642 14422 16658gt65 8531 9959 11657 13551

RaceethnicityWhite not Hispanic 145081 151694 158375 166000Black not Hispanic 202951 212425 221439 231957Hispanic 72612 76503 80491 84720AsianPacific Islander 2234 2529 2858 3187American IndianAlaska Native 1788 1889 2008 2119

Transmission categoryMale adult or adolescentMale-to-male sexual contact 181771 193245 205423 218676Injection drug use 57651 58149 58369 59077Male-to-male sexual contact and injection drug use 23965 24434 24725 25085High-risk heterosexual contacta 40084 42559 44915 47562Otherb 3218 3278 3325 3424Subtotal 306689 321665 336756 353825

Female adult or adolescentInjection drug use 32346 32735 32973 33470High-risk heterosexual contacta 80324 85348 90185 95403Otherb 2036 2123 2212 2321Subtotal 114705 120206 125370 131195

Child (lt13 yrs at diagnosis)Perinatal 6137 6154 6178 6143Otherc 570 575 571 560Subtotal 6707 6730 6748 6703

Subtotal for 33 states 428107 448605 468879 491727Data for US dependent areas 15809 16399 17150 17955

Totald 443916 465005 486028 509681Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 19

Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission categorymdash33 states with confidential name-based HIV infection reporting

Transmission category

White not Hispanic

Black not Hispanic Hispanic

AsianPacific Islander

American IndianAlaska

Native Totala

No No No No No No

Male adult or adolescentMale-to-male sexual contact 108259 77 70242 49 36043 57 1669 68 938 62 218676 62Injection drug use 12328 9 31339 22 14472 23 264 11 216 14 59077 17Male-to-male sexual contact

and injection drug use 11283 8 9587 7 3720 6 93 4 205 13 25085 7High-risk heterosexual contactb 6667 5 31140 22 8788 14 395 16 143 9 47562 13Otherc 1458 1 1492 1 404 1 30 1 17 1 3424 1Subtotal 139994 100 143799 100 63427 100 2450 100 1519 100 353825 100

Female adult or adolescentInjection drug use 8262 33 19136 23 5528 28 106 15 175 30 33470 26High-risk heterosexual contactb 16338 65 63204 75 14132 71 573 82 392 68 95403 73Otherc 450 2 1469 2 344 2 24 3 12 2 2321 2Subtotal 25050 100 83809 100 20004 100 703 100 578 100 131195 100

Child (lt13 yrs at diagnosis)Perinatal 801 84 4064 93 1183 92 28 82 20 95 6143 92Otherd 154 16 283 7 107 8 6 18 1 5 560 8Subtotal 955 100 4347 100 1290 100 34 100 21 100 6703 100

Totale 166000 231957 84720 3187 2119 491727Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of 33 states that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Includes 3745 persons of unknown race or multiple racesb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes 5 persons of unknown sex Because column totals were calculated independently of the values for the subpopulations the values

in each column may not sum to the column total

20 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Map 1 Estimated rates (per 100000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

Note Rates adjusted for reporting delays Rates of HIV infection include only persons living with HIV infection that has not progressed to AIDSSince 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 Islandsa Includes persons whose area of residence is unknown

Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

Note Rates adjusted for reporting delays Rates of HIV infection include only persons living with HIV infection that has not progressed to AIDSSince 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 Islandsa Includes persons whose area of residence is unknown

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 21

Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002ndash2006mdashUnited States and dependent areas

2002 2003 2004 2005 2006Data for 50 states and the District of Columbia

Age at end of year (yrs)lt13 2308 2006 1684 1394 111513ndash14 685 747 784 762 71115ndash19 1465 1694 1974 2243 248720ndash24 3910 4292 4629 5033 536725ndash29 12725 12743 13045 13505 1435930ndash34 35558 33870 32057 29949 2882435ndash39 70107 68106 65076 62235 5964940ndash44 80377 86294 91335 94021 9517445ndash49 64702 71276 77417 84153 9077550ndash54 41270 46855 53333 59256 6647655ndash59 20113 24145 28356 33522 3901460ndash64 9681 11293 13305 15380 18072gt65 7520 8946 10604 12430 14669

RaceethnicityWhite not Hispanic 129426 135278 141508 147426 154495Black not Hispanic 150488 161326 171654 181056 191590Hispanic 63424 67895 72024 76334 80815AsianPacific Islander 3060 3426 3759 4121 4526American IndianAlaska Native 1254 1356 1458 1562 1651

Transmission categoryMale adult or adolescentMale-to-male sexual contact 158092 168233 178551 188622 199693Injection drug use 56708 58436 59940 61229 62998Male-to-male sexual contact and injection drug use 24726 25457 26144 26785 27523High-risk heterosexual contacta 27329 30300 33181 35916 39004Otherb 3588 3665 3769 3888 4026Subtotal 270444 286091 301585 316440 333244

Female adult or adolescentInjection drug use 27863 28874 29828 30646 31575High-risk heterosexual contacta 46445 51489 56229 60693 65631Otherb 1903 2033 2178 2315 2465Subtotal 76210 82395 88236 93653 99671

Child (lt13 yrs at diagnosis)Perinatal 3633 3654 3651 3664 3660Otherc 129 124 123 122 115Subtotal 3762 3778 3774 3786 3775

Region of residenceNortheast 105599 110929 115562 120208 125620Midwest 36011 38571 41178 44171 47010South 137081 147284 157975 166962 177591West 71729 75483 78883 82540 86473

Subtotal for 50 states and the District of Columbia 350419 372267 393598 413882 436693

Data for US dependent areas 9880 10365 10713 11106 11359

Totald 360617 383024 404849 425646 448871Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

22 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission categorymdash50 states and the District of Columbia

Transmission category

White not Hispanic

Black not Hispanic Hispanic

AsianPacific Islander

American IndianAlaska

Native Totala

No No No No No No

Male adult or adolescentMale-to-male sexual contact 101299 75 57520 45 36087 57 2715 72 704 57 199693 60Injection drug use 13168 10 33911 27 14795 23 325 9 201 16 62998 19Male-to-male sexual contact and

injection drug use 12393 9 10121 8 4352 7 198 5 220 18 27523 8High-risk heterosexual contactb 6081 5 24205 19 7816 12 444 12 105 8 39004 12Otherc 1743 1 1602 1 574 1 69 2 16 1 4026 1Subtotal 134683 100 127359 100 63623 100 3752 100 1246 100 333244 100

Female adult or adolescentInjection drug use 7407 38 18531 30 5025 30 115 15 153 39 31575 32High-risk heterosexual contactb 11350 59 41741 68 11092 67 588 78 227 58 65631 66Otherc 508 3 1456 2 413 2 51 7 13 3 2465 2Subtotal 19264 100 61728 100 16531 100 753 100 393 100 99671 100

Child (lt13 yrs at diagnosis)Perinatal 500 92 2468 99 629 95 20 94 12 100 3660 97Otherd 46 8 34 1 33 5 1 6 0 0 115 3Subtotal 546 100 2503 100 662 100 21 100 12 100 3775 100

Totale 154495 191590 80815 4526 1651 436693

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Includes 3616 persons of unknown race or multiple racesb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes 3 person of unknown sex Because column totals were calculated independently of the values for the subpopulations the values in each column

may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 23

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by

area of residence and age categorymdashUnited States and dependent areas

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

Alabama 5469 17 5486 3744 11 3755Alaska 272 1 273 330 1 331Arizona 5744 49 5793 4922 7 4929Arkansas 2291 7 2298 2139 6 2145California mdash mdash mdash 61451 105 61555Colorado 5855 13 5869 4083 2 4085Connecticut mdash mdash mdash 7406 15 7421Delaware mdash mdash mdash 1753 7 1760District of Columbia mdash mdash mdash 10059 30 10089Floridab 35461 263 35723 46469 194 46663Georgia mdash mdash mdash 17336 47 17383Hawaii mdash mdash mdash 1234 3 1237Idaho 356 0 356 313 0 313Illinois mdash mdash mdash 16139 46 16185Indiana 3849 21 3870 3996 14 4010Iowa 588 2 590 869 3 872Kansas 1230 7 1237 1272 2 1274Kentucky mdash mdash mdash 2589 13 2602Louisiana 7361 101 7462 8052 21 8074Maine mdash mdash mdash 512 2 514Maryland mdash mdash mdash 14540 41 14581Massachusetts mdash mdash mdash 8806 20 8826Michigan 6118 55 6173 6615 12 6627Minnesota 3227 21 3248 2314 9 2323Mississippi 4200 32 4232 3155 13 3168Missouri 4999 33 5033 5479 7 5486Montana mdash mdash mdash 205 0 205Nebraska 688 12 700 771 2 773Nevada 3402 13 3415 2969 3 2972New Hampshire mdash mdash mdash 556 3 559New Jersey 16059 153 16212 17168 57 17226New Mexico 910 0 909 1252 3 1255New York 42220 801 43021 70697 148 70845North Carolina 11700 60 11760 8451 12 8463North Dakota 87 2 89 73 1 74Ohio 8266 57 8323 7054 30 7084Oklahoma 2191 17 2208 2191 3 2194Oregon mdash mdash mdash 2840 4 2844Pennsylvania mdash mdash mdash 18633 71 18703Rhode Island mdash mdash mdash 1296 7 1303South Carolina 6349 45 6394 7035 23 7058South Dakota 195 4 199 139 1 140Tennessee 6579 51 6631 6403 11 6414Texas 24741 262 25003 34010 53 34063Utah 893 10 903 1164 0 1164Vermont mdash mdash mdash 238 2 240Virginia 9937 41 9978 8423 24 8447Washington mdash mdash mdash 5471 5 5476West Virginia 660 5 665 749 5 754Wisconsin 2322 15 2337 2153 12 2165Wyoming 86 2 88 102 1 103

Subtotal 224303 2174 226477 435621 1115 436736

24 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age categorymdashUnited States and dependent areas (cont)

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

US dependent areasAmerican Samoa 2 0 2 1 0 1Guam 63 0 63 36 0 36Northern Mariana Islands 7 0 7 3 0 3Puerto Rico 6269 31 6300 10971 26 10997US Virgin Islands 228 2 230 312 2 314Otherc mdash mdash mdash 1 0 1

Totald 230872 2207 233079 447724 1147 448871

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reporting a See Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at

least 2003b Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterc Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasd Total number of persons living with HIV infection (not AIDS) includes persons reported from areas with confidential name-based HIV

infection reporting who were residents of other states or whose area of residence is unknown Total number of persons living with AIDS includes persons whose area of residence is unknown Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 25

Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristicsmdashUnited States and dependent areas

No of persons

Survival in months

gt12 gt24 gt36Data for 50 states and the District of Columbia

Age at diagnosis (yrs)lt13 101 096 094 09413ndash14 60 098 098 09515ndash19 305 098 096 09520ndash24 1351 096 093 09225ndash29 3034 095 092 09130ndash34 5499 094 091 08935ndash39 7888 093 090 08740ndash44 7085 092 088 08545ndash49 5090 089 085 08250ndash54 3067 086 081 07855ndash59 1505 083 078 07460ndash64 806 080 073 069gt65 614 073 068 065

RaceethnicityWhite not Hispanic 10706 092 089 087Black not Hispanic 18406 090 086 082Hispanic 6398 092 090 088AsianPacific Islander 404 094 092 090American IndianAlaska Native 167 084 081 075

Transmission categoryMale adult or adolescentMale-to-male sexual contact 12830 093 090 088Injection drug use 4048 089 084 081Male-to-male sexual contact and injection drug use 1701 093 089 086High-risk heterosexual contacta 3170 091 088 085Otherb 5019 086 083 080Subtotal 26768 091 088 085

Female adult or adolescentInjection drug use 2101 089 083 078High-risk heterosexual contacta 4686 093 089 086Otherb 2749 090 085 083Subtotal 9536 091 087 083

Child (lt13 yrs at diagnosis)Perinatal 98 096 095 095Otherc 3 100 067 067Subtotal 101 096 094 094

Subtotal for 50 states and the District of Columbia 36405 091 087 085

Data for US dependent areas 891 083 078 075

Total 37352d 091 087 084Note Excludes persons whose date of death was before or in the same month as date of diagnosis Excludes persons whose month of diagnosis or month of death is unknowna Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes 325 persons of unknown race or multiple races

26 Survival after AIDS Diagnosis

Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by year of diagnosismdashUnited States and dependent areas

Months after AIDS diagnosis

Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by age groupmdashUnited States and dependent areas

Months after AIDS diagnosis

Survival after AIDS Diagnosis 27

Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by raceethnicitymdashUnited States and dependent areas

Months after AIDS diagnosis

28 Survival after AIDS Diagnosis

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006

and cumulativemdashUnited States and dependent areas

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Alabama 510 112 462 100 8626 76 8702Alaska 24 36 38 57 648 7 655Arizona 626 105 539 87 10396 46 10442Arkansas 237 85 252 90 3891 36 3927California 4069 113 3960 109 142254 664 142918Colorado 351 75 322 68 8742 31 8773Connecticut 658 188 422 120 14716 183 14899Delaware 177 210 116 136 3547 26 3573District of Columbia 672 1155 853 1467 17372 189 17561Florida 4921 277 4932 273 104084 1530 105614Georgia 2325 255 1605 171 31734 231 31965Hawaii 105 82 93 72 2927 17 2944Idaho 24 17 26 18 604 2 606Illinois 1886 148 1382 108 33620 282 33902Indiana 407 65 346 55 8239 56 8295Iowa 93 31 86 29 1727 13 1740Kansas 105 38 120 43 2781 14 2795Kentucky 249 60 207 49 4600 32 4632Louisiana 936 208 824 192 17612 128 17740Maine 21 16 68 51 1110 8 1118Maryland 1558 279 1626 290 30252 319 30571Massachusetts 666 104 533 83 19181 214 19395Michigan 821 81 672 67 14941 113 15054Minnesota 226 44 212 41 4817 28 4845Mississippi 368 127 365 125 6642 56 6698Missouri 385 66 469 80 11016 61 11077Montana 21 22 7 07 373 3 376Nebraska 53 30 118 67 1479 11 1490Nevada 293 121 294 118 5733 29 5762New Hampshire 33 25 55 42 1074 10 1084New Jersey 1262 145 1065 122 48750 778 49528New Mexico 134 70 93 48 2603 7 2610New York 6201 321 5495 285 174908 2354 177262North Carolina 916 106 1229 139 15954 118 16072North Dakota 10 16 6 09 144 1 145Ohio 753 66 767 67 14957 138 15095Oklahoma 281 79 205 57 4836 26 4862Oregon 217 60 281 76 5995 20 6015Pennsylvania 1486 120 1893 152 33417 365 33782Rhode Island 87 81 111 104 2580 28 2608South Carolina 682 161 705 163 13301 105 13406South Dakota 18 23 18 23 255 5 260Tennessee 818 137 680 113 12457 59 12516Texas 3045 133 2998 128 69735 392 70127Utah 63 25 57 22 2295 20 2315Vermont 5 08 18 29 461 6 467Virginia 638 84 605 79 16802 177 16979Washington 485 77 389 61 11792 34 11826West Virginia 74 41 67 37 1500 11 1511Wisconsin 122 22 217 39 4513 33 4546Wyoming 6 12 8 16 228 2 230

Subtotal 40123 135 37911 127 952221 9094 961315

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 29

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulativemdashUnited States and dependent areas (cont)

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

US dependent areasAmerican Samoa 0 0 0 0 1 0 1Guam 0 0 0 0 68 1 69Northern Mariana Islands 0 0 0 0 3 0 3Puerto Rico 1029 263 850 216 29511 400 29911US Virgin Islands 17 156 32 295 629 18 647Otherb 0 0 0 0 3 0 3

Totalc 41357 138 39002 129 983343 9522 992865d

a From the beginning of the epidemic through 2006b Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasc Includes persons whose state or area of residence is unknownd Includes 916 persons whose state or area of residence is unknown

30 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

MSA (population gt 500000)

Akron Ohio 66 94 32 46 762 1 763

AlbanyndashSchenectadyndashTroy NY 97 114 105 123 2253 24 2277

Albuquerque N Mex 70 88 50 61 1404 2 1406

AllentownndashBethlehemndashEaston PandashNJ 72 91 119 149 1352 17 1369

AtlantandashSandy SpringsndashMarietta Ga 1586 319 1006 196 21896 128 22024

AugustandashRichmond County GandashSC 106 205 32 61 1851 24 1875

AustinndashRound Rock Tex 227 156 186 123 4830 26 4856

Bakersfield Calif 76 100 122 156 1528 8 1536

BaltimorendashTowson Md 1064 401 1001 377 20352 218 20570

Baton Rouge La 222 304 231 301 3732 20 3752

BirminghamndashHoover Ala 151 139 110 100 2614 25 2639

Boise CityndashNampa Idaho 14 26 14 25 281 0 281

Boston MassndashNHa 441 99 355 80 13476 147 13623

Boston Division 269 146 185 101 8451 91 8542

Cambridge Division 108 74 102 70 3126 35 3161

Essex Division 52 71 51 69 1577 20 1597

BridgeportndashStamfordndashNorwalk Conn 181 201 135 150 3733 57 3790

BuffalondashNiagara Falls NY 117 102 96 84 2476 20 2496

Cape CoralndashFort Myers Fla 44 81 91 159 1692 24 1716

CharlestonndashNorth Charleston SC 92 155 91 151 2034 18 2052

CharlottendashGastoniandashConcord NCndashSC 214 141 285 180 3242 22 3264

Chicago IllndashIndndashWis 1716 182 1159 122 30118 261 30379

Chicago Division 1604 203 1073 135 28300 248 28548

Gary Division 61 88 50 71 1038 8 1046

Lake Division 51 59 36 41 780 5 785

CincinnatindashMiddletown OhiondashKyndashInd 111 53 199 95 2735 17 2752

ClevelandndashElyriandashMentor Ohio 228 107 170 80 4226 48 4274

Colorado Springs Colo 19 32 21 35 576 5 581

Columbia SC 177 256 197 280 3274 24 3298

Columbus Ohio 166 97 165 96 3112 15 3127

Dallas Tex 874 150 929 155 20238 63 20301

Dallas Division 681 175 714 178 16038 37 16075

Fort Worth Division 193 100 215 108 4200 26 4226

Dayton Ohio 58 69 54 64 1217 15 1232

DenverndashAurora Colo 274 116 236 98 6899 22 6921

Des Moines Iowa 30 57 23 43 530 4 534

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 31

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Detroit Mich 570 127 445 100 10373 73 10446

Detroit Division 443 223 330 167 8268 57 8325

Warren Division 127 51 115 46 2105 16 2121

El Paso Tex 56 78 40 54 1476 10 1486

Fresno Calif 52 59 64 72 1430 11 1441

Grand RapidsndashWyoming Mich 46 60 51 66 816 6 822

GreensborondashHigh Point NC 52 77 66 96 1265 14 1279

Greenville SC 70 119 67 111 1292 4 1296

HarrisburgndashCarlisle Pa 23 44 67 128 1224 8 1232

HartfordndashWest HartfordndashEast Hartford Conn 256 216 135 114 5126 46 5172

Honolulu Hawaii 54 60 69 76 2121 14 2135

HoustonndashBaytownndashSugar Land Tex 1017 190 1092 197 25821 172 25993

Indianapolis Ind 191 116 150 90 3824 25 3849

Jackson Miss 134 257 117 221 2419 30 2449

Jacksonville Fla 309 248 315 246 6020 75 6095

Kansas City MondashKans 183 94 160 81 4669 15 4684

Knoxville Tenn 47 72 35 52 882 5 887

Lakeland Fla 103 190 112 199 1811 21 1832

Las VegasndashParadise Nev 245 143 258 145 4616 28 4644

Little RockndashNorth Little Rock Ark 87 135 75 115 1383 14 1397

Los Angeles Calif 1529 118 1684 130 57953 293 58246

Los Angeles Division 1339 135 1435 144 51098 250 51348

Santa Anna Division 190 63 249 83 6855 43 6898

Louisville KyndashInd 123 102 97 79 2286 22 2308

Madison Wis 10 19 29 53 520 4 524

McAllenndashEdinburgndashPharr Tex 57 84 45 64 630 11 641

Memphis TennndashMissndashArk 402 320 346 271 5128 19 5147

Miami Fla 2420 446 2289 419 55807 997 56804

Fort Lauderdale Division 810 455 769 430 16412 262 16674

Miami Division 1243 523 1165 485 29703 512 30215

West Palm Beach Division 367 290 355 279 9692 223 9915

MilwaukeendashWaukeshandashWest Allis Wis 68 45 109 72 2507 18 2525

MinneapolisndashSt PaulndashBloomington MinnndashWis 186 59 184 58 4259 22 4281

Modesto Calif 36 71 22 43 671 6 677

NashvillendashDavidsonndashMurfreesboro Tenn 224 158 172 118 3848 20 3868

New HavenndashMilford Conn 169 200 107 127 4573 73 4646

New OrleansndashMetairiendashKenner La 393 299 271 264 8835 67 8902

32 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

New York NYndashNJndashPa 6215 330 5500 292 195177 2906 198083

Edison Division 191 83 130 56 6709 139 6848

Nassau Division 262 93 246 88 8141 110 8251

New York Division 5266 456 4716 408 160408 2323 162731

Newark Division 496 231 408 190 19919 334 20253

Oklahoma City Okla 125 108 88 75 2255 5 2260

OmahandashCouncil Bluffs NebndashIowa 37 46 80 97 1035 3 1038

Orlando Fla 544 282 517 260 8653 92 8745

OxnardndashThousand OaksndashVentura Calif 49 62 21 26 1008 3 1011

Palm BayndashMelbournendashTitusville Fla 68 129 61 114 1512 11 1523

Philadelphia PandashNJndashDelndashMd 1261 217 1348 231 28221 313 28534

Camden Division 108 87 111 89 3118 42 3160

Philadelphia Division 1022 263 1144 294 22112 250 22362

Wilmington Division 131 191 93 134 2991 21 3012

PhoenixndashMesandashScottsdale Ariz 460 119 376 93 7459 31 7490

Pittsburgh Pa 143 60 135 57 3182 19 3201

PortlandndashSouth Portland Maine 9 18 34 66 562 1 563

PortlandndashVancouverndashBeaverton OrendashWash 170 81 215 101 4825 10 4835

PoughkeepsiendashNewburghndashMiddletown NY 136 204 113 168 3162 24 3186

ProvidencendashNew BedfordndashFall River RIndashMass 132 82 155 96 3900 44 3944

RaleighndashCary NC 138 145 201 202 1987 13 2000

Richmond Va 119 101 122 102 3371 35 3406

RiversidendashSan BernardinondashOntario Calif 361 92 306 76 8568 60 8628

Rochester NY 165 159 124 120 3134 13 3147

SacramentondashArden-ArcadendashRoseville Calif 154 75 169 82 4000 26 4026

St Louis MondashIll 192 69 366 131 5965 40 6005

Salt Lake City Utah 46 44 40 37 1743 10 1753

San Antonio Tex 215 114 247 127 4987 30 5017

San DiegondashCarlsbadndashSan Marcos Calif 491 167 384 131 12934 61 12995

San Francisco Calif 867 209 690 165 40152 96 40248

Oakland Division 312 126 246 99 9546 48 9594

San Francisco Division 555 329 444 261 30606 48 30654

San JosendashSunnyvalendashSanta Clara Calif 88 50 145 81 3747 15 3762

San JuanndashCaguasndashGuaynabo PR 745 289 578 223 21402 277 21679

SarasotandashBradentonndashVenice Fla 82 122 104 152 1978 27 2005

ScrantonndashWilkes-Barre Pa 27 49 47 85 572 6 578

Seattle Wash 353 110 280 86 9172 27 9199

Seattle Division 316 129 255 102 8161 18 8179

Tacoma Division 37 49 25 33 1011 9 1020

Springfield Mass 88 128 45 66 2075 26 2101

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 33

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Stockton Calif 52 78 52 77 1076 15 1091

Syracuse NY 52 80 49 75 1317 8 1325

TampandashSt PetersburgndashClearwater Fla 559 211 605 224 11174 112 11286

Toledo Ohio 25 38 66 101 812 14 826

Tucson Ariz 103 111 100 106 2010 10 2020

Tulsa Okla 83 94 65 72 1494 10 1504

Virginia BeachndashNorfolkndashNewport News VandashNC 183 111 132 80 4711 63 4774

Washington DCndashVandashMdndashWV 1322 252 1684 318 31130 315 31445

Bethesda Division 135 118 173 150 2774 23 2797

Washington Division 1187 289 1511 365 28356 292 28648

Wichita Kans 35 60 38 64 851 2 853

Worcester Mass 76 97 79 101 1783 20 1803

YoungstownndashWarrenndashBoardman OhiondashPa 27 46 26 44 519 0 519

Subtotal for MSAs (population gt500000) 33602 173 31274 159 829633 8171 837804

Metropolitan areas (population of 50000 to 499999) 4477 80 4466 79 94829 847 95676

Nonmetropolitan areas 2666 54 2732 55 52063 445 52508

Totalb 41144 137 38749 128 981708 9494 991202

Note Because of the lack of census information for all US dependent areas includes data for only the 50 states the District of Columbia and Puerto RicoMSA metropolitan statistical areaMSA definitions for this report can be found at httpwwwcensusgovpopulationwwwestimatesmetrodefhtmla Reported case counts for the metropolitan divisions do not sum to the MSA total MSA total includes data from 1 metropolitan division with

population of lt500000b Includes persons whose county of residence is unknown

34 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Alabama (January 1988) 502 6041 48 6089

Alaska (February 1999) 38 285 2 287

Arizona (January 1987) 617 5877 80 5957

Arkansas (July 1989) 206 2349 20 2369

California (April 2006) 6581 7056 92 7148

Colorado (November 1985) 319 6084 31 6115

Connecticut (January 2005)b 826 2500 101 2601

Delaware (February 2006) 788 801 18 819

Florida (July 1997)c 4163 36386 397 36783

Georgia (December 2003) 2245 8197 194 8391

Idaho (June 1986) 35 340 4 344

Illinois (January 2006) 6241 6661 162 6823

Indiana (July 1988) 399 4027 43 4070

Iowa (July 1998) 69 586 5 591

Kansas (July 1999) 142 1225 15 1240

Kentucky (October 2004) 333 1303 13 1316

Louisiana (February 1993) 728 8149 166 8315

Maine (January 2006) 386 393 3 396

Michigan (April 1992) 635 6702 134 6836

Minnesota (October 1985) 309 3356 40 3396

Mississippi (August 1988) 352 4549 59 4608

Missouri (October 1987) 502 5086 55 5141

Nebraska (September 1995) 91 672 14 686

Nevada (February 1992) 339 3532 24 3556

New Hampshire (January 2005) 59 466 9 475

New Jersey (January 1992) 1477 17513 325 17838

New Mexico (January 1998) 114 949 4 953

New York (June 2000) 5326 42345 1820 44165

North Carolina (February 1990) 1615 13879 143 14022

North Dakota (January 1988) 4 82 1 83

Ohio (June 1990) 867 8222 101 8323

Oklahoma (June 1988) 229 2401 30 2431

Oregon (April 2006) 49 95 19 114

Pennsylvania (October 2002)d 4269 9537 179 9716

Rhode Island (July 2006) 14 21 0 21

South Carolina (February 1986) 493 6970 93 7063

South Dakota (January 1988) 18 215 6 221

Tennessee (January 1992) 732 7115 90 7205

Texas (January 1999)e 3370 24282 417 24699

Utah (April 1989) 106 893 14 907

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 35

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Virginia (July 1989) 864 10257 95 10352

Washington (March 2006) 4048 4157 40 4197

West Virginia (January 1989) 66 673 8 681

Wisconsin (November 1985) 261 2500 31 2531

Wyoming (June 1989) 7 93 1 94

Subtotal 50834 274822 5146 279968

US dependent areas

American Samoa (August 2001) 0 1 0 1

Guam (March 2000) 2 66 0 66

Northern Mariana Islands (October 2001) 2 7 0 7

Puerto Rico (January 2003) 1471 5610 91 5701

US Virgin Islands (December 1998) 22 247 6 253

Persons reported from areas with confidential name-based HIV infection reporting but who were residents of other areas 132 685 21 706

Totalf 52878 282640 5314 287954

Note Includes data from 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through 2006b Beginning in 1992 Connecticut had name-based HIV reporting for cases in children only From January 2002 through December 2004

Connecticut had name- or code-based HIV reporting for cases in adolescents and adults As of January 2005 Connecticut has name-based reporting of all cases of HIV infection

c Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterd On October 18 2002 Pennsylvania initiated confidential name-based HIV infection reporting in all areas except Philadelphia Code-based

reporting was implemented in Philadelphia in March 2004 and the switch to name-based reporting was made in October 2005e From February 1994 through December 1998 Texas reported HIV infection in children onlyf Includes 1252 persons reported from areas with confidential name-based HIV infection reporting but whose area of residence is unknown

36 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulativemdashUnited States and dependent areas

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No Adult or adolescentMale-to-male sexual contact 13775 49 429897 54 mdash mdash mdash mdash 13775 35 429897 44Injection drug use 3413 12 163070 21 1826 17 67693 35 5239 13 230763 23Male-to-male sexual contact and

injection drug use 1603 6 65524 8 mdash mdash mdash mdash 1603 4 65524 7Hemophiliacoagulation disorder 43 0 5176 1 11 0 348 0 54 0 5524 1High-risk heterosexual contactc 2997 11 49610 6 4839 46 85186 44 7836 20 134796 14

Sex with injection drug user 330 1 11683 1 706 7 26073 14 1036 3 37756 4Sex with bisexual male mdash mdash mdash mdash 234 2 5162 3 234 1 5162 1Sex with person with hemophilia 1 0 84 0 11 0 502 0 12 0 586 0Sex with HIV-infected transfusion

recipient 22 0 553 0 21 0 793 0 43 0 1346 0Sex with HIV-infected person risk

factor not specified 2644 9 37290 5 3867 37 52656 27 6511 17 89946 9Receipt of blood transfusion blood

d components or tissue 63 0 5213 1 68 1 4176 2 131 0 9389 1Otherrisk factor not reported or

identifiede 6484 23 73136 9 3793 36 34311 18 10278 26 107450 11Subtotal 28378 100 791626 100 10537 100 191714 100 38916 100 983343 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 0 0 222 5 0 0 7 0 0 0 229 2Mother with documented HIV infection or

1 of the following risk factors 24 75 4315 89 50 93 4423 95 74 86 8738 92Injection drug use 4 13 1676 35 4 7 1665 36 8 9 3341 35Sex with injection drug user 4 13 789 16 4 7 750 16 8 9 1539 16Sex with bisexual male 1 3 101 2 2 4 110 2 3 3 211 2Sex with person with hemophilia 0 0 20 0 0 0 16 0 0 0 36 0Sex with HIV-infected transfusion

recipient 0 0 11 0 0 0 15 0 0 0 26 0Sex with HIV-infected person risk

factor not specified 6 19 742 15 17 31 790 17 23 27 1532 16Receipt of blood transfusion blood

components or tissue 0 0 70 1 0 0 82 2 0 0 152 2Has HIV infection risk factor not

specified 9 28 906 19 23 43 995 21 32 37 1901 20Receipt of blood transfusion blood

fcomponents or tissue 1 3 243 5 0 0 144 3 1 1 387 4Otherrisk factor not reported or

identifiedg 7 22 75 2 4 7 93 2 11 13 168 2Subtotal 32 100 4855 100 54 100 4667 100 86 100 9522 100

Total 28410 100 796481 100 10591 100 196381 100 39002 100 992865 100a From the beginning of the epidemic through 2006b From the beginning of the epidemic through 2006 Includes 3 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infectiond AIDS developed in 47 adultsadolescents after they received blood that had tested negative for HIV antibodies AIDS developed in 14 additional adults

after they received tissue organs or artificial insemination from HIV-infected donors Four of the 14 received tissue or organs from a donor who was negative for HIV antibody at the time of donation

e Includes 37 adultsadolescents who were exposed to HIV-infected blood body fluids or concentrated virus in health care laboratory or household settings as supported by seroconversion epidemiologic andor laboratory evidence One person was infected after intentional inoculation with HIV-infected blood Includes an additional 740 persons who acquired HIV infection perinatally but who were more than 12 years of age when AIDS was diagnosed These 740 persons are not counted in the values for the pediatric transmission category

f AIDS developed in 3 children after they received blood that had tested negative for HIV antibodiesg Includes 5 children who were exposed to HIV-infected blood as supported by seroconversion epidemiologic andor laboratory evidence 1 child was

infected after intentional inoculation with HIV-infected blood and 5 children were exposed to HIV-infected blood in a household setting Of the 168 children 26 had sexual contact with an adult with or at high risk for HIV infection

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 37

Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No

Adult or adolescentMale-to-male sexual contact 22912 59 103679 52 mdash mdash mdash mdash 22912 44 103679 37

Injection drug use 3503 9 24255 12 2124 16 13925 17 5627 11 38181 14

Male-to-male sexual contact and injection drug use 1946 5 10704 5 mdash mdash mdash mdash 1946 4 10704 4

Hemophiliacoagulation disorder 43 0 495 0 6 0 73 0 49 0 568 0

High-risk heterosexual contactc 2874 7 16830 8 5939 45 38315 47 8813 17 55145 20

Sex with injection drug user 308 1 2601 1 757 6 6791 8 1065 2 9392 3

Sex with bisexual male mdash mdash mdash mdash 328 2 2265 3 328 1 2265 1

Sex with person with hemophilia 4 0 31 0 16 0 201 0 20 0 232 0

Sex with HIV-infected transfusion recipient 13 0 131 0 28 0 223 0 41 0 354 0

Sex with HIV-infected person risk factor not specified 2549 7 14067 7 4810 36 28835 35 7359 14 42902 15

Receipt of blood transfusion blood components or tissue 61 0 489 0 50 0 536 1 111 0 1025 0

Otherrisk factor not reported or identified 7748 20 44021 22 5106 39 29312 36 12854 25 73338 26

Subtotal 39087 100 200473 100 13225 100 82161 100 52312 100 282640 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 8 3 106 4 0 0 1 0 8 1 107 2

Mother with documented HIV infection or 1 of the following risk factors 197 74 2195 85 254 85 2417 89 451 80 4612 87

Injection drug use 34 13 532 21 53 18 561 21 87 15 1093 21

Sex with injection drug user 12 5 208 8 21 7 213 8 33 6 421 8

Sex with bisexual male 5 2 37 1 4 1 32 1 9 2 69 1

Sex with person with hemophilia 0 0 3 0 1 0 7 0 1 0 10 0

Sex with HIV-infected transfusion recipient 0 0 4 0 0 0 4 0 0 0 8 0

Sex with HIV-infected person risk factor not specified 54 20 534 21 76 25 629 23 130 23 1163 22

Receipt of blood transfusion blood components or tissue 0 0 17 1 2 1 20 1 2 0 37 1

Has HIV infection risk factor not specified 92 35 860 33 97 32 951 35 189 33 1811 34

Receipt of blood transfusion blood components or tissue 6 2 28 1 3 1 24 1 9 2 52 1

Otherrisk factor not reported or identified 55 21 260 10 43 14 283 10 98 17 543 10

Subtotal 266 100 2589 100 300 100 2725 100 566 100 5314 100

Total 39353 100 203062 100 13525 100 84886 100 52878 100 287954 100

Note See Table 16 for the list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006b From the beginning of the epidemic through December 2006 Includes 6 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infection

38 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity

2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 6251 65 253927 73Injection drug use 733 8 31737 9Male-to-male sexual contact and injection drug use 732 8 31434 9Hemophiliacoagulation disorder 26 0 3989 1High-risk heterosexual contactb 416 4 7850 2

Sex with injection drug user 74 1 2310 1

Sex with person with hemophilia 0 0 36 0

Sex with HIV-infected transfusion recipient 2 0 176 0

Sex with HIV-infected person risk factor not specified 340 4 5328 2Receipt of blood transfusion blood components or tissue 20 0 3194 1Otherrisk factor not reported or identified 1400 15 16469 5

Total 9578 100 348600 100

Black not HispanicMale-to-male sexual contact 4309 36 103297 37Injection drug use 1635 14 83369 30Male-to-male sexual contact and injection drug use 526 4 22134 8Hemophiliacoagulation disorder 10 0 604 0High-risk heterosexual contactb 1875 16 29952 11

Sex with injection drug user 167 1 6823 2Sex with person with hemophilia 1 0 36 0Sex with HIV-infected transfusion recipient 15 0 237 0Sex with HIV-infected person risk factor not specified 1692 14 22856 8

Receipt of blood transfusion blood components or tissue 24 0 1218 0Otherrisk factor not reported or identified 3579 30 40268 14

Total 11958 100 280842 100

HispanicMale-to-male sexual contact 2816 47 64893 44Injection drug use 965 16 46337 31Male-to-male sexual contact and injection drug use 287 5 10884 7Hemophiliacoagulation disorder 6 0 466 0High-risk heterosexual contactb 638 11 10950 7

Sex with injection drug user 84 1 2409 2Sex with person with hemophilia 0 0 11 0Sex with HIV-infected transfusion recipient 5 0 125 0Sex with HIV-infected person risk factor not specified 549 9 8405 6

Receipt of blood transfusion blood components or tissue 17 0 657 0Otherrisk factor not reported or identified 1326 22 14832 10

Total 6055 100 149019 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 39

a

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulative

No No

AsianPacific IslanderMale-to-male sexual contact 225 54 4475 68Injection drug use 20 5 317 5Male-to-male sexual contact and injection drug use 17 4 284 4Hemophiliacoagulation disorder 1 0 70 1High-risk heterosexual contactb 34 8 376 6

Sex with injection drug user 1 0 54 1Sex with person with hemophilia 0 0 1 0Sex with HIV-infected transfusion recipient 0 0 8 0Sex with HIV-infected person risk factor not specified 33 8 313 5

Receipt of blood transfusion blood components or tissue 2 0 112 2Otherrisk factor not reported or identified 114 28 949 14

Total 413 100 6583 100

American IndianAlaska NativeMale-to-male sexual contact 61 49 1403 55Injection drug use 15 12 395 15Male-to-male sexual contact and injection drug use 23 19 457 18Hemophiliacoagulation disorder 0 0 27 1High-risk heterosexual contactb 9 7 118 5

Sex with injection drug user 1 1 33 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 8 6 82 3

Receipt of blood transfusion blood components or tissue 0 0 8 0Otherrisk factor not reported or identified 16 13 155 6

Total 124 100 2563 100

Total casesMale-to-male sexual contact 13775 49 429897 54Injection drug use 3413 12 163070 21Male-to-male sexual contact and injection drug use 1603 6 65524 8Hemophiliacoagulation disorder 43 0 5176 1High-risk heterosexual contactb 2997 11 49610 6

Sex with injection drug user 330 1 11683 1Sex with person with hemophilia 1 0 84 0Sex with HIV-infected transfusion recipient 22 0 553 0Sex with HIV-infected person risk factor not specified 2644 9 37290 5

Receipt of blood transfusion blood components or tissue 63 0 5213 1Otherrisk factor not reported or identified 6484 23 73136 9

Total 28378c 100 791626d 100a From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 4019 males of unknown race or multiple races

40 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 11963 73 55725 69Injection drug use 858 5 5512 7Male-to-male sexual contact and injection drug use 1092 7 5578 7Hemophiliacoagulation disorder 29 0 355 0High-risk heterosexual contactb 522 3 2658 3

Sex with injection drug user 65 0 544 1Sex with person with hemophilia 0 0 8 0Sex with HIV-infected transfusion recipient 3 0 33 0Sex with HIV-infected person risk factor not specified 454 3 2073 3

Receipt of blood transfusion blood components or tissue 14 0 197 0Otherrisk factor not reported or identified 1956 12 11147 14

Total 16434 100 81172 100

Black not HispanicMale-to-male sexual contact 6203 44 30148 37Injection drug use 1594 11 11997 15Male-to-male sexual contact and injection drug use 483 3 3489 4Hemophiliacoagulation disorder 10 0 109 0High-risk heterosexual contactb 1714 12 10905 13

Sex with injection drug user 169 1 1554 2Sex with person with hemophilia 4 0 17 0Sex with HIV-infected transfusion recipient 6 0 77 0Sex with HIV-infected person risk factor not specified 1535 11 9257 11

Receipt of blood transfusion blood components or tissue 32 0 223 0Otherrisk factor not reported or identified 4151 29 24632 30

Total 14187 100 81503 100

HispanicMale-to-male sexual contact 4094 55 15623 47Injection drug use 993 13 6407 19Male-to-male sexual contact and injection drug use 316 4 1402 4Hemophiliacoagulation disorder 3 0 26 0High-risk heterosexual contactb 582 8 2963 9

Sex with injection drug user 65 1 455 1Sex with person with hemophilia 0 0 6 0Sex with HIV-infected transfusion recipient 4 0 18 0Sex with HIV-infected person risk factor not specified 513 7 2484 7

Receipt of blood transfusion blood components or tissue 11 0 55 0Otherrisk factor not reported or identified 1475 20 6977 21

Total 7474 100 33453 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 41

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderMale-to-male sexual contact 402 70 1006 63Injection drug use 17 3 55 3Male-to-male sexual contact and injection drug use 15 3 38 2Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 25 4 96 6

Sex with injection drug user 3 1 10 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 22 4 83 5

Receipt of blood transfusion blood components or tissue 4 1 7 0Otherrisk factor not reported or identified 109 19 397 25

Total 572 100 1600 100

American IndianAlaska NativeMale-to-male sexual contact 104 61 516 57Injection drug use 13 8 101 11Male-to-male sexual contact and injection drug use 19 11 110 12Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 10 6 53 6

Sex with injection drug user 2 1 14 2Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 8 5 39 4

Receipt of blood transfusion blood components or tissue 0 0 2 0Otherrisk factor not reported or identified 24 14 125 14

Total 170 100 907 100

Total casesMale-to-male sexual contact 22912 59 103679 52Injection drug use 3503 9 24255 12Male-to-male sexual contact and injection drug use 1946 5 10704 5Hemophiliacoagulation disorder 43 0 495 0High-risk heterosexual contactb 2874 7 16830 8

Sex with injection drug user 308 1 2601 1Sex with person with hemophilia 4 0 31 0Sex with HIV-infected transfusion recipient 13 0 131 0Sex with HIV-infected person risk factor not specified 2549 7 14067 7

Receipt of blood transfusion blood components or tissue 61 0 489 0Otherrisk factor not reported or identified 7748 20 44021 22

Total 39087c 100 200473d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 1838 males of unknown race or multiple races

42 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race

ethnicity 2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 482 28 14981 40Hemophiliacoagulation disorder 4 0 123 0High-risk heterosexual contactb 725 42 15799 42

Sex with injection drug user 153 9 5650 15Sex with bisexual male 63 4 1859 5Sex with person with hemophilia 5 0 329 1Sex with HIV-infected transfusion recipient 5 0 338 1Sex with HIV-infected person risk factor not specified 499 29 7623 20

Receipt of blood transfusion blood components or tissue 15 1 1870 5Otherrisk factor not reported or identified 499 29 4801 13

Total 1725 100 37574 100

Black not HispanicInjection drug use 982 15 38914 34Hemophiliacoagulation disorder 3 0 145 0High-risk heterosexual contactb 3103 46 49876 44

Sex with injection drug user 373 6 13530 12Sex with bisexual male 136 2 2352 2Sex with person with hemophilia 4 0 121 0Sex with HIV-infected transfusion recipient 8 0 277 0Sex with HIV-infected person risk factor not specified 2582 38 33596 29

Receipt of blood transfusion blood components or tissue 39 1 1546 1Otherrisk factor not reported or identified 2612 39 23894 21

Total 6739 100 114375 100

HispanicInjection drug use 322 18 12892 35Hemophiliacoagulation disorder 4 0 67 0High-risk heterosexual contactb 894 49 17995 49

Sex with injection drug user 166 9 6522 18Sex with bisexual male 32 2 818 2Sex with person with hemophilia 1 0 45 0Sex with HIV-infected transfusion recipient 7 0 141 0Sex with HIV-infected person risk factor not specified 688 38 10469 29

Receipt of blood transfusion blood components or tissue 12 1 619 2Otherrisk factor not reported or identified 592 32 5023 14

Total 1824 100 36596 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 43

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 8 8 125 12Hemophiliacoagulation disorder 0 0 7 1High-risk heterosexual contactb 49 47 574 53

Sex with injection drug user 4 4 114 11Sex with bisexual male 2 2 80 7Sex with person with hemophilia 0 0 4 0Sex with HIV-infected transfusion recipient 1 1 25 2Sex with HIV-infected person risk factor not specified 42 40 351 33

Receipt of blood transfusion blood components or tissue 1 1 93 9Otherrisk factor not reported or identified 46 44 279 26

Total 104 100 1078 100

American IndianAlaska NativeInjection drug use 13 32 280 42Hemophiliacoagulation disorder 0 0 3 0High-risk heterosexual contactb 15 37 277 41

Sex with injection drug user 4 10 107 16Sex with bisexual male 1 2 27 4Sex with person with hemophilia 0 0 2 0Sex with HIV-infected transfusion recipient 0 0 6 1Sex with HIV-infected person risk factor not specified 10 24 135 20

Receipt of blood transfusion blood components or tissue 1 2 17 3Otherrisk factor not reported or identified 12 29 95 14

Total 41 100 672 100

Total casesInjection drug use 1826 17 67693 35Hemophiliacoagulation disorder 11 0 348 0High-risk heterosexual contactb 4839 46 85186 44

Sex with injection drug user 706 7 26073 14Sex with bisexual male 234 2 5162 3Sex with person with hemophilia 11 0 502 0Sex with HIV-infected transfusion recipient 21 0 793 0Sex with HIV-infected person risk factor not specified 3867 37 52656 27

Receipt of blood transfusion blood components or tissue 68 1 4176 2Otherrisk factor not reported or identified 3793 36 34311 18

Total 10537c 100 191714d 100a From the beginning of the epidemic through 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 104 females of unknown race or multiple racesd Includes 1419 females of unknown race or multiple races

44 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 690 26 4260 26Hemophiliacoagulation disorder 3 0 24 0

bHigh-risk heterosexual contact 1132 42 7593 46Sex with injection drug user 205 8 1876 11Sex with bisexual male 98 4 659 4Sex with person with hemophilia 10 0 115 1Sex with HIV-infected transfusion recipient 7 0 64 0Sex with HIV-infected person risk factor not specified 812 30 4879 29

Receipt of blood transfusion blood components or tissue 12 0 146 1Otherrisk factor not reported or identified 850 32 4567 28

Total 2687 100 16590 100

Black not HispanicInjection drug use 1034 13 7105 14Hemophiliacoagulation disorder 1 0 35 0

bHigh-risk heterosexual contact 3451 44 23732 46Sex with injection drug user 313 4 3473 7Sex with bisexual male 155 2 1294 3Sex with person with hemophilia 5 0 71 0Sex with HIV-infected transfusion recipient 14 0 120 0Sex with HIV-infected person risk factor not specified 2964 38 18774 36

Receipt of blood transfusion blood components or tissue 26 0 324 1Otherrisk factor not reported or identified 3370 43 20244 39

Total 7882 100 51440 100

HispanicInjection drug use 339 15 2280 18Hemophiliacoagulation disorder 2 0 11 0

bHigh-risk heterosexual contact 1198 52 6264 50Sex with injection drug user 218 9 1324 11Sex with bisexual male 62 3 266 2Sex with person with hemophilia 1 0 11 0Sex with HIV-infected transfusion recipient 7 0 39 0Sex with HIV-infected person risk factor not specified 910 39 4624 37

Receipt of blood transfusion blood components or tissue 12 1 58 0Otherrisk factor not reported or identified 767 33 3843 31

Total 2318 100 12456 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 45

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 10: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

CDC Dear colleague letter CDC recommends that all states and territories adopt confidential name-based surveillance systems to report HIV infec-tions httpwwwcdcgovhivpubs070505_dearcolleague_gerberdingpdf Pub-lished July 5 2005 Accessed March 11 2008

1981ndash2005 CDC Epidemiology of HIVAIDSmdashUnited States

MMWR 200655(21)589ndash592CDC Guidelines for national HIV case surveil-

lance including monitoring for HIV infection and AIDS MMWR 199948(RR-13)1ndash31

CDC HIV prevention strategic plan extended through 2010 httpwwwcdcgovhivresourcesreportspsp Published October 2007 Accessed March 11 2008

CDC Revised recommendations for HIV testing of adults adolescents and pregnant women in health-care settings MMWR 200655(RR-14)1ndash17

CDC Twenty-five years of HIVAIDSmdashUnited States 1981ndash2006 MMWR 200655(21)585ndash589

Glynn MK Lee LM McKenna MT The status of national HIV case surveillance United States 2006 Public Health Rep 2007122(suppl 1)63ndash71

Janssen RS Satten GA Stramer SL et al New test-ing strategy to detect early HIV-1 infection for use in incidence estimates and for clinical and prevention purposes JAMA 1998280(1)42ndash48

Lee LM McKenna MT Monitoring the incidence of HIV infection in the United States Public Health Rep 2007122(suppl 1)72ndash79

10 Comm

entary

Cases of HIVAIDS and AIDS

Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003ndash2006mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

Year of diagnosis

2003 2004 2005 2006

Data for 33 statesAge at diagnosis (yrs)lt13 211 183 169 13513ndash14 53 36 40 4115ndash19 993 993 1126 133220ndash24 3163 3368 3592 388625ndash29 4023 4057 4236 460330ndash34 5189 4820 4676 446635ndash39 6369 5807 5535 544240ndash44 5786 5429 5529 571845ndash49 4028 3877 4028 420450ndash54 2451 2401 2547 271855ndash59 1279 1363 1455 143860ndash64 655 702 692 714gt65 570 624 613 618

RaceethnicityWhite not Hispanic 10033 10181 10528 10758Black not Hispanic 17668 16718 16629 17356Hispanic 6355 6010 6217 6481AsianPacific Islander 338 339 373 397American IndianAlaska Native 179 171 182 166

Transmission categoryMale adult or adolescentMale-to-male sexual contact 15409 15880 16833 17465Injection drug use 3514 3083 2978 3016Male-to-male sexual contact and injection drug use 1349 1299 1247 1180High-risk heterosexual contacta 4269 3959 3871 4152Otherb 125 110 107 114Subtotal 24666 24331 25036 25928

Female adult or adolescentInjection drug use 2027 1856 1720 1712High-risk heterosexual contacta 7731 7182 7216 7432Otherb 134 107 97 109Subtotal 9892 9145 9033 9252

Child (lt13 yrs at diagnosis)Perinatal 190 157 147 115Otherc 23 27 23 20Subtotal 213 184 170 135

Subtotal for 33 states 34770 33659 34239 35314

Data for US dependent areas 1331 1234 1395 1503

Totald 36102 34894 35634 36817Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

Cases of HIVAIDS and AIDS 11

Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

gt12 Months after diagnosis aof HIV infection

lt12 Months after diagnosis of HIV infectionb Total

No ()c No ()c No

Data for 33 statesAge at diagnosis (yrs)lt13 148 88 21 12 16913ndash14 22 54 18 46 4015ndash19 912 81 215 19 112620ndash24 2874 80 714 20 358925ndash29 3077 73 1157 27 423430ndash34 3016 65 1655 35 467135ndash39 3353 61 2176 39 553040ndash44 3181 58 2338 42 551945ndash49 2145 53 1874 47 401950ndash54 1307 51 1239 49 254655ndash59 725 50 728 50 145360ndash64 316 46 376 54 692gt65 266 44 346 56 612RaceethnicityWhite not Hispanic 6839 65 3677 35 10516Black not Hispanic 10372 62 6242 38 16614Hispanic 3593 58 2614 42 6206AsianPacific Islander 232 62 139 38 371American IndianAlaska Native 110 61 72 39 182Transmission category

Male adult or adolescentMale-to-male sexual contact 10917 65 5902 35 16819Injection drug use 1544 52 1427 48 2971Male-to-male sexual contact and injection drug use 733 59 512 41 1245High-risk heterosexual contactd 2091 54 1773 46 3864Othere 45 42 61 58 107Subtotal 15331 61 9675 39 25006Female adult or adolescentInjection drug use 1056 62 660 38 1716High-risk heterosexual contactd 4761 66 2450 34 7210Othere 47 48 50 52 97Subtotal 5864 65 3160 35 9023Child (lt13 yrs at diagnosis)Perinatal 126 86 21 14 147Otherf 22 94 2 6 23Subtotal 148 87 22 13 170

Subtotal for 33 states 21343 62 12857 38 34200Data for US dependent areas 855 61 541 39 1395

Totalg 22197 62 13398 38 35595h

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003Data exclude 39 persons whose month of diagnosis of HIV infection is unknowna Includes persons in whom AIDS has not developedb Includes persons whose diagnoses of HIV infection and AIDS were made at the same timec Percentages represent proportions of the total number of diagnoses of HIVAIDS made during 2005 for the corresponding group (see row

entries)d Heterosexual contact with a person known to have or to be at high risk for HIV infectione Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedf Includes hemophilia blood transfusion and risk factor not reported or not identifiedg Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the

column totalh Includes 310 persons of unknown race or multiple races

12 Cases of HIVAIDS and AIDS

Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas

Year of diagnosis2002 2003 2004 2005 2006 Cumulativea

Data for 50 states and the District of ColumbiaAge at diagnosis (yrs)lt13 106 70 53 53 38 915613ndash14 62 74 70 66 73 107815ndash19 316 302 334 410 401 562620ndash24 1399 1568 1624 1675 1669 3622525ndash29 3137 3059 3196 3110 3423 11709930ndash34 5701 5521 5144 4668 4349 19753035ndash39 8217 8017 7072 6479 6402 21357340ndash44 7404 7626 7703 7378 7298 17053145ndash49 5358 5617 5498 5727 5628 10720750ndash54 3271 3364 3491 3527 3687 5990755ndash59 1607 1693 1836 1861 2071 3219060ndash64 872 864 913 872 955 17303gt65 682 763 791 727 835 15074

RaceethnicityWhite not Hispanic 11233 10948 11066 10676 10929 394024Black not Hispanic 19246 19512 18909 18081 17960 409982Hispanic 6712 7102 6771 6823 6907 161505AsianPacific Islander 425 450 444 450 519 7951American IndianAlaska Native 177 176 182 170 155 3345

Transmission categoryMale adult or adolescentMale-to-male sexual contact 15709 16078 16054 15711 16001 465965Injection drug use 5483 5275 4818 4603 4410 170171Male-to-male sexual contact and injection drug use 2075 2029 1925 1930 1803 68516High-risk heterosexual contactb 4547 4471 4506 4306 4558 65241Otherc 253 226 228 237 217 13893Subtotal 28067 28079 27532 26787 26989 783786

Female adult or adolescentInjection drug use 2897 2836 2810 2586 2385 74718High-risk heterosexual contactb 6855 7336 7113 6922 7196 108252Otherc 207 217 217 205 220 6596Subtotal 9959 10389 10141 9713 9801 189566

Child (lt13 yrs at diagnosis)Perinatal 104 70 53 52 37 8508Otherd 2 0 0 0 0 636Subtotal 106 70 53 53 38 9144

Region of residenceNortheast 10092 10342 9412 9396 9486 306241Midwest 4125 4226 4089 4371 4164 101479South 17198 17630 18225 16894 17104 374800West 6718 6339 6000 5891 6074 199978Subtotal for 50 states and the District of Columbia 38132 38538 37726 36552 36828 982498

Data for US dependent areas 1058 1060 921 955 833 31217

Totale 39250 39690 38807 37662 37852 1014797Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes persons of unknown race or multiple races and persons of unknown sex Cumulative total includes 5691 persons of unknown race or multiple

races 3 persons of unknown sex 1079 persons of unknown state of residence and 3 persons who were residents of other areas Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Cases of HIVAIDS and AIDS 13

Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002ndash2006 and cumulativemdash50 states and the District of Columbia

Year of diagnosisCumulativea2002 2003 2004 2005 2006

RaceethnicityWhite not Hispanic 14 12 7 4 4 1599Black not Hispanic 70 46 33 38 30 5654Hispanic 18 10 9 8 3 1748AsianPacific Islander 1 0 1 1 1 54American IndianAlaska Native 1 0 1 0 0 31

Transmission categoryHemophiliacoagulation disorder 0 0 0 0 0 226Mother with documented HIV infection or 1 of the following risk factors 104 70 53 52 37 8508

Injection drug use 12 8 5 3 4 3220Sex with injection drug user 4 6 3 2 1 1397Sex with bisexual male 2 0 3 1 1 209Sex with person with hemophilia 0 0 0 0 0 35Sex with HIV-infected transfusion recipient 0 0 0 0 0 22Sex with HIV-infected person risk factor not specified 36 20 20 25 13 1530Receipt of blood transfusion blood components or tissue 2 1 0 0 0 144Has HIV infection risk factor not specified 47 34 21 21 17 1951

Receipt of blood transfusion blood components or tissue 2 0 0 0 0 374Otherrisk factor not reported or identified 0 0 0 0 0 36

Totalb 106 70 53 53 38 9144

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga From the beginning of the epidemic through 2006b Includes children of unknown race or multiple races Cumulative total includes 58 children of unknown race or multiple races Because column totals

were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992ndash2006mdash50 states and the District of Columbia

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reporting

14 Cases of HIVAIDS and AIDS

Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006mdash50 states and the District of Columbia

Raceethnicity

Adults or adolescents

Children (lt13 yrs) TotalaMales Females Totala

No Rate No Rate No Rate No Rate No Rate

White not Hispanic 9267 112 1659 19 10926 64 4 00 10929 54Black not Hispanic 11540 829 6391 404 17930 603 30 04 17960 476Hispanic 5388 313 1516 95 6903 208 3 00 6907 156AsianPacific Islander 423 75 95 16 518 44 1 00 519 37American IndianAlaska Native 118 122 37 36 155 78 0 00 155 62

Totalb 26989 224 9801 78 36790 149 38 01 36828c 123

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reportingData exclude cases in persons whose state or area of residence is unknown as well as cases from US dependent areas for which census information about race and age categories is lackinga Because row totals were calculated independently of the values for the subpopulations the values in each row may not sum to the row totalb Includes person of unknown race or multiple races Because column totals were calculated independently of the values for the subpopulations the

values in each column may not sum to the column totalc Includes 358 persons of unknown race or multiple races

Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006mdash33 states with confidential name-based HIV infection reporting

Raceethnicity

Adults or adolescents

Children (lt13 yrs) TotalaMales Females Totala

No Rate No Rate No Rate No Rate No Rate

White not Hispanic 9078 167 1664 29 10742 96 16 01 10758 82Black not Hispanic 11230 1191 6033 562 17263 856 93 17 17356 677Hispanic 5058 509 1400 151 6458 337 23 04 6481 255AsianPacific Islander 318 135 79 32 397 82 0 00 397 67American IndianAlaska Native 129 177 35 46 164 110 2 06 166 88

Totalb 25928 338 9252 115 35180 224 135 04 35314c 185

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Because row totals were calculated independently of the values for the subpopulations the values in each row may not sum to the row totalb Includes persons of unknown race or multiple races Because column totals were calculated independently of the values for the subpopulations the

values in each column may not sum to the column totalc Includes 156 persons of unknown race or multiple races

Cases of HIVAIDS and AIDS 15

Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006mdashUnited States and dependent areas

Transmission category

Place of birth

United StatesCentralSouth

America Cuba Mexico Puerto Rico Totala

No No No No No No

Male-to-male sexual contact 1172 45 402 49 89 62 790 59 249 18 3337 43Injection drug use 569 22 83 10 13 9 133 10 533 40 1650 21Male-to-male sexual contact

and injection drug use 158 6 25 3 6 4 59 4 63 5 357 5High-risk heterosexual

contactb 661 25 296 36 35 24 342 26 487 36 2282 30Otherc 47 2 8 1 0 0 9 1 14 1 103 1

Totald 2608 100 814 100 145 100 1334 100 1346 100 7728 100Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Includes 222 persons whose place of birth is not among those listed and 1260 persons whose place of birth is unknownb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the

column total

16 Cases of HIVAIDS and AIDS

Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas

Year of death

Cumulativea2002 2003 2004 2005 2006

Data for 50 states and the District of ColumbiaAge at death (yrs)lt13 25 22 15 7 13 4889

13ndash14 10 6 15 12 5 276

15ndash19 39 36 36 38 44 1104

20ndash24 151 157 175 147 162 8716

25ndash29 553 512 482 458 405 43671

30ndash34 1480 1272 1128 1069 785 95351

35ndash39 2967 2763 2425 2096 1682 116746

40ndash44 3595 3516 3393 3317 2636 104133

45ndash49 3294 3234 3251 3275 2886 72831

50ndash54 2318 2373 2502 2645 2343 44255

55ndash59 1209 1322 1425 1543 1480 25123

60ndash64 616 705 741 797 771 14315

gt65 691 773 807 865 805 14393

RaceethnicityWhite not Hispanic 5214 5097 4836 4758 3860 239529

Black not Hispanic 9037 8675 8581 8679 7426 218392

Hispanic 2429 2632 2641 2513 2425 80690

AsianPacific Islander 97 84 111 87 114 3426

American IndianAlaska Native 83 73 80 65 66 1693

Transmission categoryMale adult or adolescentMale-to-male sexual contact 5960 5937 5735 5641 4930 266272

Injection drug use 3738 3547 3315 3314 2641 107173

Male-to-male sexual contact and injection drug use 1278 1299 1237 1289 1064 40993

High-risk heterosexual contactb 1465 1501 1625 1571 1470 26236

Otherc 160 149 125 117 80 9867

Subtotal 12601 12431 12038 11932 10184 450541

Female adult or adolescentInjection drug use 1923 1825 1855 1768 1456 43143

High-risk heterosexual contactb 2281 2292 2373 2458 2258 42620

Otherc 84 87 72 68 70 4131

Subtotal 4289 4204 4300 4295 3784 89895

Child (lt13 yrs at diagnosis)Perinatal 53 49 56 39 42 4848

Otherd 4 5 1 2 7 521

Subtotal 57 54 57 41 48 5369

Deaths 17

Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas (cont)

Year of death

Cumulativea2002 2003 2004 2005 2006

Region of residenceNortheast 5313 5012 4779 4750 4074 180623

Midwest 1726 1666 1482 1378 1325 54468

South 7337 7427 7535 7907 6475 197209

West 2571 2585 2600 2234 2141 113506

Subtotal for 50 states and the District of Columbia 16948 16690 16395 16268 14016 545805

Data for US dependent areas 667 575 572 562 580 19858

Totale 17628 17283 16982 16865 14627 565927f

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column totalf Includes 2082 persons of unknown race or multiple races 261 persons of unknown state of residence and 2 persons who were residents

of other areas

18 Deaths

Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003ndash2006mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

2003 2004 2005 2006Data for 33 states

Age at end of year (yrs)lt13 4154 3700 3294 286713ndash14 1130 1238 1212 113915ndash19 3298 3627 4024 453920ndash24 12389 12826 13411 1430125ndash29 26167 26924 28164 2960030ndash34 49602 47577 45109 4418935ndash39 80703 77871 75842 7363440ndash44 92040 97109 100102 10176445ndash49 71345 77490 83816 9028350ndash54 45133 51033 56640 6319555ndash59 22793 26610 31186 3600860ndash64 10820 12642 14422 16658gt65 8531 9959 11657 13551

RaceethnicityWhite not Hispanic 145081 151694 158375 166000Black not Hispanic 202951 212425 221439 231957Hispanic 72612 76503 80491 84720AsianPacific Islander 2234 2529 2858 3187American IndianAlaska Native 1788 1889 2008 2119

Transmission categoryMale adult or adolescentMale-to-male sexual contact 181771 193245 205423 218676Injection drug use 57651 58149 58369 59077Male-to-male sexual contact and injection drug use 23965 24434 24725 25085High-risk heterosexual contacta 40084 42559 44915 47562Otherb 3218 3278 3325 3424Subtotal 306689 321665 336756 353825

Female adult or adolescentInjection drug use 32346 32735 32973 33470High-risk heterosexual contacta 80324 85348 90185 95403Otherb 2036 2123 2212 2321Subtotal 114705 120206 125370 131195

Child (lt13 yrs at diagnosis)Perinatal 6137 6154 6178 6143Otherc 570 575 571 560Subtotal 6707 6730 6748 6703

Subtotal for 33 states 428107 448605 468879 491727Data for US dependent areas 15809 16399 17150 17955

Totald 443916 465005 486028 509681Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 19

Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission categorymdash33 states with confidential name-based HIV infection reporting

Transmission category

White not Hispanic

Black not Hispanic Hispanic

AsianPacific Islander

American IndianAlaska

Native Totala

No No No No No No

Male adult or adolescentMale-to-male sexual contact 108259 77 70242 49 36043 57 1669 68 938 62 218676 62Injection drug use 12328 9 31339 22 14472 23 264 11 216 14 59077 17Male-to-male sexual contact

and injection drug use 11283 8 9587 7 3720 6 93 4 205 13 25085 7High-risk heterosexual contactb 6667 5 31140 22 8788 14 395 16 143 9 47562 13Otherc 1458 1 1492 1 404 1 30 1 17 1 3424 1Subtotal 139994 100 143799 100 63427 100 2450 100 1519 100 353825 100

Female adult or adolescentInjection drug use 8262 33 19136 23 5528 28 106 15 175 30 33470 26High-risk heterosexual contactb 16338 65 63204 75 14132 71 573 82 392 68 95403 73Otherc 450 2 1469 2 344 2 24 3 12 2 2321 2Subtotal 25050 100 83809 100 20004 100 703 100 578 100 131195 100

Child (lt13 yrs at diagnosis)Perinatal 801 84 4064 93 1183 92 28 82 20 95 6143 92Otherd 154 16 283 7 107 8 6 18 1 5 560 8Subtotal 955 100 4347 100 1290 100 34 100 21 100 6703 100

Totale 166000 231957 84720 3187 2119 491727Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of 33 states that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Includes 3745 persons of unknown race or multiple racesb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes 5 persons of unknown sex Because column totals were calculated independently of the values for the subpopulations the values

in each column may not sum to the column total

20 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Map 1 Estimated rates (per 100000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

Note Rates adjusted for reporting delays Rates of HIV infection include only persons living with HIV infection that has not progressed to AIDSSince 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 Islandsa Includes persons whose area of residence is unknown

Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

Note Rates adjusted for reporting delays Rates of HIV infection include only persons living with HIV infection that has not progressed to AIDSSince 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 Islandsa Includes persons whose area of residence is unknown

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 21

Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002ndash2006mdashUnited States and dependent areas

2002 2003 2004 2005 2006Data for 50 states and the District of Columbia

Age at end of year (yrs)lt13 2308 2006 1684 1394 111513ndash14 685 747 784 762 71115ndash19 1465 1694 1974 2243 248720ndash24 3910 4292 4629 5033 536725ndash29 12725 12743 13045 13505 1435930ndash34 35558 33870 32057 29949 2882435ndash39 70107 68106 65076 62235 5964940ndash44 80377 86294 91335 94021 9517445ndash49 64702 71276 77417 84153 9077550ndash54 41270 46855 53333 59256 6647655ndash59 20113 24145 28356 33522 3901460ndash64 9681 11293 13305 15380 18072gt65 7520 8946 10604 12430 14669

RaceethnicityWhite not Hispanic 129426 135278 141508 147426 154495Black not Hispanic 150488 161326 171654 181056 191590Hispanic 63424 67895 72024 76334 80815AsianPacific Islander 3060 3426 3759 4121 4526American IndianAlaska Native 1254 1356 1458 1562 1651

Transmission categoryMale adult or adolescentMale-to-male sexual contact 158092 168233 178551 188622 199693Injection drug use 56708 58436 59940 61229 62998Male-to-male sexual contact and injection drug use 24726 25457 26144 26785 27523High-risk heterosexual contacta 27329 30300 33181 35916 39004Otherb 3588 3665 3769 3888 4026Subtotal 270444 286091 301585 316440 333244

Female adult or adolescentInjection drug use 27863 28874 29828 30646 31575High-risk heterosexual contacta 46445 51489 56229 60693 65631Otherb 1903 2033 2178 2315 2465Subtotal 76210 82395 88236 93653 99671

Child (lt13 yrs at diagnosis)Perinatal 3633 3654 3651 3664 3660Otherc 129 124 123 122 115Subtotal 3762 3778 3774 3786 3775

Region of residenceNortheast 105599 110929 115562 120208 125620Midwest 36011 38571 41178 44171 47010South 137081 147284 157975 166962 177591West 71729 75483 78883 82540 86473

Subtotal for 50 states and the District of Columbia 350419 372267 393598 413882 436693

Data for US dependent areas 9880 10365 10713 11106 11359

Totald 360617 383024 404849 425646 448871Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

22 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission categorymdash50 states and the District of Columbia

Transmission category

White not Hispanic

Black not Hispanic Hispanic

AsianPacific Islander

American IndianAlaska

Native Totala

No No No No No No

Male adult or adolescentMale-to-male sexual contact 101299 75 57520 45 36087 57 2715 72 704 57 199693 60Injection drug use 13168 10 33911 27 14795 23 325 9 201 16 62998 19Male-to-male sexual contact and

injection drug use 12393 9 10121 8 4352 7 198 5 220 18 27523 8High-risk heterosexual contactb 6081 5 24205 19 7816 12 444 12 105 8 39004 12Otherc 1743 1 1602 1 574 1 69 2 16 1 4026 1Subtotal 134683 100 127359 100 63623 100 3752 100 1246 100 333244 100

Female adult or adolescentInjection drug use 7407 38 18531 30 5025 30 115 15 153 39 31575 32High-risk heterosexual contactb 11350 59 41741 68 11092 67 588 78 227 58 65631 66Otherc 508 3 1456 2 413 2 51 7 13 3 2465 2Subtotal 19264 100 61728 100 16531 100 753 100 393 100 99671 100

Child (lt13 yrs at diagnosis)Perinatal 500 92 2468 99 629 95 20 94 12 100 3660 97Otherd 46 8 34 1 33 5 1 6 0 0 115 3Subtotal 546 100 2503 100 662 100 21 100 12 100 3775 100

Totale 154495 191590 80815 4526 1651 436693

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Includes 3616 persons of unknown race or multiple racesb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes 3 person of unknown sex Because column totals were calculated independently of the values for the subpopulations the values in each column

may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 23

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by

area of residence and age categorymdashUnited States and dependent areas

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

Alabama 5469 17 5486 3744 11 3755Alaska 272 1 273 330 1 331Arizona 5744 49 5793 4922 7 4929Arkansas 2291 7 2298 2139 6 2145California mdash mdash mdash 61451 105 61555Colorado 5855 13 5869 4083 2 4085Connecticut mdash mdash mdash 7406 15 7421Delaware mdash mdash mdash 1753 7 1760District of Columbia mdash mdash mdash 10059 30 10089Floridab 35461 263 35723 46469 194 46663Georgia mdash mdash mdash 17336 47 17383Hawaii mdash mdash mdash 1234 3 1237Idaho 356 0 356 313 0 313Illinois mdash mdash mdash 16139 46 16185Indiana 3849 21 3870 3996 14 4010Iowa 588 2 590 869 3 872Kansas 1230 7 1237 1272 2 1274Kentucky mdash mdash mdash 2589 13 2602Louisiana 7361 101 7462 8052 21 8074Maine mdash mdash mdash 512 2 514Maryland mdash mdash mdash 14540 41 14581Massachusetts mdash mdash mdash 8806 20 8826Michigan 6118 55 6173 6615 12 6627Minnesota 3227 21 3248 2314 9 2323Mississippi 4200 32 4232 3155 13 3168Missouri 4999 33 5033 5479 7 5486Montana mdash mdash mdash 205 0 205Nebraska 688 12 700 771 2 773Nevada 3402 13 3415 2969 3 2972New Hampshire mdash mdash mdash 556 3 559New Jersey 16059 153 16212 17168 57 17226New Mexico 910 0 909 1252 3 1255New York 42220 801 43021 70697 148 70845North Carolina 11700 60 11760 8451 12 8463North Dakota 87 2 89 73 1 74Ohio 8266 57 8323 7054 30 7084Oklahoma 2191 17 2208 2191 3 2194Oregon mdash mdash mdash 2840 4 2844Pennsylvania mdash mdash mdash 18633 71 18703Rhode Island mdash mdash mdash 1296 7 1303South Carolina 6349 45 6394 7035 23 7058South Dakota 195 4 199 139 1 140Tennessee 6579 51 6631 6403 11 6414Texas 24741 262 25003 34010 53 34063Utah 893 10 903 1164 0 1164Vermont mdash mdash mdash 238 2 240Virginia 9937 41 9978 8423 24 8447Washington mdash mdash mdash 5471 5 5476West Virginia 660 5 665 749 5 754Wisconsin 2322 15 2337 2153 12 2165Wyoming 86 2 88 102 1 103

Subtotal 224303 2174 226477 435621 1115 436736

24 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age categorymdashUnited States and dependent areas (cont)

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

US dependent areasAmerican Samoa 2 0 2 1 0 1Guam 63 0 63 36 0 36Northern Mariana Islands 7 0 7 3 0 3Puerto Rico 6269 31 6300 10971 26 10997US Virgin Islands 228 2 230 312 2 314Otherc mdash mdash mdash 1 0 1

Totald 230872 2207 233079 447724 1147 448871

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reporting a See Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at

least 2003b Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterc Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasd Total number of persons living with HIV infection (not AIDS) includes persons reported from areas with confidential name-based HIV

infection reporting who were residents of other states or whose area of residence is unknown Total number of persons living with AIDS includes persons whose area of residence is unknown Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 25

Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristicsmdashUnited States and dependent areas

No of persons

Survival in months

gt12 gt24 gt36Data for 50 states and the District of Columbia

Age at diagnosis (yrs)lt13 101 096 094 09413ndash14 60 098 098 09515ndash19 305 098 096 09520ndash24 1351 096 093 09225ndash29 3034 095 092 09130ndash34 5499 094 091 08935ndash39 7888 093 090 08740ndash44 7085 092 088 08545ndash49 5090 089 085 08250ndash54 3067 086 081 07855ndash59 1505 083 078 07460ndash64 806 080 073 069gt65 614 073 068 065

RaceethnicityWhite not Hispanic 10706 092 089 087Black not Hispanic 18406 090 086 082Hispanic 6398 092 090 088AsianPacific Islander 404 094 092 090American IndianAlaska Native 167 084 081 075

Transmission categoryMale adult or adolescentMale-to-male sexual contact 12830 093 090 088Injection drug use 4048 089 084 081Male-to-male sexual contact and injection drug use 1701 093 089 086High-risk heterosexual contacta 3170 091 088 085Otherb 5019 086 083 080Subtotal 26768 091 088 085

Female adult or adolescentInjection drug use 2101 089 083 078High-risk heterosexual contacta 4686 093 089 086Otherb 2749 090 085 083Subtotal 9536 091 087 083

Child (lt13 yrs at diagnosis)Perinatal 98 096 095 095Otherc 3 100 067 067Subtotal 101 096 094 094

Subtotal for 50 states and the District of Columbia 36405 091 087 085

Data for US dependent areas 891 083 078 075

Total 37352d 091 087 084Note Excludes persons whose date of death was before or in the same month as date of diagnosis Excludes persons whose month of diagnosis or month of death is unknowna Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes 325 persons of unknown race or multiple races

26 Survival after AIDS Diagnosis

Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by year of diagnosismdashUnited States and dependent areas

Months after AIDS diagnosis

Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by age groupmdashUnited States and dependent areas

Months after AIDS diagnosis

Survival after AIDS Diagnosis 27

Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by raceethnicitymdashUnited States and dependent areas

Months after AIDS diagnosis

28 Survival after AIDS Diagnosis

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006

and cumulativemdashUnited States and dependent areas

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Alabama 510 112 462 100 8626 76 8702Alaska 24 36 38 57 648 7 655Arizona 626 105 539 87 10396 46 10442Arkansas 237 85 252 90 3891 36 3927California 4069 113 3960 109 142254 664 142918Colorado 351 75 322 68 8742 31 8773Connecticut 658 188 422 120 14716 183 14899Delaware 177 210 116 136 3547 26 3573District of Columbia 672 1155 853 1467 17372 189 17561Florida 4921 277 4932 273 104084 1530 105614Georgia 2325 255 1605 171 31734 231 31965Hawaii 105 82 93 72 2927 17 2944Idaho 24 17 26 18 604 2 606Illinois 1886 148 1382 108 33620 282 33902Indiana 407 65 346 55 8239 56 8295Iowa 93 31 86 29 1727 13 1740Kansas 105 38 120 43 2781 14 2795Kentucky 249 60 207 49 4600 32 4632Louisiana 936 208 824 192 17612 128 17740Maine 21 16 68 51 1110 8 1118Maryland 1558 279 1626 290 30252 319 30571Massachusetts 666 104 533 83 19181 214 19395Michigan 821 81 672 67 14941 113 15054Minnesota 226 44 212 41 4817 28 4845Mississippi 368 127 365 125 6642 56 6698Missouri 385 66 469 80 11016 61 11077Montana 21 22 7 07 373 3 376Nebraska 53 30 118 67 1479 11 1490Nevada 293 121 294 118 5733 29 5762New Hampshire 33 25 55 42 1074 10 1084New Jersey 1262 145 1065 122 48750 778 49528New Mexico 134 70 93 48 2603 7 2610New York 6201 321 5495 285 174908 2354 177262North Carolina 916 106 1229 139 15954 118 16072North Dakota 10 16 6 09 144 1 145Ohio 753 66 767 67 14957 138 15095Oklahoma 281 79 205 57 4836 26 4862Oregon 217 60 281 76 5995 20 6015Pennsylvania 1486 120 1893 152 33417 365 33782Rhode Island 87 81 111 104 2580 28 2608South Carolina 682 161 705 163 13301 105 13406South Dakota 18 23 18 23 255 5 260Tennessee 818 137 680 113 12457 59 12516Texas 3045 133 2998 128 69735 392 70127Utah 63 25 57 22 2295 20 2315Vermont 5 08 18 29 461 6 467Virginia 638 84 605 79 16802 177 16979Washington 485 77 389 61 11792 34 11826West Virginia 74 41 67 37 1500 11 1511Wisconsin 122 22 217 39 4513 33 4546Wyoming 6 12 8 16 228 2 230

Subtotal 40123 135 37911 127 952221 9094 961315

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 29

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulativemdashUnited States and dependent areas (cont)

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

US dependent areasAmerican Samoa 0 0 0 0 1 0 1Guam 0 0 0 0 68 1 69Northern Mariana Islands 0 0 0 0 3 0 3Puerto Rico 1029 263 850 216 29511 400 29911US Virgin Islands 17 156 32 295 629 18 647Otherb 0 0 0 0 3 0 3

Totalc 41357 138 39002 129 983343 9522 992865d

a From the beginning of the epidemic through 2006b Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasc Includes persons whose state or area of residence is unknownd Includes 916 persons whose state or area of residence is unknown

30 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

MSA (population gt 500000)

Akron Ohio 66 94 32 46 762 1 763

AlbanyndashSchenectadyndashTroy NY 97 114 105 123 2253 24 2277

Albuquerque N Mex 70 88 50 61 1404 2 1406

AllentownndashBethlehemndashEaston PandashNJ 72 91 119 149 1352 17 1369

AtlantandashSandy SpringsndashMarietta Ga 1586 319 1006 196 21896 128 22024

AugustandashRichmond County GandashSC 106 205 32 61 1851 24 1875

AustinndashRound Rock Tex 227 156 186 123 4830 26 4856

Bakersfield Calif 76 100 122 156 1528 8 1536

BaltimorendashTowson Md 1064 401 1001 377 20352 218 20570

Baton Rouge La 222 304 231 301 3732 20 3752

BirminghamndashHoover Ala 151 139 110 100 2614 25 2639

Boise CityndashNampa Idaho 14 26 14 25 281 0 281

Boston MassndashNHa 441 99 355 80 13476 147 13623

Boston Division 269 146 185 101 8451 91 8542

Cambridge Division 108 74 102 70 3126 35 3161

Essex Division 52 71 51 69 1577 20 1597

BridgeportndashStamfordndashNorwalk Conn 181 201 135 150 3733 57 3790

BuffalondashNiagara Falls NY 117 102 96 84 2476 20 2496

Cape CoralndashFort Myers Fla 44 81 91 159 1692 24 1716

CharlestonndashNorth Charleston SC 92 155 91 151 2034 18 2052

CharlottendashGastoniandashConcord NCndashSC 214 141 285 180 3242 22 3264

Chicago IllndashIndndashWis 1716 182 1159 122 30118 261 30379

Chicago Division 1604 203 1073 135 28300 248 28548

Gary Division 61 88 50 71 1038 8 1046

Lake Division 51 59 36 41 780 5 785

CincinnatindashMiddletown OhiondashKyndashInd 111 53 199 95 2735 17 2752

ClevelandndashElyriandashMentor Ohio 228 107 170 80 4226 48 4274

Colorado Springs Colo 19 32 21 35 576 5 581

Columbia SC 177 256 197 280 3274 24 3298

Columbus Ohio 166 97 165 96 3112 15 3127

Dallas Tex 874 150 929 155 20238 63 20301

Dallas Division 681 175 714 178 16038 37 16075

Fort Worth Division 193 100 215 108 4200 26 4226

Dayton Ohio 58 69 54 64 1217 15 1232

DenverndashAurora Colo 274 116 236 98 6899 22 6921

Des Moines Iowa 30 57 23 43 530 4 534

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 31

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Detroit Mich 570 127 445 100 10373 73 10446

Detroit Division 443 223 330 167 8268 57 8325

Warren Division 127 51 115 46 2105 16 2121

El Paso Tex 56 78 40 54 1476 10 1486

Fresno Calif 52 59 64 72 1430 11 1441

Grand RapidsndashWyoming Mich 46 60 51 66 816 6 822

GreensborondashHigh Point NC 52 77 66 96 1265 14 1279

Greenville SC 70 119 67 111 1292 4 1296

HarrisburgndashCarlisle Pa 23 44 67 128 1224 8 1232

HartfordndashWest HartfordndashEast Hartford Conn 256 216 135 114 5126 46 5172

Honolulu Hawaii 54 60 69 76 2121 14 2135

HoustonndashBaytownndashSugar Land Tex 1017 190 1092 197 25821 172 25993

Indianapolis Ind 191 116 150 90 3824 25 3849

Jackson Miss 134 257 117 221 2419 30 2449

Jacksonville Fla 309 248 315 246 6020 75 6095

Kansas City MondashKans 183 94 160 81 4669 15 4684

Knoxville Tenn 47 72 35 52 882 5 887

Lakeland Fla 103 190 112 199 1811 21 1832

Las VegasndashParadise Nev 245 143 258 145 4616 28 4644

Little RockndashNorth Little Rock Ark 87 135 75 115 1383 14 1397

Los Angeles Calif 1529 118 1684 130 57953 293 58246

Los Angeles Division 1339 135 1435 144 51098 250 51348

Santa Anna Division 190 63 249 83 6855 43 6898

Louisville KyndashInd 123 102 97 79 2286 22 2308

Madison Wis 10 19 29 53 520 4 524

McAllenndashEdinburgndashPharr Tex 57 84 45 64 630 11 641

Memphis TennndashMissndashArk 402 320 346 271 5128 19 5147

Miami Fla 2420 446 2289 419 55807 997 56804

Fort Lauderdale Division 810 455 769 430 16412 262 16674

Miami Division 1243 523 1165 485 29703 512 30215

West Palm Beach Division 367 290 355 279 9692 223 9915

MilwaukeendashWaukeshandashWest Allis Wis 68 45 109 72 2507 18 2525

MinneapolisndashSt PaulndashBloomington MinnndashWis 186 59 184 58 4259 22 4281

Modesto Calif 36 71 22 43 671 6 677

NashvillendashDavidsonndashMurfreesboro Tenn 224 158 172 118 3848 20 3868

New HavenndashMilford Conn 169 200 107 127 4573 73 4646

New OrleansndashMetairiendashKenner La 393 299 271 264 8835 67 8902

32 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

New York NYndashNJndashPa 6215 330 5500 292 195177 2906 198083

Edison Division 191 83 130 56 6709 139 6848

Nassau Division 262 93 246 88 8141 110 8251

New York Division 5266 456 4716 408 160408 2323 162731

Newark Division 496 231 408 190 19919 334 20253

Oklahoma City Okla 125 108 88 75 2255 5 2260

OmahandashCouncil Bluffs NebndashIowa 37 46 80 97 1035 3 1038

Orlando Fla 544 282 517 260 8653 92 8745

OxnardndashThousand OaksndashVentura Calif 49 62 21 26 1008 3 1011

Palm BayndashMelbournendashTitusville Fla 68 129 61 114 1512 11 1523

Philadelphia PandashNJndashDelndashMd 1261 217 1348 231 28221 313 28534

Camden Division 108 87 111 89 3118 42 3160

Philadelphia Division 1022 263 1144 294 22112 250 22362

Wilmington Division 131 191 93 134 2991 21 3012

PhoenixndashMesandashScottsdale Ariz 460 119 376 93 7459 31 7490

Pittsburgh Pa 143 60 135 57 3182 19 3201

PortlandndashSouth Portland Maine 9 18 34 66 562 1 563

PortlandndashVancouverndashBeaverton OrendashWash 170 81 215 101 4825 10 4835

PoughkeepsiendashNewburghndashMiddletown NY 136 204 113 168 3162 24 3186

ProvidencendashNew BedfordndashFall River RIndashMass 132 82 155 96 3900 44 3944

RaleighndashCary NC 138 145 201 202 1987 13 2000

Richmond Va 119 101 122 102 3371 35 3406

RiversidendashSan BernardinondashOntario Calif 361 92 306 76 8568 60 8628

Rochester NY 165 159 124 120 3134 13 3147

SacramentondashArden-ArcadendashRoseville Calif 154 75 169 82 4000 26 4026

St Louis MondashIll 192 69 366 131 5965 40 6005

Salt Lake City Utah 46 44 40 37 1743 10 1753

San Antonio Tex 215 114 247 127 4987 30 5017

San DiegondashCarlsbadndashSan Marcos Calif 491 167 384 131 12934 61 12995

San Francisco Calif 867 209 690 165 40152 96 40248

Oakland Division 312 126 246 99 9546 48 9594

San Francisco Division 555 329 444 261 30606 48 30654

San JosendashSunnyvalendashSanta Clara Calif 88 50 145 81 3747 15 3762

San JuanndashCaguasndashGuaynabo PR 745 289 578 223 21402 277 21679

SarasotandashBradentonndashVenice Fla 82 122 104 152 1978 27 2005

ScrantonndashWilkes-Barre Pa 27 49 47 85 572 6 578

Seattle Wash 353 110 280 86 9172 27 9199

Seattle Division 316 129 255 102 8161 18 8179

Tacoma Division 37 49 25 33 1011 9 1020

Springfield Mass 88 128 45 66 2075 26 2101

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 33

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Stockton Calif 52 78 52 77 1076 15 1091

Syracuse NY 52 80 49 75 1317 8 1325

TampandashSt PetersburgndashClearwater Fla 559 211 605 224 11174 112 11286

Toledo Ohio 25 38 66 101 812 14 826

Tucson Ariz 103 111 100 106 2010 10 2020

Tulsa Okla 83 94 65 72 1494 10 1504

Virginia BeachndashNorfolkndashNewport News VandashNC 183 111 132 80 4711 63 4774

Washington DCndashVandashMdndashWV 1322 252 1684 318 31130 315 31445

Bethesda Division 135 118 173 150 2774 23 2797

Washington Division 1187 289 1511 365 28356 292 28648

Wichita Kans 35 60 38 64 851 2 853

Worcester Mass 76 97 79 101 1783 20 1803

YoungstownndashWarrenndashBoardman OhiondashPa 27 46 26 44 519 0 519

Subtotal for MSAs (population gt500000) 33602 173 31274 159 829633 8171 837804

Metropolitan areas (population of 50000 to 499999) 4477 80 4466 79 94829 847 95676

Nonmetropolitan areas 2666 54 2732 55 52063 445 52508

Totalb 41144 137 38749 128 981708 9494 991202

Note Because of the lack of census information for all US dependent areas includes data for only the 50 states the District of Columbia and Puerto RicoMSA metropolitan statistical areaMSA definitions for this report can be found at httpwwwcensusgovpopulationwwwestimatesmetrodefhtmla Reported case counts for the metropolitan divisions do not sum to the MSA total MSA total includes data from 1 metropolitan division with

population of lt500000b Includes persons whose county of residence is unknown

34 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Alabama (January 1988) 502 6041 48 6089

Alaska (February 1999) 38 285 2 287

Arizona (January 1987) 617 5877 80 5957

Arkansas (July 1989) 206 2349 20 2369

California (April 2006) 6581 7056 92 7148

Colorado (November 1985) 319 6084 31 6115

Connecticut (January 2005)b 826 2500 101 2601

Delaware (February 2006) 788 801 18 819

Florida (July 1997)c 4163 36386 397 36783

Georgia (December 2003) 2245 8197 194 8391

Idaho (June 1986) 35 340 4 344

Illinois (January 2006) 6241 6661 162 6823

Indiana (July 1988) 399 4027 43 4070

Iowa (July 1998) 69 586 5 591

Kansas (July 1999) 142 1225 15 1240

Kentucky (October 2004) 333 1303 13 1316

Louisiana (February 1993) 728 8149 166 8315

Maine (January 2006) 386 393 3 396

Michigan (April 1992) 635 6702 134 6836

Minnesota (October 1985) 309 3356 40 3396

Mississippi (August 1988) 352 4549 59 4608

Missouri (October 1987) 502 5086 55 5141

Nebraska (September 1995) 91 672 14 686

Nevada (February 1992) 339 3532 24 3556

New Hampshire (January 2005) 59 466 9 475

New Jersey (January 1992) 1477 17513 325 17838

New Mexico (January 1998) 114 949 4 953

New York (June 2000) 5326 42345 1820 44165

North Carolina (February 1990) 1615 13879 143 14022

North Dakota (January 1988) 4 82 1 83

Ohio (June 1990) 867 8222 101 8323

Oklahoma (June 1988) 229 2401 30 2431

Oregon (April 2006) 49 95 19 114

Pennsylvania (October 2002)d 4269 9537 179 9716

Rhode Island (July 2006) 14 21 0 21

South Carolina (February 1986) 493 6970 93 7063

South Dakota (January 1988) 18 215 6 221

Tennessee (January 1992) 732 7115 90 7205

Texas (January 1999)e 3370 24282 417 24699

Utah (April 1989) 106 893 14 907

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 35

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Virginia (July 1989) 864 10257 95 10352

Washington (March 2006) 4048 4157 40 4197

West Virginia (January 1989) 66 673 8 681

Wisconsin (November 1985) 261 2500 31 2531

Wyoming (June 1989) 7 93 1 94

Subtotal 50834 274822 5146 279968

US dependent areas

American Samoa (August 2001) 0 1 0 1

Guam (March 2000) 2 66 0 66

Northern Mariana Islands (October 2001) 2 7 0 7

Puerto Rico (January 2003) 1471 5610 91 5701

US Virgin Islands (December 1998) 22 247 6 253

Persons reported from areas with confidential name-based HIV infection reporting but who were residents of other areas 132 685 21 706

Totalf 52878 282640 5314 287954

Note Includes data from 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through 2006b Beginning in 1992 Connecticut had name-based HIV reporting for cases in children only From January 2002 through December 2004

Connecticut had name- or code-based HIV reporting for cases in adolescents and adults As of January 2005 Connecticut has name-based reporting of all cases of HIV infection

c Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterd On October 18 2002 Pennsylvania initiated confidential name-based HIV infection reporting in all areas except Philadelphia Code-based

reporting was implemented in Philadelphia in March 2004 and the switch to name-based reporting was made in October 2005e From February 1994 through December 1998 Texas reported HIV infection in children onlyf Includes 1252 persons reported from areas with confidential name-based HIV infection reporting but whose area of residence is unknown

36 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulativemdashUnited States and dependent areas

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No Adult or adolescentMale-to-male sexual contact 13775 49 429897 54 mdash mdash mdash mdash 13775 35 429897 44Injection drug use 3413 12 163070 21 1826 17 67693 35 5239 13 230763 23Male-to-male sexual contact and

injection drug use 1603 6 65524 8 mdash mdash mdash mdash 1603 4 65524 7Hemophiliacoagulation disorder 43 0 5176 1 11 0 348 0 54 0 5524 1High-risk heterosexual contactc 2997 11 49610 6 4839 46 85186 44 7836 20 134796 14

Sex with injection drug user 330 1 11683 1 706 7 26073 14 1036 3 37756 4Sex with bisexual male mdash mdash mdash mdash 234 2 5162 3 234 1 5162 1Sex with person with hemophilia 1 0 84 0 11 0 502 0 12 0 586 0Sex with HIV-infected transfusion

recipient 22 0 553 0 21 0 793 0 43 0 1346 0Sex with HIV-infected person risk

factor not specified 2644 9 37290 5 3867 37 52656 27 6511 17 89946 9Receipt of blood transfusion blood

d components or tissue 63 0 5213 1 68 1 4176 2 131 0 9389 1Otherrisk factor not reported or

identifiede 6484 23 73136 9 3793 36 34311 18 10278 26 107450 11Subtotal 28378 100 791626 100 10537 100 191714 100 38916 100 983343 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 0 0 222 5 0 0 7 0 0 0 229 2Mother with documented HIV infection or

1 of the following risk factors 24 75 4315 89 50 93 4423 95 74 86 8738 92Injection drug use 4 13 1676 35 4 7 1665 36 8 9 3341 35Sex with injection drug user 4 13 789 16 4 7 750 16 8 9 1539 16Sex with bisexual male 1 3 101 2 2 4 110 2 3 3 211 2Sex with person with hemophilia 0 0 20 0 0 0 16 0 0 0 36 0Sex with HIV-infected transfusion

recipient 0 0 11 0 0 0 15 0 0 0 26 0Sex with HIV-infected person risk

factor not specified 6 19 742 15 17 31 790 17 23 27 1532 16Receipt of blood transfusion blood

components or tissue 0 0 70 1 0 0 82 2 0 0 152 2Has HIV infection risk factor not

specified 9 28 906 19 23 43 995 21 32 37 1901 20Receipt of blood transfusion blood

fcomponents or tissue 1 3 243 5 0 0 144 3 1 1 387 4Otherrisk factor not reported or

identifiedg 7 22 75 2 4 7 93 2 11 13 168 2Subtotal 32 100 4855 100 54 100 4667 100 86 100 9522 100

Total 28410 100 796481 100 10591 100 196381 100 39002 100 992865 100a From the beginning of the epidemic through 2006b From the beginning of the epidemic through 2006 Includes 3 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infectiond AIDS developed in 47 adultsadolescents after they received blood that had tested negative for HIV antibodies AIDS developed in 14 additional adults

after they received tissue organs or artificial insemination from HIV-infected donors Four of the 14 received tissue or organs from a donor who was negative for HIV antibody at the time of donation

e Includes 37 adultsadolescents who were exposed to HIV-infected blood body fluids or concentrated virus in health care laboratory or household settings as supported by seroconversion epidemiologic andor laboratory evidence One person was infected after intentional inoculation with HIV-infected blood Includes an additional 740 persons who acquired HIV infection perinatally but who were more than 12 years of age when AIDS was diagnosed These 740 persons are not counted in the values for the pediatric transmission category

f AIDS developed in 3 children after they received blood that had tested negative for HIV antibodiesg Includes 5 children who were exposed to HIV-infected blood as supported by seroconversion epidemiologic andor laboratory evidence 1 child was

infected after intentional inoculation with HIV-infected blood and 5 children were exposed to HIV-infected blood in a household setting Of the 168 children 26 had sexual contact with an adult with or at high risk for HIV infection

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 37

Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No

Adult or adolescentMale-to-male sexual contact 22912 59 103679 52 mdash mdash mdash mdash 22912 44 103679 37

Injection drug use 3503 9 24255 12 2124 16 13925 17 5627 11 38181 14

Male-to-male sexual contact and injection drug use 1946 5 10704 5 mdash mdash mdash mdash 1946 4 10704 4

Hemophiliacoagulation disorder 43 0 495 0 6 0 73 0 49 0 568 0

High-risk heterosexual contactc 2874 7 16830 8 5939 45 38315 47 8813 17 55145 20

Sex with injection drug user 308 1 2601 1 757 6 6791 8 1065 2 9392 3

Sex with bisexual male mdash mdash mdash mdash 328 2 2265 3 328 1 2265 1

Sex with person with hemophilia 4 0 31 0 16 0 201 0 20 0 232 0

Sex with HIV-infected transfusion recipient 13 0 131 0 28 0 223 0 41 0 354 0

Sex with HIV-infected person risk factor not specified 2549 7 14067 7 4810 36 28835 35 7359 14 42902 15

Receipt of blood transfusion blood components or tissue 61 0 489 0 50 0 536 1 111 0 1025 0

Otherrisk factor not reported or identified 7748 20 44021 22 5106 39 29312 36 12854 25 73338 26

Subtotal 39087 100 200473 100 13225 100 82161 100 52312 100 282640 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 8 3 106 4 0 0 1 0 8 1 107 2

Mother with documented HIV infection or 1 of the following risk factors 197 74 2195 85 254 85 2417 89 451 80 4612 87

Injection drug use 34 13 532 21 53 18 561 21 87 15 1093 21

Sex with injection drug user 12 5 208 8 21 7 213 8 33 6 421 8

Sex with bisexual male 5 2 37 1 4 1 32 1 9 2 69 1

Sex with person with hemophilia 0 0 3 0 1 0 7 0 1 0 10 0

Sex with HIV-infected transfusion recipient 0 0 4 0 0 0 4 0 0 0 8 0

Sex with HIV-infected person risk factor not specified 54 20 534 21 76 25 629 23 130 23 1163 22

Receipt of blood transfusion blood components or tissue 0 0 17 1 2 1 20 1 2 0 37 1

Has HIV infection risk factor not specified 92 35 860 33 97 32 951 35 189 33 1811 34

Receipt of blood transfusion blood components or tissue 6 2 28 1 3 1 24 1 9 2 52 1

Otherrisk factor not reported or identified 55 21 260 10 43 14 283 10 98 17 543 10

Subtotal 266 100 2589 100 300 100 2725 100 566 100 5314 100

Total 39353 100 203062 100 13525 100 84886 100 52878 100 287954 100

Note See Table 16 for the list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006b From the beginning of the epidemic through December 2006 Includes 6 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infection

38 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity

2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 6251 65 253927 73Injection drug use 733 8 31737 9Male-to-male sexual contact and injection drug use 732 8 31434 9Hemophiliacoagulation disorder 26 0 3989 1High-risk heterosexual contactb 416 4 7850 2

Sex with injection drug user 74 1 2310 1

Sex with person with hemophilia 0 0 36 0

Sex with HIV-infected transfusion recipient 2 0 176 0

Sex with HIV-infected person risk factor not specified 340 4 5328 2Receipt of blood transfusion blood components or tissue 20 0 3194 1Otherrisk factor not reported or identified 1400 15 16469 5

Total 9578 100 348600 100

Black not HispanicMale-to-male sexual contact 4309 36 103297 37Injection drug use 1635 14 83369 30Male-to-male sexual contact and injection drug use 526 4 22134 8Hemophiliacoagulation disorder 10 0 604 0High-risk heterosexual contactb 1875 16 29952 11

Sex with injection drug user 167 1 6823 2Sex with person with hemophilia 1 0 36 0Sex with HIV-infected transfusion recipient 15 0 237 0Sex with HIV-infected person risk factor not specified 1692 14 22856 8

Receipt of blood transfusion blood components or tissue 24 0 1218 0Otherrisk factor not reported or identified 3579 30 40268 14

Total 11958 100 280842 100

HispanicMale-to-male sexual contact 2816 47 64893 44Injection drug use 965 16 46337 31Male-to-male sexual contact and injection drug use 287 5 10884 7Hemophiliacoagulation disorder 6 0 466 0High-risk heterosexual contactb 638 11 10950 7

Sex with injection drug user 84 1 2409 2Sex with person with hemophilia 0 0 11 0Sex with HIV-infected transfusion recipient 5 0 125 0Sex with HIV-infected person risk factor not specified 549 9 8405 6

Receipt of blood transfusion blood components or tissue 17 0 657 0Otherrisk factor not reported or identified 1326 22 14832 10

Total 6055 100 149019 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 39

a

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulative

No No

AsianPacific IslanderMale-to-male sexual contact 225 54 4475 68Injection drug use 20 5 317 5Male-to-male sexual contact and injection drug use 17 4 284 4Hemophiliacoagulation disorder 1 0 70 1High-risk heterosexual contactb 34 8 376 6

Sex with injection drug user 1 0 54 1Sex with person with hemophilia 0 0 1 0Sex with HIV-infected transfusion recipient 0 0 8 0Sex with HIV-infected person risk factor not specified 33 8 313 5

Receipt of blood transfusion blood components or tissue 2 0 112 2Otherrisk factor not reported or identified 114 28 949 14

Total 413 100 6583 100

American IndianAlaska NativeMale-to-male sexual contact 61 49 1403 55Injection drug use 15 12 395 15Male-to-male sexual contact and injection drug use 23 19 457 18Hemophiliacoagulation disorder 0 0 27 1High-risk heterosexual contactb 9 7 118 5

Sex with injection drug user 1 1 33 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 8 6 82 3

Receipt of blood transfusion blood components or tissue 0 0 8 0Otherrisk factor not reported or identified 16 13 155 6

Total 124 100 2563 100

Total casesMale-to-male sexual contact 13775 49 429897 54Injection drug use 3413 12 163070 21Male-to-male sexual contact and injection drug use 1603 6 65524 8Hemophiliacoagulation disorder 43 0 5176 1High-risk heterosexual contactb 2997 11 49610 6

Sex with injection drug user 330 1 11683 1Sex with person with hemophilia 1 0 84 0Sex with HIV-infected transfusion recipient 22 0 553 0Sex with HIV-infected person risk factor not specified 2644 9 37290 5

Receipt of blood transfusion blood components or tissue 63 0 5213 1Otherrisk factor not reported or identified 6484 23 73136 9

Total 28378c 100 791626d 100a From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 4019 males of unknown race or multiple races

40 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 11963 73 55725 69Injection drug use 858 5 5512 7Male-to-male sexual contact and injection drug use 1092 7 5578 7Hemophiliacoagulation disorder 29 0 355 0High-risk heterosexual contactb 522 3 2658 3

Sex with injection drug user 65 0 544 1Sex with person with hemophilia 0 0 8 0Sex with HIV-infected transfusion recipient 3 0 33 0Sex with HIV-infected person risk factor not specified 454 3 2073 3

Receipt of blood transfusion blood components or tissue 14 0 197 0Otherrisk factor not reported or identified 1956 12 11147 14

Total 16434 100 81172 100

Black not HispanicMale-to-male sexual contact 6203 44 30148 37Injection drug use 1594 11 11997 15Male-to-male sexual contact and injection drug use 483 3 3489 4Hemophiliacoagulation disorder 10 0 109 0High-risk heterosexual contactb 1714 12 10905 13

Sex with injection drug user 169 1 1554 2Sex with person with hemophilia 4 0 17 0Sex with HIV-infected transfusion recipient 6 0 77 0Sex with HIV-infected person risk factor not specified 1535 11 9257 11

Receipt of blood transfusion blood components or tissue 32 0 223 0Otherrisk factor not reported or identified 4151 29 24632 30

Total 14187 100 81503 100

HispanicMale-to-male sexual contact 4094 55 15623 47Injection drug use 993 13 6407 19Male-to-male sexual contact and injection drug use 316 4 1402 4Hemophiliacoagulation disorder 3 0 26 0High-risk heterosexual contactb 582 8 2963 9

Sex with injection drug user 65 1 455 1Sex with person with hemophilia 0 0 6 0Sex with HIV-infected transfusion recipient 4 0 18 0Sex with HIV-infected person risk factor not specified 513 7 2484 7

Receipt of blood transfusion blood components or tissue 11 0 55 0Otherrisk factor not reported or identified 1475 20 6977 21

Total 7474 100 33453 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 41

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderMale-to-male sexual contact 402 70 1006 63Injection drug use 17 3 55 3Male-to-male sexual contact and injection drug use 15 3 38 2Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 25 4 96 6

Sex with injection drug user 3 1 10 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 22 4 83 5

Receipt of blood transfusion blood components or tissue 4 1 7 0Otherrisk factor not reported or identified 109 19 397 25

Total 572 100 1600 100

American IndianAlaska NativeMale-to-male sexual contact 104 61 516 57Injection drug use 13 8 101 11Male-to-male sexual contact and injection drug use 19 11 110 12Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 10 6 53 6

Sex with injection drug user 2 1 14 2Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 8 5 39 4

Receipt of blood transfusion blood components or tissue 0 0 2 0Otherrisk factor not reported or identified 24 14 125 14

Total 170 100 907 100

Total casesMale-to-male sexual contact 22912 59 103679 52Injection drug use 3503 9 24255 12Male-to-male sexual contact and injection drug use 1946 5 10704 5Hemophiliacoagulation disorder 43 0 495 0High-risk heterosexual contactb 2874 7 16830 8

Sex with injection drug user 308 1 2601 1Sex with person with hemophilia 4 0 31 0Sex with HIV-infected transfusion recipient 13 0 131 0Sex with HIV-infected person risk factor not specified 2549 7 14067 7

Receipt of blood transfusion blood components or tissue 61 0 489 0Otherrisk factor not reported or identified 7748 20 44021 22

Total 39087c 100 200473d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 1838 males of unknown race or multiple races

42 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race

ethnicity 2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 482 28 14981 40Hemophiliacoagulation disorder 4 0 123 0High-risk heterosexual contactb 725 42 15799 42

Sex with injection drug user 153 9 5650 15Sex with bisexual male 63 4 1859 5Sex with person with hemophilia 5 0 329 1Sex with HIV-infected transfusion recipient 5 0 338 1Sex with HIV-infected person risk factor not specified 499 29 7623 20

Receipt of blood transfusion blood components or tissue 15 1 1870 5Otherrisk factor not reported or identified 499 29 4801 13

Total 1725 100 37574 100

Black not HispanicInjection drug use 982 15 38914 34Hemophiliacoagulation disorder 3 0 145 0High-risk heterosexual contactb 3103 46 49876 44

Sex with injection drug user 373 6 13530 12Sex with bisexual male 136 2 2352 2Sex with person with hemophilia 4 0 121 0Sex with HIV-infected transfusion recipient 8 0 277 0Sex with HIV-infected person risk factor not specified 2582 38 33596 29

Receipt of blood transfusion blood components or tissue 39 1 1546 1Otherrisk factor not reported or identified 2612 39 23894 21

Total 6739 100 114375 100

HispanicInjection drug use 322 18 12892 35Hemophiliacoagulation disorder 4 0 67 0High-risk heterosexual contactb 894 49 17995 49

Sex with injection drug user 166 9 6522 18Sex with bisexual male 32 2 818 2Sex with person with hemophilia 1 0 45 0Sex with HIV-infected transfusion recipient 7 0 141 0Sex with HIV-infected person risk factor not specified 688 38 10469 29

Receipt of blood transfusion blood components or tissue 12 1 619 2Otherrisk factor not reported or identified 592 32 5023 14

Total 1824 100 36596 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 43

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 8 8 125 12Hemophiliacoagulation disorder 0 0 7 1High-risk heterosexual contactb 49 47 574 53

Sex with injection drug user 4 4 114 11Sex with bisexual male 2 2 80 7Sex with person with hemophilia 0 0 4 0Sex with HIV-infected transfusion recipient 1 1 25 2Sex with HIV-infected person risk factor not specified 42 40 351 33

Receipt of blood transfusion blood components or tissue 1 1 93 9Otherrisk factor not reported or identified 46 44 279 26

Total 104 100 1078 100

American IndianAlaska NativeInjection drug use 13 32 280 42Hemophiliacoagulation disorder 0 0 3 0High-risk heterosexual contactb 15 37 277 41

Sex with injection drug user 4 10 107 16Sex with bisexual male 1 2 27 4Sex with person with hemophilia 0 0 2 0Sex with HIV-infected transfusion recipient 0 0 6 1Sex with HIV-infected person risk factor not specified 10 24 135 20

Receipt of blood transfusion blood components or tissue 1 2 17 3Otherrisk factor not reported or identified 12 29 95 14

Total 41 100 672 100

Total casesInjection drug use 1826 17 67693 35Hemophiliacoagulation disorder 11 0 348 0High-risk heterosexual contactb 4839 46 85186 44

Sex with injection drug user 706 7 26073 14Sex with bisexual male 234 2 5162 3Sex with person with hemophilia 11 0 502 0Sex with HIV-infected transfusion recipient 21 0 793 0Sex with HIV-infected person risk factor not specified 3867 37 52656 27

Receipt of blood transfusion blood components or tissue 68 1 4176 2Otherrisk factor not reported or identified 3793 36 34311 18

Total 10537c 100 191714d 100a From the beginning of the epidemic through 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 104 females of unknown race or multiple racesd Includes 1419 females of unknown race or multiple races

44 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 690 26 4260 26Hemophiliacoagulation disorder 3 0 24 0

bHigh-risk heterosexual contact 1132 42 7593 46Sex with injection drug user 205 8 1876 11Sex with bisexual male 98 4 659 4Sex with person with hemophilia 10 0 115 1Sex with HIV-infected transfusion recipient 7 0 64 0Sex with HIV-infected person risk factor not specified 812 30 4879 29

Receipt of blood transfusion blood components or tissue 12 0 146 1Otherrisk factor not reported or identified 850 32 4567 28

Total 2687 100 16590 100

Black not HispanicInjection drug use 1034 13 7105 14Hemophiliacoagulation disorder 1 0 35 0

bHigh-risk heterosexual contact 3451 44 23732 46Sex with injection drug user 313 4 3473 7Sex with bisexual male 155 2 1294 3Sex with person with hemophilia 5 0 71 0Sex with HIV-infected transfusion recipient 14 0 120 0Sex with HIV-infected person risk factor not specified 2964 38 18774 36

Receipt of blood transfusion blood components or tissue 26 0 324 1Otherrisk factor not reported or identified 3370 43 20244 39

Total 7882 100 51440 100

HispanicInjection drug use 339 15 2280 18Hemophiliacoagulation disorder 2 0 11 0

bHigh-risk heterosexual contact 1198 52 6264 50Sex with injection drug user 218 9 1324 11Sex with bisexual male 62 3 266 2Sex with person with hemophilia 1 0 11 0Sex with HIV-infected transfusion recipient 7 0 39 0Sex with HIV-infected person risk factor not specified 910 39 4624 37

Receipt of blood transfusion blood components or tissue 12 1 58 0Otherrisk factor not reported or identified 767 33 3843 31

Total 2318 100 12456 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 45

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 11: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Cases of HIVAIDS and AIDS

Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003ndash2006mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

Year of diagnosis

2003 2004 2005 2006

Data for 33 statesAge at diagnosis (yrs)lt13 211 183 169 13513ndash14 53 36 40 4115ndash19 993 993 1126 133220ndash24 3163 3368 3592 388625ndash29 4023 4057 4236 460330ndash34 5189 4820 4676 446635ndash39 6369 5807 5535 544240ndash44 5786 5429 5529 571845ndash49 4028 3877 4028 420450ndash54 2451 2401 2547 271855ndash59 1279 1363 1455 143860ndash64 655 702 692 714gt65 570 624 613 618

RaceethnicityWhite not Hispanic 10033 10181 10528 10758Black not Hispanic 17668 16718 16629 17356Hispanic 6355 6010 6217 6481AsianPacific Islander 338 339 373 397American IndianAlaska Native 179 171 182 166

Transmission categoryMale adult or adolescentMale-to-male sexual contact 15409 15880 16833 17465Injection drug use 3514 3083 2978 3016Male-to-male sexual contact and injection drug use 1349 1299 1247 1180High-risk heterosexual contacta 4269 3959 3871 4152Otherb 125 110 107 114Subtotal 24666 24331 25036 25928

Female adult or adolescentInjection drug use 2027 1856 1720 1712High-risk heterosexual contacta 7731 7182 7216 7432Otherb 134 107 97 109Subtotal 9892 9145 9033 9252

Child (lt13 yrs at diagnosis)Perinatal 190 157 147 115Otherc 23 27 23 20Subtotal 213 184 170 135

Subtotal for 33 states 34770 33659 34239 35314

Data for US dependent areas 1331 1234 1395 1503

Totald 36102 34894 35634 36817Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

Cases of HIVAIDS and AIDS 11

Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

gt12 Months after diagnosis aof HIV infection

lt12 Months after diagnosis of HIV infectionb Total

No ()c No ()c No

Data for 33 statesAge at diagnosis (yrs)lt13 148 88 21 12 16913ndash14 22 54 18 46 4015ndash19 912 81 215 19 112620ndash24 2874 80 714 20 358925ndash29 3077 73 1157 27 423430ndash34 3016 65 1655 35 467135ndash39 3353 61 2176 39 553040ndash44 3181 58 2338 42 551945ndash49 2145 53 1874 47 401950ndash54 1307 51 1239 49 254655ndash59 725 50 728 50 145360ndash64 316 46 376 54 692gt65 266 44 346 56 612RaceethnicityWhite not Hispanic 6839 65 3677 35 10516Black not Hispanic 10372 62 6242 38 16614Hispanic 3593 58 2614 42 6206AsianPacific Islander 232 62 139 38 371American IndianAlaska Native 110 61 72 39 182Transmission category

Male adult or adolescentMale-to-male sexual contact 10917 65 5902 35 16819Injection drug use 1544 52 1427 48 2971Male-to-male sexual contact and injection drug use 733 59 512 41 1245High-risk heterosexual contactd 2091 54 1773 46 3864Othere 45 42 61 58 107Subtotal 15331 61 9675 39 25006Female adult or adolescentInjection drug use 1056 62 660 38 1716High-risk heterosexual contactd 4761 66 2450 34 7210Othere 47 48 50 52 97Subtotal 5864 65 3160 35 9023Child (lt13 yrs at diagnosis)Perinatal 126 86 21 14 147Otherf 22 94 2 6 23Subtotal 148 87 22 13 170

Subtotal for 33 states 21343 62 12857 38 34200Data for US dependent areas 855 61 541 39 1395

Totalg 22197 62 13398 38 35595h

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003Data exclude 39 persons whose month of diagnosis of HIV infection is unknowna Includes persons in whom AIDS has not developedb Includes persons whose diagnoses of HIV infection and AIDS were made at the same timec Percentages represent proportions of the total number of diagnoses of HIVAIDS made during 2005 for the corresponding group (see row

entries)d Heterosexual contact with a person known to have or to be at high risk for HIV infectione Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedf Includes hemophilia blood transfusion and risk factor not reported or not identifiedg Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the

column totalh Includes 310 persons of unknown race or multiple races

12 Cases of HIVAIDS and AIDS

Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas

Year of diagnosis2002 2003 2004 2005 2006 Cumulativea

Data for 50 states and the District of ColumbiaAge at diagnosis (yrs)lt13 106 70 53 53 38 915613ndash14 62 74 70 66 73 107815ndash19 316 302 334 410 401 562620ndash24 1399 1568 1624 1675 1669 3622525ndash29 3137 3059 3196 3110 3423 11709930ndash34 5701 5521 5144 4668 4349 19753035ndash39 8217 8017 7072 6479 6402 21357340ndash44 7404 7626 7703 7378 7298 17053145ndash49 5358 5617 5498 5727 5628 10720750ndash54 3271 3364 3491 3527 3687 5990755ndash59 1607 1693 1836 1861 2071 3219060ndash64 872 864 913 872 955 17303gt65 682 763 791 727 835 15074

RaceethnicityWhite not Hispanic 11233 10948 11066 10676 10929 394024Black not Hispanic 19246 19512 18909 18081 17960 409982Hispanic 6712 7102 6771 6823 6907 161505AsianPacific Islander 425 450 444 450 519 7951American IndianAlaska Native 177 176 182 170 155 3345

Transmission categoryMale adult or adolescentMale-to-male sexual contact 15709 16078 16054 15711 16001 465965Injection drug use 5483 5275 4818 4603 4410 170171Male-to-male sexual contact and injection drug use 2075 2029 1925 1930 1803 68516High-risk heterosexual contactb 4547 4471 4506 4306 4558 65241Otherc 253 226 228 237 217 13893Subtotal 28067 28079 27532 26787 26989 783786

Female adult or adolescentInjection drug use 2897 2836 2810 2586 2385 74718High-risk heterosexual contactb 6855 7336 7113 6922 7196 108252Otherc 207 217 217 205 220 6596Subtotal 9959 10389 10141 9713 9801 189566

Child (lt13 yrs at diagnosis)Perinatal 104 70 53 52 37 8508Otherd 2 0 0 0 0 636Subtotal 106 70 53 53 38 9144

Region of residenceNortheast 10092 10342 9412 9396 9486 306241Midwest 4125 4226 4089 4371 4164 101479South 17198 17630 18225 16894 17104 374800West 6718 6339 6000 5891 6074 199978Subtotal for 50 states and the District of Columbia 38132 38538 37726 36552 36828 982498

Data for US dependent areas 1058 1060 921 955 833 31217

Totale 39250 39690 38807 37662 37852 1014797Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes persons of unknown race or multiple races and persons of unknown sex Cumulative total includes 5691 persons of unknown race or multiple

races 3 persons of unknown sex 1079 persons of unknown state of residence and 3 persons who were residents of other areas Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Cases of HIVAIDS and AIDS 13

Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002ndash2006 and cumulativemdash50 states and the District of Columbia

Year of diagnosisCumulativea2002 2003 2004 2005 2006

RaceethnicityWhite not Hispanic 14 12 7 4 4 1599Black not Hispanic 70 46 33 38 30 5654Hispanic 18 10 9 8 3 1748AsianPacific Islander 1 0 1 1 1 54American IndianAlaska Native 1 0 1 0 0 31

Transmission categoryHemophiliacoagulation disorder 0 0 0 0 0 226Mother with documented HIV infection or 1 of the following risk factors 104 70 53 52 37 8508

Injection drug use 12 8 5 3 4 3220Sex with injection drug user 4 6 3 2 1 1397Sex with bisexual male 2 0 3 1 1 209Sex with person with hemophilia 0 0 0 0 0 35Sex with HIV-infected transfusion recipient 0 0 0 0 0 22Sex with HIV-infected person risk factor not specified 36 20 20 25 13 1530Receipt of blood transfusion blood components or tissue 2 1 0 0 0 144Has HIV infection risk factor not specified 47 34 21 21 17 1951

Receipt of blood transfusion blood components or tissue 2 0 0 0 0 374Otherrisk factor not reported or identified 0 0 0 0 0 36

Totalb 106 70 53 53 38 9144

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga From the beginning of the epidemic through 2006b Includes children of unknown race or multiple races Cumulative total includes 58 children of unknown race or multiple races Because column totals

were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992ndash2006mdash50 states and the District of Columbia

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reporting

14 Cases of HIVAIDS and AIDS

Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006mdash50 states and the District of Columbia

Raceethnicity

Adults or adolescents

Children (lt13 yrs) TotalaMales Females Totala

No Rate No Rate No Rate No Rate No Rate

White not Hispanic 9267 112 1659 19 10926 64 4 00 10929 54Black not Hispanic 11540 829 6391 404 17930 603 30 04 17960 476Hispanic 5388 313 1516 95 6903 208 3 00 6907 156AsianPacific Islander 423 75 95 16 518 44 1 00 519 37American IndianAlaska Native 118 122 37 36 155 78 0 00 155 62

Totalb 26989 224 9801 78 36790 149 38 01 36828c 123

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reportingData exclude cases in persons whose state or area of residence is unknown as well as cases from US dependent areas for which census information about race and age categories is lackinga Because row totals were calculated independently of the values for the subpopulations the values in each row may not sum to the row totalb Includes person of unknown race or multiple races Because column totals were calculated independently of the values for the subpopulations the

values in each column may not sum to the column totalc Includes 358 persons of unknown race or multiple races

Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006mdash33 states with confidential name-based HIV infection reporting

Raceethnicity

Adults or adolescents

Children (lt13 yrs) TotalaMales Females Totala

No Rate No Rate No Rate No Rate No Rate

White not Hispanic 9078 167 1664 29 10742 96 16 01 10758 82Black not Hispanic 11230 1191 6033 562 17263 856 93 17 17356 677Hispanic 5058 509 1400 151 6458 337 23 04 6481 255AsianPacific Islander 318 135 79 32 397 82 0 00 397 67American IndianAlaska Native 129 177 35 46 164 110 2 06 166 88

Totalb 25928 338 9252 115 35180 224 135 04 35314c 185

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Because row totals were calculated independently of the values for the subpopulations the values in each row may not sum to the row totalb Includes persons of unknown race or multiple races Because column totals were calculated independently of the values for the subpopulations the

values in each column may not sum to the column totalc Includes 156 persons of unknown race or multiple races

Cases of HIVAIDS and AIDS 15

Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006mdashUnited States and dependent areas

Transmission category

Place of birth

United StatesCentralSouth

America Cuba Mexico Puerto Rico Totala

No No No No No No

Male-to-male sexual contact 1172 45 402 49 89 62 790 59 249 18 3337 43Injection drug use 569 22 83 10 13 9 133 10 533 40 1650 21Male-to-male sexual contact

and injection drug use 158 6 25 3 6 4 59 4 63 5 357 5High-risk heterosexual

contactb 661 25 296 36 35 24 342 26 487 36 2282 30Otherc 47 2 8 1 0 0 9 1 14 1 103 1

Totald 2608 100 814 100 145 100 1334 100 1346 100 7728 100Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Includes 222 persons whose place of birth is not among those listed and 1260 persons whose place of birth is unknownb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the

column total

16 Cases of HIVAIDS and AIDS

Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas

Year of death

Cumulativea2002 2003 2004 2005 2006

Data for 50 states and the District of ColumbiaAge at death (yrs)lt13 25 22 15 7 13 4889

13ndash14 10 6 15 12 5 276

15ndash19 39 36 36 38 44 1104

20ndash24 151 157 175 147 162 8716

25ndash29 553 512 482 458 405 43671

30ndash34 1480 1272 1128 1069 785 95351

35ndash39 2967 2763 2425 2096 1682 116746

40ndash44 3595 3516 3393 3317 2636 104133

45ndash49 3294 3234 3251 3275 2886 72831

50ndash54 2318 2373 2502 2645 2343 44255

55ndash59 1209 1322 1425 1543 1480 25123

60ndash64 616 705 741 797 771 14315

gt65 691 773 807 865 805 14393

RaceethnicityWhite not Hispanic 5214 5097 4836 4758 3860 239529

Black not Hispanic 9037 8675 8581 8679 7426 218392

Hispanic 2429 2632 2641 2513 2425 80690

AsianPacific Islander 97 84 111 87 114 3426

American IndianAlaska Native 83 73 80 65 66 1693

Transmission categoryMale adult or adolescentMale-to-male sexual contact 5960 5937 5735 5641 4930 266272

Injection drug use 3738 3547 3315 3314 2641 107173

Male-to-male sexual contact and injection drug use 1278 1299 1237 1289 1064 40993

High-risk heterosexual contactb 1465 1501 1625 1571 1470 26236

Otherc 160 149 125 117 80 9867

Subtotal 12601 12431 12038 11932 10184 450541

Female adult or adolescentInjection drug use 1923 1825 1855 1768 1456 43143

High-risk heterosexual contactb 2281 2292 2373 2458 2258 42620

Otherc 84 87 72 68 70 4131

Subtotal 4289 4204 4300 4295 3784 89895

Child (lt13 yrs at diagnosis)Perinatal 53 49 56 39 42 4848

Otherd 4 5 1 2 7 521

Subtotal 57 54 57 41 48 5369

Deaths 17

Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas (cont)

Year of death

Cumulativea2002 2003 2004 2005 2006

Region of residenceNortheast 5313 5012 4779 4750 4074 180623

Midwest 1726 1666 1482 1378 1325 54468

South 7337 7427 7535 7907 6475 197209

West 2571 2585 2600 2234 2141 113506

Subtotal for 50 states and the District of Columbia 16948 16690 16395 16268 14016 545805

Data for US dependent areas 667 575 572 562 580 19858

Totale 17628 17283 16982 16865 14627 565927f

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column totalf Includes 2082 persons of unknown race or multiple races 261 persons of unknown state of residence and 2 persons who were residents

of other areas

18 Deaths

Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003ndash2006mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

2003 2004 2005 2006Data for 33 states

Age at end of year (yrs)lt13 4154 3700 3294 286713ndash14 1130 1238 1212 113915ndash19 3298 3627 4024 453920ndash24 12389 12826 13411 1430125ndash29 26167 26924 28164 2960030ndash34 49602 47577 45109 4418935ndash39 80703 77871 75842 7363440ndash44 92040 97109 100102 10176445ndash49 71345 77490 83816 9028350ndash54 45133 51033 56640 6319555ndash59 22793 26610 31186 3600860ndash64 10820 12642 14422 16658gt65 8531 9959 11657 13551

RaceethnicityWhite not Hispanic 145081 151694 158375 166000Black not Hispanic 202951 212425 221439 231957Hispanic 72612 76503 80491 84720AsianPacific Islander 2234 2529 2858 3187American IndianAlaska Native 1788 1889 2008 2119

Transmission categoryMale adult or adolescentMale-to-male sexual contact 181771 193245 205423 218676Injection drug use 57651 58149 58369 59077Male-to-male sexual contact and injection drug use 23965 24434 24725 25085High-risk heterosexual contacta 40084 42559 44915 47562Otherb 3218 3278 3325 3424Subtotal 306689 321665 336756 353825

Female adult or adolescentInjection drug use 32346 32735 32973 33470High-risk heterosexual contacta 80324 85348 90185 95403Otherb 2036 2123 2212 2321Subtotal 114705 120206 125370 131195

Child (lt13 yrs at diagnosis)Perinatal 6137 6154 6178 6143Otherc 570 575 571 560Subtotal 6707 6730 6748 6703

Subtotal for 33 states 428107 448605 468879 491727Data for US dependent areas 15809 16399 17150 17955

Totald 443916 465005 486028 509681Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 19

Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission categorymdash33 states with confidential name-based HIV infection reporting

Transmission category

White not Hispanic

Black not Hispanic Hispanic

AsianPacific Islander

American IndianAlaska

Native Totala

No No No No No No

Male adult or adolescentMale-to-male sexual contact 108259 77 70242 49 36043 57 1669 68 938 62 218676 62Injection drug use 12328 9 31339 22 14472 23 264 11 216 14 59077 17Male-to-male sexual contact

and injection drug use 11283 8 9587 7 3720 6 93 4 205 13 25085 7High-risk heterosexual contactb 6667 5 31140 22 8788 14 395 16 143 9 47562 13Otherc 1458 1 1492 1 404 1 30 1 17 1 3424 1Subtotal 139994 100 143799 100 63427 100 2450 100 1519 100 353825 100

Female adult or adolescentInjection drug use 8262 33 19136 23 5528 28 106 15 175 30 33470 26High-risk heterosexual contactb 16338 65 63204 75 14132 71 573 82 392 68 95403 73Otherc 450 2 1469 2 344 2 24 3 12 2 2321 2Subtotal 25050 100 83809 100 20004 100 703 100 578 100 131195 100

Child (lt13 yrs at diagnosis)Perinatal 801 84 4064 93 1183 92 28 82 20 95 6143 92Otherd 154 16 283 7 107 8 6 18 1 5 560 8Subtotal 955 100 4347 100 1290 100 34 100 21 100 6703 100

Totale 166000 231957 84720 3187 2119 491727Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of 33 states that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Includes 3745 persons of unknown race or multiple racesb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes 5 persons of unknown sex Because column totals were calculated independently of the values for the subpopulations the values

in each column may not sum to the column total

20 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Map 1 Estimated rates (per 100000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

Note Rates adjusted for reporting delays Rates of HIV infection include only persons living with HIV infection that has not progressed to AIDSSince 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 Islandsa Includes persons whose area of residence is unknown

Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

Note Rates adjusted for reporting delays Rates of HIV infection include only persons living with HIV infection that has not progressed to AIDSSince 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 Islandsa Includes persons whose area of residence is unknown

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 21

Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002ndash2006mdashUnited States and dependent areas

2002 2003 2004 2005 2006Data for 50 states and the District of Columbia

Age at end of year (yrs)lt13 2308 2006 1684 1394 111513ndash14 685 747 784 762 71115ndash19 1465 1694 1974 2243 248720ndash24 3910 4292 4629 5033 536725ndash29 12725 12743 13045 13505 1435930ndash34 35558 33870 32057 29949 2882435ndash39 70107 68106 65076 62235 5964940ndash44 80377 86294 91335 94021 9517445ndash49 64702 71276 77417 84153 9077550ndash54 41270 46855 53333 59256 6647655ndash59 20113 24145 28356 33522 3901460ndash64 9681 11293 13305 15380 18072gt65 7520 8946 10604 12430 14669

RaceethnicityWhite not Hispanic 129426 135278 141508 147426 154495Black not Hispanic 150488 161326 171654 181056 191590Hispanic 63424 67895 72024 76334 80815AsianPacific Islander 3060 3426 3759 4121 4526American IndianAlaska Native 1254 1356 1458 1562 1651

Transmission categoryMale adult or adolescentMale-to-male sexual contact 158092 168233 178551 188622 199693Injection drug use 56708 58436 59940 61229 62998Male-to-male sexual contact and injection drug use 24726 25457 26144 26785 27523High-risk heterosexual contacta 27329 30300 33181 35916 39004Otherb 3588 3665 3769 3888 4026Subtotal 270444 286091 301585 316440 333244

Female adult or adolescentInjection drug use 27863 28874 29828 30646 31575High-risk heterosexual contacta 46445 51489 56229 60693 65631Otherb 1903 2033 2178 2315 2465Subtotal 76210 82395 88236 93653 99671

Child (lt13 yrs at diagnosis)Perinatal 3633 3654 3651 3664 3660Otherc 129 124 123 122 115Subtotal 3762 3778 3774 3786 3775

Region of residenceNortheast 105599 110929 115562 120208 125620Midwest 36011 38571 41178 44171 47010South 137081 147284 157975 166962 177591West 71729 75483 78883 82540 86473

Subtotal for 50 states and the District of Columbia 350419 372267 393598 413882 436693

Data for US dependent areas 9880 10365 10713 11106 11359

Totald 360617 383024 404849 425646 448871Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

22 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission categorymdash50 states and the District of Columbia

Transmission category

White not Hispanic

Black not Hispanic Hispanic

AsianPacific Islander

American IndianAlaska

Native Totala

No No No No No No

Male adult or adolescentMale-to-male sexual contact 101299 75 57520 45 36087 57 2715 72 704 57 199693 60Injection drug use 13168 10 33911 27 14795 23 325 9 201 16 62998 19Male-to-male sexual contact and

injection drug use 12393 9 10121 8 4352 7 198 5 220 18 27523 8High-risk heterosexual contactb 6081 5 24205 19 7816 12 444 12 105 8 39004 12Otherc 1743 1 1602 1 574 1 69 2 16 1 4026 1Subtotal 134683 100 127359 100 63623 100 3752 100 1246 100 333244 100

Female adult or adolescentInjection drug use 7407 38 18531 30 5025 30 115 15 153 39 31575 32High-risk heterosexual contactb 11350 59 41741 68 11092 67 588 78 227 58 65631 66Otherc 508 3 1456 2 413 2 51 7 13 3 2465 2Subtotal 19264 100 61728 100 16531 100 753 100 393 100 99671 100

Child (lt13 yrs at diagnosis)Perinatal 500 92 2468 99 629 95 20 94 12 100 3660 97Otherd 46 8 34 1 33 5 1 6 0 0 115 3Subtotal 546 100 2503 100 662 100 21 100 12 100 3775 100

Totale 154495 191590 80815 4526 1651 436693

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Includes 3616 persons of unknown race or multiple racesb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes 3 person of unknown sex Because column totals were calculated independently of the values for the subpopulations the values in each column

may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 23

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by

area of residence and age categorymdashUnited States and dependent areas

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

Alabama 5469 17 5486 3744 11 3755Alaska 272 1 273 330 1 331Arizona 5744 49 5793 4922 7 4929Arkansas 2291 7 2298 2139 6 2145California mdash mdash mdash 61451 105 61555Colorado 5855 13 5869 4083 2 4085Connecticut mdash mdash mdash 7406 15 7421Delaware mdash mdash mdash 1753 7 1760District of Columbia mdash mdash mdash 10059 30 10089Floridab 35461 263 35723 46469 194 46663Georgia mdash mdash mdash 17336 47 17383Hawaii mdash mdash mdash 1234 3 1237Idaho 356 0 356 313 0 313Illinois mdash mdash mdash 16139 46 16185Indiana 3849 21 3870 3996 14 4010Iowa 588 2 590 869 3 872Kansas 1230 7 1237 1272 2 1274Kentucky mdash mdash mdash 2589 13 2602Louisiana 7361 101 7462 8052 21 8074Maine mdash mdash mdash 512 2 514Maryland mdash mdash mdash 14540 41 14581Massachusetts mdash mdash mdash 8806 20 8826Michigan 6118 55 6173 6615 12 6627Minnesota 3227 21 3248 2314 9 2323Mississippi 4200 32 4232 3155 13 3168Missouri 4999 33 5033 5479 7 5486Montana mdash mdash mdash 205 0 205Nebraska 688 12 700 771 2 773Nevada 3402 13 3415 2969 3 2972New Hampshire mdash mdash mdash 556 3 559New Jersey 16059 153 16212 17168 57 17226New Mexico 910 0 909 1252 3 1255New York 42220 801 43021 70697 148 70845North Carolina 11700 60 11760 8451 12 8463North Dakota 87 2 89 73 1 74Ohio 8266 57 8323 7054 30 7084Oklahoma 2191 17 2208 2191 3 2194Oregon mdash mdash mdash 2840 4 2844Pennsylvania mdash mdash mdash 18633 71 18703Rhode Island mdash mdash mdash 1296 7 1303South Carolina 6349 45 6394 7035 23 7058South Dakota 195 4 199 139 1 140Tennessee 6579 51 6631 6403 11 6414Texas 24741 262 25003 34010 53 34063Utah 893 10 903 1164 0 1164Vermont mdash mdash mdash 238 2 240Virginia 9937 41 9978 8423 24 8447Washington mdash mdash mdash 5471 5 5476West Virginia 660 5 665 749 5 754Wisconsin 2322 15 2337 2153 12 2165Wyoming 86 2 88 102 1 103

Subtotal 224303 2174 226477 435621 1115 436736

24 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age categorymdashUnited States and dependent areas (cont)

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

US dependent areasAmerican Samoa 2 0 2 1 0 1Guam 63 0 63 36 0 36Northern Mariana Islands 7 0 7 3 0 3Puerto Rico 6269 31 6300 10971 26 10997US Virgin Islands 228 2 230 312 2 314Otherc mdash mdash mdash 1 0 1

Totald 230872 2207 233079 447724 1147 448871

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reporting a See Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at

least 2003b Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterc Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasd Total number of persons living with HIV infection (not AIDS) includes persons reported from areas with confidential name-based HIV

infection reporting who were residents of other states or whose area of residence is unknown Total number of persons living with AIDS includes persons whose area of residence is unknown Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 25

Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristicsmdashUnited States and dependent areas

No of persons

Survival in months

gt12 gt24 gt36Data for 50 states and the District of Columbia

Age at diagnosis (yrs)lt13 101 096 094 09413ndash14 60 098 098 09515ndash19 305 098 096 09520ndash24 1351 096 093 09225ndash29 3034 095 092 09130ndash34 5499 094 091 08935ndash39 7888 093 090 08740ndash44 7085 092 088 08545ndash49 5090 089 085 08250ndash54 3067 086 081 07855ndash59 1505 083 078 07460ndash64 806 080 073 069gt65 614 073 068 065

RaceethnicityWhite not Hispanic 10706 092 089 087Black not Hispanic 18406 090 086 082Hispanic 6398 092 090 088AsianPacific Islander 404 094 092 090American IndianAlaska Native 167 084 081 075

Transmission categoryMale adult or adolescentMale-to-male sexual contact 12830 093 090 088Injection drug use 4048 089 084 081Male-to-male sexual contact and injection drug use 1701 093 089 086High-risk heterosexual contacta 3170 091 088 085Otherb 5019 086 083 080Subtotal 26768 091 088 085

Female adult or adolescentInjection drug use 2101 089 083 078High-risk heterosexual contacta 4686 093 089 086Otherb 2749 090 085 083Subtotal 9536 091 087 083

Child (lt13 yrs at diagnosis)Perinatal 98 096 095 095Otherc 3 100 067 067Subtotal 101 096 094 094

Subtotal for 50 states and the District of Columbia 36405 091 087 085

Data for US dependent areas 891 083 078 075

Total 37352d 091 087 084Note Excludes persons whose date of death was before or in the same month as date of diagnosis Excludes persons whose month of diagnosis or month of death is unknowna Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes 325 persons of unknown race or multiple races

26 Survival after AIDS Diagnosis

Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by year of diagnosismdashUnited States and dependent areas

Months after AIDS diagnosis

Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by age groupmdashUnited States and dependent areas

Months after AIDS diagnosis

Survival after AIDS Diagnosis 27

Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by raceethnicitymdashUnited States and dependent areas

Months after AIDS diagnosis

28 Survival after AIDS Diagnosis

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006

and cumulativemdashUnited States and dependent areas

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Alabama 510 112 462 100 8626 76 8702Alaska 24 36 38 57 648 7 655Arizona 626 105 539 87 10396 46 10442Arkansas 237 85 252 90 3891 36 3927California 4069 113 3960 109 142254 664 142918Colorado 351 75 322 68 8742 31 8773Connecticut 658 188 422 120 14716 183 14899Delaware 177 210 116 136 3547 26 3573District of Columbia 672 1155 853 1467 17372 189 17561Florida 4921 277 4932 273 104084 1530 105614Georgia 2325 255 1605 171 31734 231 31965Hawaii 105 82 93 72 2927 17 2944Idaho 24 17 26 18 604 2 606Illinois 1886 148 1382 108 33620 282 33902Indiana 407 65 346 55 8239 56 8295Iowa 93 31 86 29 1727 13 1740Kansas 105 38 120 43 2781 14 2795Kentucky 249 60 207 49 4600 32 4632Louisiana 936 208 824 192 17612 128 17740Maine 21 16 68 51 1110 8 1118Maryland 1558 279 1626 290 30252 319 30571Massachusetts 666 104 533 83 19181 214 19395Michigan 821 81 672 67 14941 113 15054Minnesota 226 44 212 41 4817 28 4845Mississippi 368 127 365 125 6642 56 6698Missouri 385 66 469 80 11016 61 11077Montana 21 22 7 07 373 3 376Nebraska 53 30 118 67 1479 11 1490Nevada 293 121 294 118 5733 29 5762New Hampshire 33 25 55 42 1074 10 1084New Jersey 1262 145 1065 122 48750 778 49528New Mexico 134 70 93 48 2603 7 2610New York 6201 321 5495 285 174908 2354 177262North Carolina 916 106 1229 139 15954 118 16072North Dakota 10 16 6 09 144 1 145Ohio 753 66 767 67 14957 138 15095Oklahoma 281 79 205 57 4836 26 4862Oregon 217 60 281 76 5995 20 6015Pennsylvania 1486 120 1893 152 33417 365 33782Rhode Island 87 81 111 104 2580 28 2608South Carolina 682 161 705 163 13301 105 13406South Dakota 18 23 18 23 255 5 260Tennessee 818 137 680 113 12457 59 12516Texas 3045 133 2998 128 69735 392 70127Utah 63 25 57 22 2295 20 2315Vermont 5 08 18 29 461 6 467Virginia 638 84 605 79 16802 177 16979Washington 485 77 389 61 11792 34 11826West Virginia 74 41 67 37 1500 11 1511Wisconsin 122 22 217 39 4513 33 4546Wyoming 6 12 8 16 228 2 230

Subtotal 40123 135 37911 127 952221 9094 961315

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 29

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulativemdashUnited States and dependent areas (cont)

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

US dependent areasAmerican Samoa 0 0 0 0 1 0 1Guam 0 0 0 0 68 1 69Northern Mariana Islands 0 0 0 0 3 0 3Puerto Rico 1029 263 850 216 29511 400 29911US Virgin Islands 17 156 32 295 629 18 647Otherb 0 0 0 0 3 0 3

Totalc 41357 138 39002 129 983343 9522 992865d

a From the beginning of the epidemic through 2006b Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasc Includes persons whose state or area of residence is unknownd Includes 916 persons whose state or area of residence is unknown

30 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

MSA (population gt 500000)

Akron Ohio 66 94 32 46 762 1 763

AlbanyndashSchenectadyndashTroy NY 97 114 105 123 2253 24 2277

Albuquerque N Mex 70 88 50 61 1404 2 1406

AllentownndashBethlehemndashEaston PandashNJ 72 91 119 149 1352 17 1369

AtlantandashSandy SpringsndashMarietta Ga 1586 319 1006 196 21896 128 22024

AugustandashRichmond County GandashSC 106 205 32 61 1851 24 1875

AustinndashRound Rock Tex 227 156 186 123 4830 26 4856

Bakersfield Calif 76 100 122 156 1528 8 1536

BaltimorendashTowson Md 1064 401 1001 377 20352 218 20570

Baton Rouge La 222 304 231 301 3732 20 3752

BirminghamndashHoover Ala 151 139 110 100 2614 25 2639

Boise CityndashNampa Idaho 14 26 14 25 281 0 281

Boston MassndashNHa 441 99 355 80 13476 147 13623

Boston Division 269 146 185 101 8451 91 8542

Cambridge Division 108 74 102 70 3126 35 3161

Essex Division 52 71 51 69 1577 20 1597

BridgeportndashStamfordndashNorwalk Conn 181 201 135 150 3733 57 3790

BuffalondashNiagara Falls NY 117 102 96 84 2476 20 2496

Cape CoralndashFort Myers Fla 44 81 91 159 1692 24 1716

CharlestonndashNorth Charleston SC 92 155 91 151 2034 18 2052

CharlottendashGastoniandashConcord NCndashSC 214 141 285 180 3242 22 3264

Chicago IllndashIndndashWis 1716 182 1159 122 30118 261 30379

Chicago Division 1604 203 1073 135 28300 248 28548

Gary Division 61 88 50 71 1038 8 1046

Lake Division 51 59 36 41 780 5 785

CincinnatindashMiddletown OhiondashKyndashInd 111 53 199 95 2735 17 2752

ClevelandndashElyriandashMentor Ohio 228 107 170 80 4226 48 4274

Colorado Springs Colo 19 32 21 35 576 5 581

Columbia SC 177 256 197 280 3274 24 3298

Columbus Ohio 166 97 165 96 3112 15 3127

Dallas Tex 874 150 929 155 20238 63 20301

Dallas Division 681 175 714 178 16038 37 16075

Fort Worth Division 193 100 215 108 4200 26 4226

Dayton Ohio 58 69 54 64 1217 15 1232

DenverndashAurora Colo 274 116 236 98 6899 22 6921

Des Moines Iowa 30 57 23 43 530 4 534

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 31

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Detroit Mich 570 127 445 100 10373 73 10446

Detroit Division 443 223 330 167 8268 57 8325

Warren Division 127 51 115 46 2105 16 2121

El Paso Tex 56 78 40 54 1476 10 1486

Fresno Calif 52 59 64 72 1430 11 1441

Grand RapidsndashWyoming Mich 46 60 51 66 816 6 822

GreensborondashHigh Point NC 52 77 66 96 1265 14 1279

Greenville SC 70 119 67 111 1292 4 1296

HarrisburgndashCarlisle Pa 23 44 67 128 1224 8 1232

HartfordndashWest HartfordndashEast Hartford Conn 256 216 135 114 5126 46 5172

Honolulu Hawaii 54 60 69 76 2121 14 2135

HoustonndashBaytownndashSugar Land Tex 1017 190 1092 197 25821 172 25993

Indianapolis Ind 191 116 150 90 3824 25 3849

Jackson Miss 134 257 117 221 2419 30 2449

Jacksonville Fla 309 248 315 246 6020 75 6095

Kansas City MondashKans 183 94 160 81 4669 15 4684

Knoxville Tenn 47 72 35 52 882 5 887

Lakeland Fla 103 190 112 199 1811 21 1832

Las VegasndashParadise Nev 245 143 258 145 4616 28 4644

Little RockndashNorth Little Rock Ark 87 135 75 115 1383 14 1397

Los Angeles Calif 1529 118 1684 130 57953 293 58246

Los Angeles Division 1339 135 1435 144 51098 250 51348

Santa Anna Division 190 63 249 83 6855 43 6898

Louisville KyndashInd 123 102 97 79 2286 22 2308

Madison Wis 10 19 29 53 520 4 524

McAllenndashEdinburgndashPharr Tex 57 84 45 64 630 11 641

Memphis TennndashMissndashArk 402 320 346 271 5128 19 5147

Miami Fla 2420 446 2289 419 55807 997 56804

Fort Lauderdale Division 810 455 769 430 16412 262 16674

Miami Division 1243 523 1165 485 29703 512 30215

West Palm Beach Division 367 290 355 279 9692 223 9915

MilwaukeendashWaukeshandashWest Allis Wis 68 45 109 72 2507 18 2525

MinneapolisndashSt PaulndashBloomington MinnndashWis 186 59 184 58 4259 22 4281

Modesto Calif 36 71 22 43 671 6 677

NashvillendashDavidsonndashMurfreesboro Tenn 224 158 172 118 3848 20 3868

New HavenndashMilford Conn 169 200 107 127 4573 73 4646

New OrleansndashMetairiendashKenner La 393 299 271 264 8835 67 8902

32 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

New York NYndashNJndashPa 6215 330 5500 292 195177 2906 198083

Edison Division 191 83 130 56 6709 139 6848

Nassau Division 262 93 246 88 8141 110 8251

New York Division 5266 456 4716 408 160408 2323 162731

Newark Division 496 231 408 190 19919 334 20253

Oklahoma City Okla 125 108 88 75 2255 5 2260

OmahandashCouncil Bluffs NebndashIowa 37 46 80 97 1035 3 1038

Orlando Fla 544 282 517 260 8653 92 8745

OxnardndashThousand OaksndashVentura Calif 49 62 21 26 1008 3 1011

Palm BayndashMelbournendashTitusville Fla 68 129 61 114 1512 11 1523

Philadelphia PandashNJndashDelndashMd 1261 217 1348 231 28221 313 28534

Camden Division 108 87 111 89 3118 42 3160

Philadelphia Division 1022 263 1144 294 22112 250 22362

Wilmington Division 131 191 93 134 2991 21 3012

PhoenixndashMesandashScottsdale Ariz 460 119 376 93 7459 31 7490

Pittsburgh Pa 143 60 135 57 3182 19 3201

PortlandndashSouth Portland Maine 9 18 34 66 562 1 563

PortlandndashVancouverndashBeaverton OrendashWash 170 81 215 101 4825 10 4835

PoughkeepsiendashNewburghndashMiddletown NY 136 204 113 168 3162 24 3186

ProvidencendashNew BedfordndashFall River RIndashMass 132 82 155 96 3900 44 3944

RaleighndashCary NC 138 145 201 202 1987 13 2000

Richmond Va 119 101 122 102 3371 35 3406

RiversidendashSan BernardinondashOntario Calif 361 92 306 76 8568 60 8628

Rochester NY 165 159 124 120 3134 13 3147

SacramentondashArden-ArcadendashRoseville Calif 154 75 169 82 4000 26 4026

St Louis MondashIll 192 69 366 131 5965 40 6005

Salt Lake City Utah 46 44 40 37 1743 10 1753

San Antonio Tex 215 114 247 127 4987 30 5017

San DiegondashCarlsbadndashSan Marcos Calif 491 167 384 131 12934 61 12995

San Francisco Calif 867 209 690 165 40152 96 40248

Oakland Division 312 126 246 99 9546 48 9594

San Francisco Division 555 329 444 261 30606 48 30654

San JosendashSunnyvalendashSanta Clara Calif 88 50 145 81 3747 15 3762

San JuanndashCaguasndashGuaynabo PR 745 289 578 223 21402 277 21679

SarasotandashBradentonndashVenice Fla 82 122 104 152 1978 27 2005

ScrantonndashWilkes-Barre Pa 27 49 47 85 572 6 578

Seattle Wash 353 110 280 86 9172 27 9199

Seattle Division 316 129 255 102 8161 18 8179

Tacoma Division 37 49 25 33 1011 9 1020

Springfield Mass 88 128 45 66 2075 26 2101

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 33

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Stockton Calif 52 78 52 77 1076 15 1091

Syracuse NY 52 80 49 75 1317 8 1325

TampandashSt PetersburgndashClearwater Fla 559 211 605 224 11174 112 11286

Toledo Ohio 25 38 66 101 812 14 826

Tucson Ariz 103 111 100 106 2010 10 2020

Tulsa Okla 83 94 65 72 1494 10 1504

Virginia BeachndashNorfolkndashNewport News VandashNC 183 111 132 80 4711 63 4774

Washington DCndashVandashMdndashWV 1322 252 1684 318 31130 315 31445

Bethesda Division 135 118 173 150 2774 23 2797

Washington Division 1187 289 1511 365 28356 292 28648

Wichita Kans 35 60 38 64 851 2 853

Worcester Mass 76 97 79 101 1783 20 1803

YoungstownndashWarrenndashBoardman OhiondashPa 27 46 26 44 519 0 519

Subtotal for MSAs (population gt500000) 33602 173 31274 159 829633 8171 837804

Metropolitan areas (population of 50000 to 499999) 4477 80 4466 79 94829 847 95676

Nonmetropolitan areas 2666 54 2732 55 52063 445 52508

Totalb 41144 137 38749 128 981708 9494 991202

Note Because of the lack of census information for all US dependent areas includes data for only the 50 states the District of Columbia and Puerto RicoMSA metropolitan statistical areaMSA definitions for this report can be found at httpwwwcensusgovpopulationwwwestimatesmetrodefhtmla Reported case counts for the metropolitan divisions do not sum to the MSA total MSA total includes data from 1 metropolitan division with

population of lt500000b Includes persons whose county of residence is unknown

34 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Alabama (January 1988) 502 6041 48 6089

Alaska (February 1999) 38 285 2 287

Arizona (January 1987) 617 5877 80 5957

Arkansas (July 1989) 206 2349 20 2369

California (April 2006) 6581 7056 92 7148

Colorado (November 1985) 319 6084 31 6115

Connecticut (January 2005)b 826 2500 101 2601

Delaware (February 2006) 788 801 18 819

Florida (July 1997)c 4163 36386 397 36783

Georgia (December 2003) 2245 8197 194 8391

Idaho (June 1986) 35 340 4 344

Illinois (January 2006) 6241 6661 162 6823

Indiana (July 1988) 399 4027 43 4070

Iowa (July 1998) 69 586 5 591

Kansas (July 1999) 142 1225 15 1240

Kentucky (October 2004) 333 1303 13 1316

Louisiana (February 1993) 728 8149 166 8315

Maine (January 2006) 386 393 3 396

Michigan (April 1992) 635 6702 134 6836

Minnesota (October 1985) 309 3356 40 3396

Mississippi (August 1988) 352 4549 59 4608

Missouri (October 1987) 502 5086 55 5141

Nebraska (September 1995) 91 672 14 686

Nevada (February 1992) 339 3532 24 3556

New Hampshire (January 2005) 59 466 9 475

New Jersey (January 1992) 1477 17513 325 17838

New Mexico (January 1998) 114 949 4 953

New York (June 2000) 5326 42345 1820 44165

North Carolina (February 1990) 1615 13879 143 14022

North Dakota (January 1988) 4 82 1 83

Ohio (June 1990) 867 8222 101 8323

Oklahoma (June 1988) 229 2401 30 2431

Oregon (April 2006) 49 95 19 114

Pennsylvania (October 2002)d 4269 9537 179 9716

Rhode Island (July 2006) 14 21 0 21

South Carolina (February 1986) 493 6970 93 7063

South Dakota (January 1988) 18 215 6 221

Tennessee (January 1992) 732 7115 90 7205

Texas (January 1999)e 3370 24282 417 24699

Utah (April 1989) 106 893 14 907

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 35

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Virginia (July 1989) 864 10257 95 10352

Washington (March 2006) 4048 4157 40 4197

West Virginia (January 1989) 66 673 8 681

Wisconsin (November 1985) 261 2500 31 2531

Wyoming (June 1989) 7 93 1 94

Subtotal 50834 274822 5146 279968

US dependent areas

American Samoa (August 2001) 0 1 0 1

Guam (March 2000) 2 66 0 66

Northern Mariana Islands (October 2001) 2 7 0 7

Puerto Rico (January 2003) 1471 5610 91 5701

US Virgin Islands (December 1998) 22 247 6 253

Persons reported from areas with confidential name-based HIV infection reporting but who were residents of other areas 132 685 21 706

Totalf 52878 282640 5314 287954

Note Includes data from 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through 2006b Beginning in 1992 Connecticut had name-based HIV reporting for cases in children only From January 2002 through December 2004

Connecticut had name- or code-based HIV reporting for cases in adolescents and adults As of January 2005 Connecticut has name-based reporting of all cases of HIV infection

c Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterd On October 18 2002 Pennsylvania initiated confidential name-based HIV infection reporting in all areas except Philadelphia Code-based

reporting was implemented in Philadelphia in March 2004 and the switch to name-based reporting was made in October 2005e From February 1994 through December 1998 Texas reported HIV infection in children onlyf Includes 1252 persons reported from areas with confidential name-based HIV infection reporting but whose area of residence is unknown

36 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulativemdashUnited States and dependent areas

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No Adult or adolescentMale-to-male sexual contact 13775 49 429897 54 mdash mdash mdash mdash 13775 35 429897 44Injection drug use 3413 12 163070 21 1826 17 67693 35 5239 13 230763 23Male-to-male sexual contact and

injection drug use 1603 6 65524 8 mdash mdash mdash mdash 1603 4 65524 7Hemophiliacoagulation disorder 43 0 5176 1 11 0 348 0 54 0 5524 1High-risk heterosexual contactc 2997 11 49610 6 4839 46 85186 44 7836 20 134796 14

Sex with injection drug user 330 1 11683 1 706 7 26073 14 1036 3 37756 4Sex with bisexual male mdash mdash mdash mdash 234 2 5162 3 234 1 5162 1Sex with person with hemophilia 1 0 84 0 11 0 502 0 12 0 586 0Sex with HIV-infected transfusion

recipient 22 0 553 0 21 0 793 0 43 0 1346 0Sex with HIV-infected person risk

factor not specified 2644 9 37290 5 3867 37 52656 27 6511 17 89946 9Receipt of blood transfusion blood

d components or tissue 63 0 5213 1 68 1 4176 2 131 0 9389 1Otherrisk factor not reported or

identifiede 6484 23 73136 9 3793 36 34311 18 10278 26 107450 11Subtotal 28378 100 791626 100 10537 100 191714 100 38916 100 983343 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 0 0 222 5 0 0 7 0 0 0 229 2Mother with documented HIV infection or

1 of the following risk factors 24 75 4315 89 50 93 4423 95 74 86 8738 92Injection drug use 4 13 1676 35 4 7 1665 36 8 9 3341 35Sex with injection drug user 4 13 789 16 4 7 750 16 8 9 1539 16Sex with bisexual male 1 3 101 2 2 4 110 2 3 3 211 2Sex with person with hemophilia 0 0 20 0 0 0 16 0 0 0 36 0Sex with HIV-infected transfusion

recipient 0 0 11 0 0 0 15 0 0 0 26 0Sex with HIV-infected person risk

factor not specified 6 19 742 15 17 31 790 17 23 27 1532 16Receipt of blood transfusion blood

components or tissue 0 0 70 1 0 0 82 2 0 0 152 2Has HIV infection risk factor not

specified 9 28 906 19 23 43 995 21 32 37 1901 20Receipt of blood transfusion blood

fcomponents or tissue 1 3 243 5 0 0 144 3 1 1 387 4Otherrisk factor not reported or

identifiedg 7 22 75 2 4 7 93 2 11 13 168 2Subtotal 32 100 4855 100 54 100 4667 100 86 100 9522 100

Total 28410 100 796481 100 10591 100 196381 100 39002 100 992865 100a From the beginning of the epidemic through 2006b From the beginning of the epidemic through 2006 Includes 3 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infectiond AIDS developed in 47 adultsadolescents after they received blood that had tested negative for HIV antibodies AIDS developed in 14 additional adults

after they received tissue organs or artificial insemination from HIV-infected donors Four of the 14 received tissue or organs from a donor who was negative for HIV antibody at the time of donation

e Includes 37 adultsadolescents who were exposed to HIV-infected blood body fluids or concentrated virus in health care laboratory or household settings as supported by seroconversion epidemiologic andor laboratory evidence One person was infected after intentional inoculation with HIV-infected blood Includes an additional 740 persons who acquired HIV infection perinatally but who were more than 12 years of age when AIDS was diagnosed These 740 persons are not counted in the values for the pediatric transmission category

f AIDS developed in 3 children after they received blood that had tested negative for HIV antibodiesg Includes 5 children who were exposed to HIV-infected blood as supported by seroconversion epidemiologic andor laboratory evidence 1 child was

infected after intentional inoculation with HIV-infected blood and 5 children were exposed to HIV-infected blood in a household setting Of the 168 children 26 had sexual contact with an adult with or at high risk for HIV infection

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 37

Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No

Adult or adolescentMale-to-male sexual contact 22912 59 103679 52 mdash mdash mdash mdash 22912 44 103679 37

Injection drug use 3503 9 24255 12 2124 16 13925 17 5627 11 38181 14

Male-to-male sexual contact and injection drug use 1946 5 10704 5 mdash mdash mdash mdash 1946 4 10704 4

Hemophiliacoagulation disorder 43 0 495 0 6 0 73 0 49 0 568 0

High-risk heterosexual contactc 2874 7 16830 8 5939 45 38315 47 8813 17 55145 20

Sex with injection drug user 308 1 2601 1 757 6 6791 8 1065 2 9392 3

Sex with bisexual male mdash mdash mdash mdash 328 2 2265 3 328 1 2265 1

Sex with person with hemophilia 4 0 31 0 16 0 201 0 20 0 232 0

Sex with HIV-infected transfusion recipient 13 0 131 0 28 0 223 0 41 0 354 0

Sex with HIV-infected person risk factor not specified 2549 7 14067 7 4810 36 28835 35 7359 14 42902 15

Receipt of blood transfusion blood components or tissue 61 0 489 0 50 0 536 1 111 0 1025 0

Otherrisk factor not reported or identified 7748 20 44021 22 5106 39 29312 36 12854 25 73338 26

Subtotal 39087 100 200473 100 13225 100 82161 100 52312 100 282640 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 8 3 106 4 0 0 1 0 8 1 107 2

Mother with documented HIV infection or 1 of the following risk factors 197 74 2195 85 254 85 2417 89 451 80 4612 87

Injection drug use 34 13 532 21 53 18 561 21 87 15 1093 21

Sex with injection drug user 12 5 208 8 21 7 213 8 33 6 421 8

Sex with bisexual male 5 2 37 1 4 1 32 1 9 2 69 1

Sex with person with hemophilia 0 0 3 0 1 0 7 0 1 0 10 0

Sex with HIV-infected transfusion recipient 0 0 4 0 0 0 4 0 0 0 8 0

Sex with HIV-infected person risk factor not specified 54 20 534 21 76 25 629 23 130 23 1163 22

Receipt of blood transfusion blood components or tissue 0 0 17 1 2 1 20 1 2 0 37 1

Has HIV infection risk factor not specified 92 35 860 33 97 32 951 35 189 33 1811 34

Receipt of blood transfusion blood components or tissue 6 2 28 1 3 1 24 1 9 2 52 1

Otherrisk factor not reported or identified 55 21 260 10 43 14 283 10 98 17 543 10

Subtotal 266 100 2589 100 300 100 2725 100 566 100 5314 100

Total 39353 100 203062 100 13525 100 84886 100 52878 100 287954 100

Note See Table 16 for the list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006b From the beginning of the epidemic through December 2006 Includes 6 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infection

38 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity

2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 6251 65 253927 73Injection drug use 733 8 31737 9Male-to-male sexual contact and injection drug use 732 8 31434 9Hemophiliacoagulation disorder 26 0 3989 1High-risk heterosexual contactb 416 4 7850 2

Sex with injection drug user 74 1 2310 1

Sex with person with hemophilia 0 0 36 0

Sex with HIV-infected transfusion recipient 2 0 176 0

Sex with HIV-infected person risk factor not specified 340 4 5328 2Receipt of blood transfusion blood components or tissue 20 0 3194 1Otherrisk factor not reported or identified 1400 15 16469 5

Total 9578 100 348600 100

Black not HispanicMale-to-male sexual contact 4309 36 103297 37Injection drug use 1635 14 83369 30Male-to-male sexual contact and injection drug use 526 4 22134 8Hemophiliacoagulation disorder 10 0 604 0High-risk heterosexual contactb 1875 16 29952 11

Sex with injection drug user 167 1 6823 2Sex with person with hemophilia 1 0 36 0Sex with HIV-infected transfusion recipient 15 0 237 0Sex with HIV-infected person risk factor not specified 1692 14 22856 8

Receipt of blood transfusion blood components or tissue 24 0 1218 0Otherrisk factor not reported or identified 3579 30 40268 14

Total 11958 100 280842 100

HispanicMale-to-male sexual contact 2816 47 64893 44Injection drug use 965 16 46337 31Male-to-male sexual contact and injection drug use 287 5 10884 7Hemophiliacoagulation disorder 6 0 466 0High-risk heterosexual contactb 638 11 10950 7

Sex with injection drug user 84 1 2409 2Sex with person with hemophilia 0 0 11 0Sex with HIV-infected transfusion recipient 5 0 125 0Sex with HIV-infected person risk factor not specified 549 9 8405 6

Receipt of blood transfusion blood components or tissue 17 0 657 0Otherrisk factor not reported or identified 1326 22 14832 10

Total 6055 100 149019 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 39

a

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulative

No No

AsianPacific IslanderMale-to-male sexual contact 225 54 4475 68Injection drug use 20 5 317 5Male-to-male sexual contact and injection drug use 17 4 284 4Hemophiliacoagulation disorder 1 0 70 1High-risk heterosexual contactb 34 8 376 6

Sex with injection drug user 1 0 54 1Sex with person with hemophilia 0 0 1 0Sex with HIV-infected transfusion recipient 0 0 8 0Sex with HIV-infected person risk factor not specified 33 8 313 5

Receipt of blood transfusion blood components or tissue 2 0 112 2Otherrisk factor not reported or identified 114 28 949 14

Total 413 100 6583 100

American IndianAlaska NativeMale-to-male sexual contact 61 49 1403 55Injection drug use 15 12 395 15Male-to-male sexual contact and injection drug use 23 19 457 18Hemophiliacoagulation disorder 0 0 27 1High-risk heterosexual contactb 9 7 118 5

Sex with injection drug user 1 1 33 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 8 6 82 3

Receipt of blood transfusion blood components or tissue 0 0 8 0Otherrisk factor not reported or identified 16 13 155 6

Total 124 100 2563 100

Total casesMale-to-male sexual contact 13775 49 429897 54Injection drug use 3413 12 163070 21Male-to-male sexual contact and injection drug use 1603 6 65524 8Hemophiliacoagulation disorder 43 0 5176 1High-risk heterosexual contactb 2997 11 49610 6

Sex with injection drug user 330 1 11683 1Sex with person with hemophilia 1 0 84 0Sex with HIV-infected transfusion recipient 22 0 553 0Sex with HIV-infected person risk factor not specified 2644 9 37290 5

Receipt of blood transfusion blood components or tissue 63 0 5213 1Otherrisk factor not reported or identified 6484 23 73136 9

Total 28378c 100 791626d 100a From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 4019 males of unknown race or multiple races

40 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 11963 73 55725 69Injection drug use 858 5 5512 7Male-to-male sexual contact and injection drug use 1092 7 5578 7Hemophiliacoagulation disorder 29 0 355 0High-risk heterosexual contactb 522 3 2658 3

Sex with injection drug user 65 0 544 1Sex with person with hemophilia 0 0 8 0Sex with HIV-infected transfusion recipient 3 0 33 0Sex with HIV-infected person risk factor not specified 454 3 2073 3

Receipt of blood transfusion blood components or tissue 14 0 197 0Otherrisk factor not reported or identified 1956 12 11147 14

Total 16434 100 81172 100

Black not HispanicMale-to-male sexual contact 6203 44 30148 37Injection drug use 1594 11 11997 15Male-to-male sexual contact and injection drug use 483 3 3489 4Hemophiliacoagulation disorder 10 0 109 0High-risk heterosexual contactb 1714 12 10905 13

Sex with injection drug user 169 1 1554 2Sex with person with hemophilia 4 0 17 0Sex with HIV-infected transfusion recipient 6 0 77 0Sex with HIV-infected person risk factor not specified 1535 11 9257 11

Receipt of blood transfusion blood components or tissue 32 0 223 0Otherrisk factor not reported or identified 4151 29 24632 30

Total 14187 100 81503 100

HispanicMale-to-male sexual contact 4094 55 15623 47Injection drug use 993 13 6407 19Male-to-male sexual contact and injection drug use 316 4 1402 4Hemophiliacoagulation disorder 3 0 26 0High-risk heterosexual contactb 582 8 2963 9

Sex with injection drug user 65 1 455 1Sex with person with hemophilia 0 0 6 0Sex with HIV-infected transfusion recipient 4 0 18 0Sex with HIV-infected person risk factor not specified 513 7 2484 7

Receipt of blood transfusion blood components or tissue 11 0 55 0Otherrisk factor not reported or identified 1475 20 6977 21

Total 7474 100 33453 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 41

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderMale-to-male sexual contact 402 70 1006 63Injection drug use 17 3 55 3Male-to-male sexual contact and injection drug use 15 3 38 2Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 25 4 96 6

Sex with injection drug user 3 1 10 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 22 4 83 5

Receipt of blood transfusion blood components or tissue 4 1 7 0Otherrisk factor not reported or identified 109 19 397 25

Total 572 100 1600 100

American IndianAlaska NativeMale-to-male sexual contact 104 61 516 57Injection drug use 13 8 101 11Male-to-male sexual contact and injection drug use 19 11 110 12Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 10 6 53 6

Sex with injection drug user 2 1 14 2Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 8 5 39 4

Receipt of blood transfusion blood components or tissue 0 0 2 0Otherrisk factor not reported or identified 24 14 125 14

Total 170 100 907 100

Total casesMale-to-male sexual contact 22912 59 103679 52Injection drug use 3503 9 24255 12Male-to-male sexual contact and injection drug use 1946 5 10704 5Hemophiliacoagulation disorder 43 0 495 0High-risk heterosexual contactb 2874 7 16830 8

Sex with injection drug user 308 1 2601 1Sex with person with hemophilia 4 0 31 0Sex with HIV-infected transfusion recipient 13 0 131 0Sex with HIV-infected person risk factor not specified 2549 7 14067 7

Receipt of blood transfusion blood components or tissue 61 0 489 0Otherrisk factor not reported or identified 7748 20 44021 22

Total 39087c 100 200473d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 1838 males of unknown race or multiple races

42 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race

ethnicity 2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 482 28 14981 40Hemophiliacoagulation disorder 4 0 123 0High-risk heterosexual contactb 725 42 15799 42

Sex with injection drug user 153 9 5650 15Sex with bisexual male 63 4 1859 5Sex with person with hemophilia 5 0 329 1Sex with HIV-infected transfusion recipient 5 0 338 1Sex with HIV-infected person risk factor not specified 499 29 7623 20

Receipt of blood transfusion blood components or tissue 15 1 1870 5Otherrisk factor not reported or identified 499 29 4801 13

Total 1725 100 37574 100

Black not HispanicInjection drug use 982 15 38914 34Hemophiliacoagulation disorder 3 0 145 0High-risk heterosexual contactb 3103 46 49876 44

Sex with injection drug user 373 6 13530 12Sex with bisexual male 136 2 2352 2Sex with person with hemophilia 4 0 121 0Sex with HIV-infected transfusion recipient 8 0 277 0Sex with HIV-infected person risk factor not specified 2582 38 33596 29

Receipt of blood transfusion blood components or tissue 39 1 1546 1Otherrisk factor not reported or identified 2612 39 23894 21

Total 6739 100 114375 100

HispanicInjection drug use 322 18 12892 35Hemophiliacoagulation disorder 4 0 67 0High-risk heterosexual contactb 894 49 17995 49

Sex with injection drug user 166 9 6522 18Sex with bisexual male 32 2 818 2Sex with person with hemophilia 1 0 45 0Sex with HIV-infected transfusion recipient 7 0 141 0Sex with HIV-infected person risk factor not specified 688 38 10469 29

Receipt of blood transfusion blood components or tissue 12 1 619 2Otherrisk factor not reported or identified 592 32 5023 14

Total 1824 100 36596 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 43

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 8 8 125 12Hemophiliacoagulation disorder 0 0 7 1High-risk heterosexual contactb 49 47 574 53

Sex with injection drug user 4 4 114 11Sex with bisexual male 2 2 80 7Sex with person with hemophilia 0 0 4 0Sex with HIV-infected transfusion recipient 1 1 25 2Sex with HIV-infected person risk factor not specified 42 40 351 33

Receipt of blood transfusion blood components or tissue 1 1 93 9Otherrisk factor not reported or identified 46 44 279 26

Total 104 100 1078 100

American IndianAlaska NativeInjection drug use 13 32 280 42Hemophiliacoagulation disorder 0 0 3 0High-risk heterosexual contactb 15 37 277 41

Sex with injection drug user 4 10 107 16Sex with bisexual male 1 2 27 4Sex with person with hemophilia 0 0 2 0Sex with HIV-infected transfusion recipient 0 0 6 1Sex with HIV-infected person risk factor not specified 10 24 135 20

Receipt of blood transfusion blood components or tissue 1 2 17 3Otherrisk factor not reported or identified 12 29 95 14

Total 41 100 672 100

Total casesInjection drug use 1826 17 67693 35Hemophiliacoagulation disorder 11 0 348 0High-risk heterosexual contactb 4839 46 85186 44

Sex with injection drug user 706 7 26073 14Sex with bisexual male 234 2 5162 3Sex with person with hemophilia 11 0 502 0Sex with HIV-infected transfusion recipient 21 0 793 0Sex with HIV-infected person risk factor not specified 3867 37 52656 27

Receipt of blood transfusion blood components or tissue 68 1 4176 2Otherrisk factor not reported or identified 3793 36 34311 18

Total 10537c 100 191714d 100a From the beginning of the epidemic through 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 104 females of unknown race or multiple racesd Includes 1419 females of unknown race or multiple races

44 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 690 26 4260 26Hemophiliacoagulation disorder 3 0 24 0

bHigh-risk heterosexual contact 1132 42 7593 46Sex with injection drug user 205 8 1876 11Sex with bisexual male 98 4 659 4Sex with person with hemophilia 10 0 115 1Sex with HIV-infected transfusion recipient 7 0 64 0Sex with HIV-infected person risk factor not specified 812 30 4879 29

Receipt of blood transfusion blood components or tissue 12 0 146 1Otherrisk factor not reported or identified 850 32 4567 28

Total 2687 100 16590 100

Black not HispanicInjection drug use 1034 13 7105 14Hemophiliacoagulation disorder 1 0 35 0

bHigh-risk heterosexual contact 3451 44 23732 46Sex with injection drug user 313 4 3473 7Sex with bisexual male 155 2 1294 3Sex with person with hemophilia 5 0 71 0Sex with HIV-infected transfusion recipient 14 0 120 0Sex with HIV-infected person risk factor not specified 2964 38 18774 36

Receipt of blood transfusion blood components or tissue 26 0 324 1Otherrisk factor not reported or identified 3370 43 20244 39

Total 7882 100 51440 100

HispanicInjection drug use 339 15 2280 18Hemophiliacoagulation disorder 2 0 11 0

bHigh-risk heterosexual contact 1198 52 6264 50Sex with injection drug user 218 9 1324 11Sex with bisexual male 62 3 266 2Sex with person with hemophilia 1 0 11 0Sex with HIV-infected transfusion recipient 7 0 39 0Sex with HIV-infected person risk factor not specified 910 39 4624 37

Receipt of blood transfusion blood components or tissue 12 1 58 0Otherrisk factor not reported or identified 767 33 3843 31

Total 2318 100 12456 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 45

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 12: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

gt12 Months after diagnosis aof HIV infection

lt12 Months after diagnosis of HIV infectionb Total

No ()c No ()c No

Data for 33 statesAge at diagnosis (yrs)lt13 148 88 21 12 16913ndash14 22 54 18 46 4015ndash19 912 81 215 19 112620ndash24 2874 80 714 20 358925ndash29 3077 73 1157 27 423430ndash34 3016 65 1655 35 467135ndash39 3353 61 2176 39 553040ndash44 3181 58 2338 42 551945ndash49 2145 53 1874 47 401950ndash54 1307 51 1239 49 254655ndash59 725 50 728 50 145360ndash64 316 46 376 54 692gt65 266 44 346 56 612RaceethnicityWhite not Hispanic 6839 65 3677 35 10516Black not Hispanic 10372 62 6242 38 16614Hispanic 3593 58 2614 42 6206AsianPacific Islander 232 62 139 38 371American IndianAlaska Native 110 61 72 39 182Transmission category

Male adult or adolescentMale-to-male sexual contact 10917 65 5902 35 16819Injection drug use 1544 52 1427 48 2971Male-to-male sexual contact and injection drug use 733 59 512 41 1245High-risk heterosexual contactd 2091 54 1773 46 3864Othere 45 42 61 58 107Subtotal 15331 61 9675 39 25006Female adult or adolescentInjection drug use 1056 62 660 38 1716High-risk heterosexual contactd 4761 66 2450 34 7210Othere 47 48 50 52 97Subtotal 5864 65 3160 35 9023Child (lt13 yrs at diagnosis)Perinatal 126 86 21 14 147Otherf 22 94 2 6 23Subtotal 148 87 22 13 170

Subtotal for 33 states 21343 62 12857 38 34200Data for US dependent areas 855 61 541 39 1395

Totalg 22197 62 13398 38 35595h

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003Data exclude 39 persons whose month of diagnosis of HIV infection is unknowna Includes persons in whom AIDS has not developedb Includes persons whose diagnoses of HIV infection and AIDS were made at the same timec Percentages represent proportions of the total number of diagnoses of HIVAIDS made during 2005 for the corresponding group (see row

entries)d Heterosexual contact with a person known to have or to be at high risk for HIV infectione Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedf Includes hemophilia blood transfusion and risk factor not reported or not identifiedg Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the

column totalh Includes 310 persons of unknown race or multiple races

12 Cases of HIVAIDS and AIDS

Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas

Year of diagnosis2002 2003 2004 2005 2006 Cumulativea

Data for 50 states and the District of ColumbiaAge at diagnosis (yrs)lt13 106 70 53 53 38 915613ndash14 62 74 70 66 73 107815ndash19 316 302 334 410 401 562620ndash24 1399 1568 1624 1675 1669 3622525ndash29 3137 3059 3196 3110 3423 11709930ndash34 5701 5521 5144 4668 4349 19753035ndash39 8217 8017 7072 6479 6402 21357340ndash44 7404 7626 7703 7378 7298 17053145ndash49 5358 5617 5498 5727 5628 10720750ndash54 3271 3364 3491 3527 3687 5990755ndash59 1607 1693 1836 1861 2071 3219060ndash64 872 864 913 872 955 17303gt65 682 763 791 727 835 15074

RaceethnicityWhite not Hispanic 11233 10948 11066 10676 10929 394024Black not Hispanic 19246 19512 18909 18081 17960 409982Hispanic 6712 7102 6771 6823 6907 161505AsianPacific Islander 425 450 444 450 519 7951American IndianAlaska Native 177 176 182 170 155 3345

Transmission categoryMale adult or adolescentMale-to-male sexual contact 15709 16078 16054 15711 16001 465965Injection drug use 5483 5275 4818 4603 4410 170171Male-to-male sexual contact and injection drug use 2075 2029 1925 1930 1803 68516High-risk heterosexual contactb 4547 4471 4506 4306 4558 65241Otherc 253 226 228 237 217 13893Subtotal 28067 28079 27532 26787 26989 783786

Female adult or adolescentInjection drug use 2897 2836 2810 2586 2385 74718High-risk heterosexual contactb 6855 7336 7113 6922 7196 108252Otherc 207 217 217 205 220 6596Subtotal 9959 10389 10141 9713 9801 189566

Child (lt13 yrs at diagnosis)Perinatal 104 70 53 52 37 8508Otherd 2 0 0 0 0 636Subtotal 106 70 53 53 38 9144

Region of residenceNortheast 10092 10342 9412 9396 9486 306241Midwest 4125 4226 4089 4371 4164 101479South 17198 17630 18225 16894 17104 374800West 6718 6339 6000 5891 6074 199978Subtotal for 50 states and the District of Columbia 38132 38538 37726 36552 36828 982498

Data for US dependent areas 1058 1060 921 955 833 31217

Totale 39250 39690 38807 37662 37852 1014797Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes persons of unknown race or multiple races and persons of unknown sex Cumulative total includes 5691 persons of unknown race or multiple

races 3 persons of unknown sex 1079 persons of unknown state of residence and 3 persons who were residents of other areas Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Cases of HIVAIDS and AIDS 13

Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002ndash2006 and cumulativemdash50 states and the District of Columbia

Year of diagnosisCumulativea2002 2003 2004 2005 2006

RaceethnicityWhite not Hispanic 14 12 7 4 4 1599Black not Hispanic 70 46 33 38 30 5654Hispanic 18 10 9 8 3 1748AsianPacific Islander 1 0 1 1 1 54American IndianAlaska Native 1 0 1 0 0 31

Transmission categoryHemophiliacoagulation disorder 0 0 0 0 0 226Mother with documented HIV infection or 1 of the following risk factors 104 70 53 52 37 8508

Injection drug use 12 8 5 3 4 3220Sex with injection drug user 4 6 3 2 1 1397Sex with bisexual male 2 0 3 1 1 209Sex with person with hemophilia 0 0 0 0 0 35Sex with HIV-infected transfusion recipient 0 0 0 0 0 22Sex with HIV-infected person risk factor not specified 36 20 20 25 13 1530Receipt of blood transfusion blood components or tissue 2 1 0 0 0 144Has HIV infection risk factor not specified 47 34 21 21 17 1951

Receipt of blood transfusion blood components or tissue 2 0 0 0 0 374Otherrisk factor not reported or identified 0 0 0 0 0 36

Totalb 106 70 53 53 38 9144

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga From the beginning of the epidemic through 2006b Includes children of unknown race or multiple races Cumulative total includes 58 children of unknown race or multiple races Because column totals

were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992ndash2006mdash50 states and the District of Columbia

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reporting

14 Cases of HIVAIDS and AIDS

Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006mdash50 states and the District of Columbia

Raceethnicity

Adults or adolescents

Children (lt13 yrs) TotalaMales Females Totala

No Rate No Rate No Rate No Rate No Rate

White not Hispanic 9267 112 1659 19 10926 64 4 00 10929 54Black not Hispanic 11540 829 6391 404 17930 603 30 04 17960 476Hispanic 5388 313 1516 95 6903 208 3 00 6907 156AsianPacific Islander 423 75 95 16 518 44 1 00 519 37American IndianAlaska Native 118 122 37 36 155 78 0 00 155 62

Totalb 26989 224 9801 78 36790 149 38 01 36828c 123

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reportingData exclude cases in persons whose state or area of residence is unknown as well as cases from US dependent areas for which census information about race and age categories is lackinga Because row totals were calculated independently of the values for the subpopulations the values in each row may not sum to the row totalb Includes person of unknown race or multiple races Because column totals were calculated independently of the values for the subpopulations the

values in each column may not sum to the column totalc Includes 358 persons of unknown race or multiple races

Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006mdash33 states with confidential name-based HIV infection reporting

Raceethnicity

Adults or adolescents

Children (lt13 yrs) TotalaMales Females Totala

No Rate No Rate No Rate No Rate No Rate

White not Hispanic 9078 167 1664 29 10742 96 16 01 10758 82Black not Hispanic 11230 1191 6033 562 17263 856 93 17 17356 677Hispanic 5058 509 1400 151 6458 337 23 04 6481 255AsianPacific Islander 318 135 79 32 397 82 0 00 397 67American IndianAlaska Native 129 177 35 46 164 110 2 06 166 88

Totalb 25928 338 9252 115 35180 224 135 04 35314c 185

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Because row totals were calculated independently of the values for the subpopulations the values in each row may not sum to the row totalb Includes persons of unknown race or multiple races Because column totals were calculated independently of the values for the subpopulations the

values in each column may not sum to the column totalc Includes 156 persons of unknown race or multiple races

Cases of HIVAIDS and AIDS 15

Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006mdashUnited States and dependent areas

Transmission category

Place of birth

United StatesCentralSouth

America Cuba Mexico Puerto Rico Totala

No No No No No No

Male-to-male sexual contact 1172 45 402 49 89 62 790 59 249 18 3337 43Injection drug use 569 22 83 10 13 9 133 10 533 40 1650 21Male-to-male sexual contact

and injection drug use 158 6 25 3 6 4 59 4 63 5 357 5High-risk heterosexual

contactb 661 25 296 36 35 24 342 26 487 36 2282 30Otherc 47 2 8 1 0 0 9 1 14 1 103 1

Totald 2608 100 814 100 145 100 1334 100 1346 100 7728 100Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Includes 222 persons whose place of birth is not among those listed and 1260 persons whose place of birth is unknownb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the

column total

16 Cases of HIVAIDS and AIDS

Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas

Year of death

Cumulativea2002 2003 2004 2005 2006

Data for 50 states and the District of ColumbiaAge at death (yrs)lt13 25 22 15 7 13 4889

13ndash14 10 6 15 12 5 276

15ndash19 39 36 36 38 44 1104

20ndash24 151 157 175 147 162 8716

25ndash29 553 512 482 458 405 43671

30ndash34 1480 1272 1128 1069 785 95351

35ndash39 2967 2763 2425 2096 1682 116746

40ndash44 3595 3516 3393 3317 2636 104133

45ndash49 3294 3234 3251 3275 2886 72831

50ndash54 2318 2373 2502 2645 2343 44255

55ndash59 1209 1322 1425 1543 1480 25123

60ndash64 616 705 741 797 771 14315

gt65 691 773 807 865 805 14393

RaceethnicityWhite not Hispanic 5214 5097 4836 4758 3860 239529

Black not Hispanic 9037 8675 8581 8679 7426 218392

Hispanic 2429 2632 2641 2513 2425 80690

AsianPacific Islander 97 84 111 87 114 3426

American IndianAlaska Native 83 73 80 65 66 1693

Transmission categoryMale adult or adolescentMale-to-male sexual contact 5960 5937 5735 5641 4930 266272

Injection drug use 3738 3547 3315 3314 2641 107173

Male-to-male sexual contact and injection drug use 1278 1299 1237 1289 1064 40993

High-risk heterosexual contactb 1465 1501 1625 1571 1470 26236

Otherc 160 149 125 117 80 9867

Subtotal 12601 12431 12038 11932 10184 450541

Female adult or adolescentInjection drug use 1923 1825 1855 1768 1456 43143

High-risk heterosexual contactb 2281 2292 2373 2458 2258 42620

Otherc 84 87 72 68 70 4131

Subtotal 4289 4204 4300 4295 3784 89895

Child (lt13 yrs at diagnosis)Perinatal 53 49 56 39 42 4848

Otherd 4 5 1 2 7 521

Subtotal 57 54 57 41 48 5369

Deaths 17

Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas (cont)

Year of death

Cumulativea2002 2003 2004 2005 2006

Region of residenceNortheast 5313 5012 4779 4750 4074 180623

Midwest 1726 1666 1482 1378 1325 54468

South 7337 7427 7535 7907 6475 197209

West 2571 2585 2600 2234 2141 113506

Subtotal for 50 states and the District of Columbia 16948 16690 16395 16268 14016 545805

Data for US dependent areas 667 575 572 562 580 19858

Totale 17628 17283 16982 16865 14627 565927f

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column totalf Includes 2082 persons of unknown race or multiple races 261 persons of unknown state of residence and 2 persons who were residents

of other areas

18 Deaths

Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003ndash2006mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

2003 2004 2005 2006Data for 33 states

Age at end of year (yrs)lt13 4154 3700 3294 286713ndash14 1130 1238 1212 113915ndash19 3298 3627 4024 453920ndash24 12389 12826 13411 1430125ndash29 26167 26924 28164 2960030ndash34 49602 47577 45109 4418935ndash39 80703 77871 75842 7363440ndash44 92040 97109 100102 10176445ndash49 71345 77490 83816 9028350ndash54 45133 51033 56640 6319555ndash59 22793 26610 31186 3600860ndash64 10820 12642 14422 16658gt65 8531 9959 11657 13551

RaceethnicityWhite not Hispanic 145081 151694 158375 166000Black not Hispanic 202951 212425 221439 231957Hispanic 72612 76503 80491 84720AsianPacific Islander 2234 2529 2858 3187American IndianAlaska Native 1788 1889 2008 2119

Transmission categoryMale adult or adolescentMale-to-male sexual contact 181771 193245 205423 218676Injection drug use 57651 58149 58369 59077Male-to-male sexual contact and injection drug use 23965 24434 24725 25085High-risk heterosexual contacta 40084 42559 44915 47562Otherb 3218 3278 3325 3424Subtotal 306689 321665 336756 353825

Female adult or adolescentInjection drug use 32346 32735 32973 33470High-risk heterosexual contacta 80324 85348 90185 95403Otherb 2036 2123 2212 2321Subtotal 114705 120206 125370 131195

Child (lt13 yrs at diagnosis)Perinatal 6137 6154 6178 6143Otherc 570 575 571 560Subtotal 6707 6730 6748 6703

Subtotal for 33 states 428107 448605 468879 491727Data for US dependent areas 15809 16399 17150 17955

Totald 443916 465005 486028 509681Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 19

Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission categorymdash33 states with confidential name-based HIV infection reporting

Transmission category

White not Hispanic

Black not Hispanic Hispanic

AsianPacific Islander

American IndianAlaska

Native Totala

No No No No No No

Male adult or adolescentMale-to-male sexual contact 108259 77 70242 49 36043 57 1669 68 938 62 218676 62Injection drug use 12328 9 31339 22 14472 23 264 11 216 14 59077 17Male-to-male sexual contact

and injection drug use 11283 8 9587 7 3720 6 93 4 205 13 25085 7High-risk heterosexual contactb 6667 5 31140 22 8788 14 395 16 143 9 47562 13Otherc 1458 1 1492 1 404 1 30 1 17 1 3424 1Subtotal 139994 100 143799 100 63427 100 2450 100 1519 100 353825 100

Female adult or adolescentInjection drug use 8262 33 19136 23 5528 28 106 15 175 30 33470 26High-risk heterosexual contactb 16338 65 63204 75 14132 71 573 82 392 68 95403 73Otherc 450 2 1469 2 344 2 24 3 12 2 2321 2Subtotal 25050 100 83809 100 20004 100 703 100 578 100 131195 100

Child (lt13 yrs at diagnosis)Perinatal 801 84 4064 93 1183 92 28 82 20 95 6143 92Otherd 154 16 283 7 107 8 6 18 1 5 560 8Subtotal 955 100 4347 100 1290 100 34 100 21 100 6703 100

Totale 166000 231957 84720 3187 2119 491727Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of 33 states that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Includes 3745 persons of unknown race or multiple racesb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes 5 persons of unknown sex Because column totals were calculated independently of the values for the subpopulations the values

in each column may not sum to the column total

20 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Map 1 Estimated rates (per 100000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

Note Rates adjusted for reporting delays Rates of HIV infection include only persons living with HIV infection that has not progressed to AIDSSince 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 Islandsa Includes persons whose area of residence is unknown

Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

Note Rates adjusted for reporting delays Rates of HIV infection include only persons living with HIV infection that has not progressed to AIDSSince 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 Islandsa Includes persons whose area of residence is unknown

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 21

Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002ndash2006mdashUnited States and dependent areas

2002 2003 2004 2005 2006Data for 50 states and the District of Columbia

Age at end of year (yrs)lt13 2308 2006 1684 1394 111513ndash14 685 747 784 762 71115ndash19 1465 1694 1974 2243 248720ndash24 3910 4292 4629 5033 536725ndash29 12725 12743 13045 13505 1435930ndash34 35558 33870 32057 29949 2882435ndash39 70107 68106 65076 62235 5964940ndash44 80377 86294 91335 94021 9517445ndash49 64702 71276 77417 84153 9077550ndash54 41270 46855 53333 59256 6647655ndash59 20113 24145 28356 33522 3901460ndash64 9681 11293 13305 15380 18072gt65 7520 8946 10604 12430 14669

RaceethnicityWhite not Hispanic 129426 135278 141508 147426 154495Black not Hispanic 150488 161326 171654 181056 191590Hispanic 63424 67895 72024 76334 80815AsianPacific Islander 3060 3426 3759 4121 4526American IndianAlaska Native 1254 1356 1458 1562 1651

Transmission categoryMale adult or adolescentMale-to-male sexual contact 158092 168233 178551 188622 199693Injection drug use 56708 58436 59940 61229 62998Male-to-male sexual contact and injection drug use 24726 25457 26144 26785 27523High-risk heterosexual contacta 27329 30300 33181 35916 39004Otherb 3588 3665 3769 3888 4026Subtotal 270444 286091 301585 316440 333244

Female adult or adolescentInjection drug use 27863 28874 29828 30646 31575High-risk heterosexual contacta 46445 51489 56229 60693 65631Otherb 1903 2033 2178 2315 2465Subtotal 76210 82395 88236 93653 99671

Child (lt13 yrs at diagnosis)Perinatal 3633 3654 3651 3664 3660Otherc 129 124 123 122 115Subtotal 3762 3778 3774 3786 3775

Region of residenceNortheast 105599 110929 115562 120208 125620Midwest 36011 38571 41178 44171 47010South 137081 147284 157975 166962 177591West 71729 75483 78883 82540 86473

Subtotal for 50 states and the District of Columbia 350419 372267 393598 413882 436693

Data for US dependent areas 9880 10365 10713 11106 11359

Totald 360617 383024 404849 425646 448871Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

22 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission categorymdash50 states and the District of Columbia

Transmission category

White not Hispanic

Black not Hispanic Hispanic

AsianPacific Islander

American IndianAlaska

Native Totala

No No No No No No

Male adult or adolescentMale-to-male sexual contact 101299 75 57520 45 36087 57 2715 72 704 57 199693 60Injection drug use 13168 10 33911 27 14795 23 325 9 201 16 62998 19Male-to-male sexual contact and

injection drug use 12393 9 10121 8 4352 7 198 5 220 18 27523 8High-risk heterosexual contactb 6081 5 24205 19 7816 12 444 12 105 8 39004 12Otherc 1743 1 1602 1 574 1 69 2 16 1 4026 1Subtotal 134683 100 127359 100 63623 100 3752 100 1246 100 333244 100

Female adult or adolescentInjection drug use 7407 38 18531 30 5025 30 115 15 153 39 31575 32High-risk heterosexual contactb 11350 59 41741 68 11092 67 588 78 227 58 65631 66Otherc 508 3 1456 2 413 2 51 7 13 3 2465 2Subtotal 19264 100 61728 100 16531 100 753 100 393 100 99671 100

Child (lt13 yrs at diagnosis)Perinatal 500 92 2468 99 629 95 20 94 12 100 3660 97Otherd 46 8 34 1 33 5 1 6 0 0 115 3Subtotal 546 100 2503 100 662 100 21 100 12 100 3775 100

Totale 154495 191590 80815 4526 1651 436693

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Includes 3616 persons of unknown race or multiple racesb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes 3 person of unknown sex Because column totals were calculated independently of the values for the subpopulations the values in each column

may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 23

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by

area of residence and age categorymdashUnited States and dependent areas

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

Alabama 5469 17 5486 3744 11 3755Alaska 272 1 273 330 1 331Arizona 5744 49 5793 4922 7 4929Arkansas 2291 7 2298 2139 6 2145California mdash mdash mdash 61451 105 61555Colorado 5855 13 5869 4083 2 4085Connecticut mdash mdash mdash 7406 15 7421Delaware mdash mdash mdash 1753 7 1760District of Columbia mdash mdash mdash 10059 30 10089Floridab 35461 263 35723 46469 194 46663Georgia mdash mdash mdash 17336 47 17383Hawaii mdash mdash mdash 1234 3 1237Idaho 356 0 356 313 0 313Illinois mdash mdash mdash 16139 46 16185Indiana 3849 21 3870 3996 14 4010Iowa 588 2 590 869 3 872Kansas 1230 7 1237 1272 2 1274Kentucky mdash mdash mdash 2589 13 2602Louisiana 7361 101 7462 8052 21 8074Maine mdash mdash mdash 512 2 514Maryland mdash mdash mdash 14540 41 14581Massachusetts mdash mdash mdash 8806 20 8826Michigan 6118 55 6173 6615 12 6627Minnesota 3227 21 3248 2314 9 2323Mississippi 4200 32 4232 3155 13 3168Missouri 4999 33 5033 5479 7 5486Montana mdash mdash mdash 205 0 205Nebraska 688 12 700 771 2 773Nevada 3402 13 3415 2969 3 2972New Hampshire mdash mdash mdash 556 3 559New Jersey 16059 153 16212 17168 57 17226New Mexico 910 0 909 1252 3 1255New York 42220 801 43021 70697 148 70845North Carolina 11700 60 11760 8451 12 8463North Dakota 87 2 89 73 1 74Ohio 8266 57 8323 7054 30 7084Oklahoma 2191 17 2208 2191 3 2194Oregon mdash mdash mdash 2840 4 2844Pennsylvania mdash mdash mdash 18633 71 18703Rhode Island mdash mdash mdash 1296 7 1303South Carolina 6349 45 6394 7035 23 7058South Dakota 195 4 199 139 1 140Tennessee 6579 51 6631 6403 11 6414Texas 24741 262 25003 34010 53 34063Utah 893 10 903 1164 0 1164Vermont mdash mdash mdash 238 2 240Virginia 9937 41 9978 8423 24 8447Washington mdash mdash mdash 5471 5 5476West Virginia 660 5 665 749 5 754Wisconsin 2322 15 2337 2153 12 2165Wyoming 86 2 88 102 1 103

Subtotal 224303 2174 226477 435621 1115 436736

24 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age categorymdashUnited States and dependent areas (cont)

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

US dependent areasAmerican Samoa 2 0 2 1 0 1Guam 63 0 63 36 0 36Northern Mariana Islands 7 0 7 3 0 3Puerto Rico 6269 31 6300 10971 26 10997US Virgin Islands 228 2 230 312 2 314Otherc mdash mdash mdash 1 0 1

Totald 230872 2207 233079 447724 1147 448871

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reporting a See Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at

least 2003b Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterc Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasd Total number of persons living with HIV infection (not AIDS) includes persons reported from areas with confidential name-based HIV

infection reporting who were residents of other states or whose area of residence is unknown Total number of persons living with AIDS includes persons whose area of residence is unknown Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 25

Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristicsmdashUnited States and dependent areas

No of persons

Survival in months

gt12 gt24 gt36Data for 50 states and the District of Columbia

Age at diagnosis (yrs)lt13 101 096 094 09413ndash14 60 098 098 09515ndash19 305 098 096 09520ndash24 1351 096 093 09225ndash29 3034 095 092 09130ndash34 5499 094 091 08935ndash39 7888 093 090 08740ndash44 7085 092 088 08545ndash49 5090 089 085 08250ndash54 3067 086 081 07855ndash59 1505 083 078 07460ndash64 806 080 073 069gt65 614 073 068 065

RaceethnicityWhite not Hispanic 10706 092 089 087Black not Hispanic 18406 090 086 082Hispanic 6398 092 090 088AsianPacific Islander 404 094 092 090American IndianAlaska Native 167 084 081 075

Transmission categoryMale adult or adolescentMale-to-male sexual contact 12830 093 090 088Injection drug use 4048 089 084 081Male-to-male sexual contact and injection drug use 1701 093 089 086High-risk heterosexual contacta 3170 091 088 085Otherb 5019 086 083 080Subtotal 26768 091 088 085

Female adult or adolescentInjection drug use 2101 089 083 078High-risk heterosexual contacta 4686 093 089 086Otherb 2749 090 085 083Subtotal 9536 091 087 083

Child (lt13 yrs at diagnosis)Perinatal 98 096 095 095Otherc 3 100 067 067Subtotal 101 096 094 094

Subtotal for 50 states and the District of Columbia 36405 091 087 085

Data for US dependent areas 891 083 078 075

Total 37352d 091 087 084Note Excludes persons whose date of death was before or in the same month as date of diagnosis Excludes persons whose month of diagnosis or month of death is unknowna Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes 325 persons of unknown race or multiple races

26 Survival after AIDS Diagnosis

Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by year of diagnosismdashUnited States and dependent areas

Months after AIDS diagnosis

Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by age groupmdashUnited States and dependent areas

Months after AIDS diagnosis

Survival after AIDS Diagnosis 27

Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by raceethnicitymdashUnited States and dependent areas

Months after AIDS diagnosis

28 Survival after AIDS Diagnosis

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006

and cumulativemdashUnited States and dependent areas

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Alabama 510 112 462 100 8626 76 8702Alaska 24 36 38 57 648 7 655Arizona 626 105 539 87 10396 46 10442Arkansas 237 85 252 90 3891 36 3927California 4069 113 3960 109 142254 664 142918Colorado 351 75 322 68 8742 31 8773Connecticut 658 188 422 120 14716 183 14899Delaware 177 210 116 136 3547 26 3573District of Columbia 672 1155 853 1467 17372 189 17561Florida 4921 277 4932 273 104084 1530 105614Georgia 2325 255 1605 171 31734 231 31965Hawaii 105 82 93 72 2927 17 2944Idaho 24 17 26 18 604 2 606Illinois 1886 148 1382 108 33620 282 33902Indiana 407 65 346 55 8239 56 8295Iowa 93 31 86 29 1727 13 1740Kansas 105 38 120 43 2781 14 2795Kentucky 249 60 207 49 4600 32 4632Louisiana 936 208 824 192 17612 128 17740Maine 21 16 68 51 1110 8 1118Maryland 1558 279 1626 290 30252 319 30571Massachusetts 666 104 533 83 19181 214 19395Michigan 821 81 672 67 14941 113 15054Minnesota 226 44 212 41 4817 28 4845Mississippi 368 127 365 125 6642 56 6698Missouri 385 66 469 80 11016 61 11077Montana 21 22 7 07 373 3 376Nebraska 53 30 118 67 1479 11 1490Nevada 293 121 294 118 5733 29 5762New Hampshire 33 25 55 42 1074 10 1084New Jersey 1262 145 1065 122 48750 778 49528New Mexico 134 70 93 48 2603 7 2610New York 6201 321 5495 285 174908 2354 177262North Carolina 916 106 1229 139 15954 118 16072North Dakota 10 16 6 09 144 1 145Ohio 753 66 767 67 14957 138 15095Oklahoma 281 79 205 57 4836 26 4862Oregon 217 60 281 76 5995 20 6015Pennsylvania 1486 120 1893 152 33417 365 33782Rhode Island 87 81 111 104 2580 28 2608South Carolina 682 161 705 163 13301 105 13406South Dakota 18 23 18 23 255 5 260Tennessee 818 137 680 113 12457 59 12516Texas 3045 133 2998 128 69735 392 70127Utah 63 25 57 22 2295 20 2315Vermont 5 08 18 29 461 6 467Virginia 638 84 605 79 16802 177 16979Washington 485 77 389 61 11792 34 11826West Virginia 74 41 67 37 1500 11 1511Wisconsin 122 22 217 39 4513 33 4546Wyoming 6 12 8 16 228 2 230

Subtotal 40123 135 37911 127 952221 9094 961315

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 29

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulativemdashUnited States and dependent areas (cont)

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

US dependent areasAmerican Samoa 0 0 0 0 1 0 1Guam 0 0 0 0 68 1 69Northern Mariana Islands 0 0 0 0 3 0 3Puerto Rico 1029 263 850 216 29511 400 29911US Virgin Islands 17 156 32 295 629 18 647Otherb 0 0 0 0 3 0 3

Totalc 41357 138 39002 129 983343 9522 992865d

a From the beginning of the epidemic through 2006b Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasc Includes persons whose state or area of residence is unknownd Includes 916 persons whose state or area of residence is unknown

30 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

MSA (population gt 500000)

Akron Ohio 66 94 32 46 762 1 763

AlbanyndashSchenectadyndashTroy NY 97 114 105 123 2253 24 2277

Albuquerque N Mex 70 88 50 61 1404 2 1406

AllentownndashBethlehemndashEaston PandashNJ 72 91 119 149 1352 17 1369

AtlantandashSandy SpringsndashMarietta Ga 1586 319 1006 196 21896 128 22024

AugustandashRichmond County GandashSC 106 205 32 61 1851 24 1875

AustinndashRound Rock Tex 227 156 186 123 4830 26 4856

Bakersfield Calif 76 100 122 156 1528 8 1536

BaltimorendashTowson Md 1064 401 1001 377 20352 218 20570

Baton Rouge La 222 304 231 301 3732 20 3752

BirminghamndashHoover Ala 151 139 110 100 2614 25 2639

Boise CityndashNampa Idaho 14 26 14 25 281 0 281

Boston MassndashNHa 441 99 355 80 13476 147 13623

Boston Division 269 146 185 101 8451 91 8542

Cambridge Division 108 74 102 70 3126 35 3161

Essex Division 52 71 51 69 1577 20 1597

BridgeportndashStamfordndashNorwalk Conn 181 201 135 150 3733 57 3790

BuffalondashNiagara Falls NY 117 102 96 84 2476 20 2496

Cape CoralndashFort Myers Fla 44 81 91 159 1692 24 1716

CharlestonndashNorth Charleston SC 92 155 91 151 2034 18 2052

CharlottendashGastoniandashConcord NCndashSC 214 141 285 180 3242 22 3264

Chicago IllndashIndndashWis 1716 182 1159 122 30118 261 30379

Chicago Division 1604 203 1073 135 28300 248 28548

Gary Division 61 88 50 71 1038 8 1046

Lake Division 51 59 36 41 780 5 785

CincinnatindashMiddletown OhiondashKyndashInd 111 53 199 95 2735 17 2752

ClevelandndashElyriandashMentor Ohio 228 107 170 80 4226 48 4274

Colorado Springs Colo 19 32 21 35 576 5 581

Columbia SC 177 256 197 280 3274 24 3298

Columbus Ohio 166 97 165 96 3112 15 3127

Dallas Tex 874 150 929 155 20238 63 20301

Dallas Division 681 175 714 178 16038 37 16075

Fort Worth Division 193 100 215 108 4200 26 4226

Dayton Ohio 58 69 54 64 1217 15 1232

DenverndashAurora Colo 274 116 236 98 6899 22 6921

Des Moines Iowa 30 57 23 43 530 4 534

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 31

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Detroit Mich 570 127 445 100 10373 73 10446

Detroit Division 443 223 330 167 8268 57 8325

Warren Division 127 51 115 46 2105 16 2121

El Paso Tex 56 78 40 54 1476 10 1486

Fresno Calif 52 59 64 72 1430 11 1441

Grand RapidsndashWyoming Mich 46 60 51 66 816 6 822

GreensborondashHigh Point NC 52 77 66 96 1265 14 1279

Greenville SC 70 119 67 111 1292 4 1296

HarrisburgndashCarlisle Pa 23 44 67 128 1224 8 1232

HartfordndashWest HartfordndashEast Hartford Conn 256 216 135 114 5126 46 5172

Honolulu Hawaii 54 60 69 76 2121 14 2135

HoustonndashBaytownndashSugar Land Tex 1017 190 1092 197 25821 172 25993

Indianapolis Ind 191 116 150 90 3824 25 3849

Jackson Miss 134 257 117 221 2419 30 2449

Jacksonville Fla 309 248 315 246 6020 75 6095

Kansas City MondashKans 183 94 160 81 4669 15 4684

Knoxville Tenn 47 72 35 52 882 5 887

Lakeland Fla 103 190 112 199 1811 21 1832

Las VegasndashParadise Nev 245 143 258 145 4616 28 4644

Little RockndashNorth Little Rock Ark 87 135 75 115 1383 14 1397

Los Angeles Calif 1529 118 1684 130 57953 293 58246

Los Angeles Division 1339 135 1435 144 51098 250 51348

Santa Anna Division 190 63 249 83 6855 43 6898

Louisville KyndashInd 123 102 97 79 2286 22 2308

Madison Wis 10 19 29 53 520 4 524

McAllenndashEdinburgndashPharr Tex 57 84 45 64 630 11 641

Memphis TennndashMissndashArk 402 320 346 271 5128 19 5147

Miami Fla 2420 446 2289 419 55807 997 56804

Fort Lauderdale Division 810 455 769 430 16412 262 16674

Miami Division 1243 523 1165 485 29703 512 30215

West Palm Beach Division 367 290 355 279 9692 223 9915

MilwaukeendashWaukeshandashWest Allis Wis 68 45 109 72 2507 18 2525

MinneapolisndashSt PaulndashBloomington MinnndashWis 186 59 184 58 4259 22 4281

Modesto Calif 36 71 22 43 671 6 677

NashvillendashDavidsonndashMurfreesboro Tenn 224 158 172 118 3848 20 3868

New HavenndashMilford Conn 169 200 107 127 4573 73 4646

New OrleansndashMetairiendashKenner La 393 299 271 264 8835 67 8902

32 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

New York NYndashNJndashPa 6215 330 5500 292 195177 2906 198083

Edison Division 191 83 130 56 6709 139 6848

Nassau Division 262 93 246 88 8141 110 8251

New York Division 5266 456 4716 408 160408 2323 162731

Newark Division 496 231 408 190 19919 334 20253

Oklahoma City Okla 125 108 88 75 2255 5 2260

OmahandashCouncil Bluffs NebndashIowa 37 46 80 97 1035 3 1038

Orlando Fla 544 282 517 260 8653 92 8745

OxnardndashThousand OaksndashVentura Calif 49 62 21 26 1008 3 1011

Palm BayndashMelbournendashTitusville Fla 68 129 61 114 1512 11 1523

Philadelphia PandashNJndashDelndashMd 1261 217 1348 231 28221 313 28534

Camden Division 108 87 111 89 3118 42 3160

Philadelphia Division 1022 263 1144 294 22112 250 22362

Wilmington Division 131 191 93 134 2991 21 3012

PhoenixndashMesandashScottsdale Ariz 460 119 376 93 7459 31 7490

Pittsburgh Pa 143 60 135 57 3182 19 3201

PortlandndashSouth Portland Maine 9 18 34 66 562 1 563

PortlandndashVancouverndashBeaverton OrendashWash 170 81 215 101 4825 10 4835

PoughkeepsiendashNewburghndashMiddletown NY 136 204 113 168 3162 24 3186

ProvidencendashNew BedfordndashFall River RIndashMass 132 82 155 96 3900 44 3944

RaleighndashCary NC 138 145 201 202 1987 13 2000

Richmond Va 119 101 122 102 3371 35 3406

RiversidendashSan BernardinondashOntario Calif 361 92 306 76 8568 60 8628

Rochester NY 165 159 124 120 3134 13 3147

SacramentondashArden-ArcadendashRoseville Calif 154 75 169 82 4000 26 4026

St Louis MondashIll 192 69 366 131 5965 40 6005

Salt Lake City Utah 46 44 40 37 1743 10 1753

San Antonio Tex 215 114 247 127 4987 30 5017

San DiegondashCarlsbadndashSan Marcos Calif 491 167 384 131 12934 61 12995

San Francisco Calif 867 209 690 165 40152 96 40248

Oakland Division 312 126 246 99 9546 48 9594

San Francisco Division 555 329 444 261 30606 48 30654

San JosendashSunnyvalendashSanta Clara Calif 88 50 145 81 3747 15 3762

San JuanndashCaguasndashGuaynabo PR 745 289 578 223 21402 277 21679

SarasotandashBradentonndashVenice Fla 82 122 104 152 1978 27 2005

ScrantonndashWilkes-Barre Pa 27 49 47 85 572 6 578

Seattle Wash 353 110 280 86 9172 27 9199

Seattle Division 316 129 255 102 8161 18 8179

Tacoma Division 37 49 25 33 1011 9 1020

Springfield Mass 88 128 45 66 2075 26 2101

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 33

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Stockton Calif 52 78 52 77 1076 15 1091

Syracuse NY 52 80 49 75 1317 8 1325

TampandashSt PetersburgndashClearwater Fla 559 211 605 224 11174 112 11286

Toledo Ohio 25 38 66 101 812 14 826

Tucson Ariz 103 111 100 106 2010 10 2020

Tulsa Okla 83 94 65 72 1494 10 1504

Virginia BeachndashNorfolkndashNewport News VandashNC 183 111 132 80 4711 63 4774

Washington DCndashVandashMdndashWV 1322 252 1684 318 31130 315 31445

Bethesda Division 135 118 173 150 2774 23 2797

Washington Division 1187 289 1511 365 28356 292 28648

Wichita Kans 35 60 38 64 851 2 853

Worcester Mass 76 97 79 101 1783 20 1803

YoungstownndashWarrenndashBoardman OhiondashPa 27 46 26 44 519 0 519

Subtotal for MSAs (population gt500000) 33602 173 31274 159 829633 8171 837804

Metropolitan areas (population of 50000 to 499999) 4477 80 4466 79 94829 847 95676

Nonmetropolitan areas 2666 54 2732 55 52063 445 52508

Totalb 41144 137 38749 128 981708 9494 991202

Note Because of the lack of census information for all US dependent areas includes data for only the 50 states the District of Columbia and Puerto RicoMSA metropolitan statistical areaMSA definitions for this report can be found at httpwwwcensusgovpopulationwwwestimatesmetrodefhtmla Reported case counts for the metropolitan divisions do not sum to the MSA total MSA total includes data from 1 metropolitan division with

population of lt500000b Includes persons whose county of residence is unknown

34 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Alabama (January 1988) 502 6041 48 6089

Alaska (February 1999) 38 285 2 287

Arizona (January 1987) 617 5877 80 5957

Arkansas (July 1989) 206 2349 20 2369

California (April 2006) 6581 7056 92 7148

Colorado (November 1985) 319 6084 31 6115

Connecticut (January 2005)b 826 2500 101 2601

Delaware (February 2006) 788 801 18 819

Florida (July 1997)c 4163 36386 397 36783

Georgia (December 2003) 2245 8197 194 8391

Idaho (June 1986) 35 340 4 344

Illinois (January 2006) 6241 6661 162 6823

Indiana (July 1988) 399 4027 43 4070

Iowa (July 1998) 69 586 5 591

Kansas (July 1999) 142 1225 15 1240

Kentucky (October 2004) 333 1303 13 1316

Louisiana (February 1993) 728 8149 166 8315

Maine (January 2006) 386 393 3 396

Michigan (April 1992) 635 6702 134 6836

Minnesota (October 1985) 309 3356 40 3396

Mississippi (August 1988) 352 4549 59 4608

Missouri (October 1987) 502 5086 55 5141

Nebraska (September 1995) 91 672 14 686

Nevada (February 1992) 339 3532 24 3556

New Hampshire (January 2005) 59 466 9 475

New Jersey (January 1992) 1477 17513 325 17838

New Mexico (January 1998) 114 949 4 953

New York (June 2000) 5326 42345 1820 44165

North Carolina (February 1990) 1615 13879 143 14022

North Dakota (January 1988) 4 82 1 83

Ohio (June 1990) 867 8222 101 8323

Oklahoma (June 1988) 229 2401 30 2431

Oregon (April 2006) 49 95 19 114

Pennsylvania (October 2002)d 4269 9537 179 9716

Rhode Island (July 2006) 14 21 0 21

South Carolina (February 1986) 493 6970 93 7063

South Dakota (January 1988) 18 215 6 221

Tennessee (January 1992) 732 7115 90 7205

Texas (January 1999)e 3370 24282 417 24699

Utah (April 1989) 106 893 14 907

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 35

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Virginia (July 1989) 864 10257 95 10352

Washington (March 2006) 4048 4157 40 4197

West Virginia (January 1989) 66 673 8 681

Wisconsin (November 1985) 261 2500 31 2531

Wyoming (June 1989) 7 93 1 94

Subtotal 50834 274822 5146 279968

US dependent areas

American Samoa (August 2001) 0 1 0 1

Guam (March 2000) 2 66 0 66

Northern Mariana Islands (October 2001) 2 7 0 7

Puerto Rico (January 2003) 1471 5610 91 5701

US Virgin Islands (December 1998) 22 247 6 253

Persons reported from areas with confidential name-based HIV infection reporting but who were residents of other areas 132 685 21 706

Totalf 52878 282640 5314 287954

Note Includes data from 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through 2006b Beginning in 1992 Connecticut had name-based HIV reporting for cases in children only From January 2002 through December 2004

Connecticut had name- or code-based HIV reporting for cases in adolescents and adults As of January 2005 Connecticut has name-based reporting of all cases of HIV infection

c Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterd On October 18 2002 Pennsylvania initiated confidential name-based HIV infection reporting in all areas except Philadelphia Code-based

reporting was implemented in Philadelphia in March 2004 and the switch to name-based reporting was made in October 2005e From February 1994 through December 1998 Texas reported HIV infection in children onlyf Includes 1252 persons reported from areas with confidential name-based HIV infection reporting but whose area of residence is unknown

36 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulativemdashUnited States and dependent areas

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No Adult or adolescentMale-to-male sexual contact 13775 49 429897 54 mdash mdash mdash mdash 13775 35 429897 44Injection drug use 3413 12 163070 21 1826 17 67693 35 5239 13 230763 23Male-to-male sexual contact and

injection drug use 1603 6 65524 8 mdash mdash mdash mdash 1603 4 65524 7Hemophiliacoagulation disorder 43 0 5176 1 11 0 348 0 54 0 5524 1High-risk heterosexual contactc 2997 11 49610 6 4839 46 85186 44 7836 20 134796 14

Sex with injection drug user 330 1 11683 1 706 7 26073 14 1036 3 37756 4Sex with bisexual male mdash mdash mdash mdash 234 2 5162 3 234 1 5162 1Sex with person with hemophilia 1 0 84 0 11 0 502 0 12 0 586 0Sex with HIV-infected transfusion

recipient 22 0 553 0 21 0 793 0 43 0 1346 0Sex with HIV-infected person risk

factor not specified 2644 9 37290 5 3867 37 52656 27 6511 17 89946 9Receipt of blood transfusion blood

d components or tissue 63 0 5213 1 68 1 4176 2 131 0 9389 1Otherrisk factor not reported or

identifiede 6484 23 73136 9 3793 36 34311 18 10278 26 107450 11Subtotal 28378 100 791626 100 10537 100 191714 100 38916 100 983343 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 0 0 222 5 0 0 7 0 0 0 229 2Mother with documented HIV infection or

1 of the following risk factors 24 75 4315 89 50 93 4423 95 74 86 8738 92Injection drug use 4 13 1676 35 4 7 1665 36 8 9 3341 35Sex with injection drug user 4 13 789 16 4 7 750 16 8 9 1539 16Sex with bisexual male 1 3 101 2 2 4 110 2 3 3 211 2Sex with person with hemophilia 0 0 20 0 0 0 16 0 0 0 36 0Sex with HIV-infected transfusion

recipient 0 0 11 0 0 0 15 0 0 0 26 0Sex with HIV-infected person risk

factor not specified 6 19 742 15 17 31 790 17 23 27 1532 16Receipt of blood transfusion blood

components or tissue 0 0 70 1 0 0 82 2 0 0 152 2Has HIV infection risk factor not

specified 9 28 906 19 23 43 995 21 32 37 1901 20Receipt of blood transfusion blood

fcomponents or tissue 1 3 243 5 0 0 144 3 1 1 387 4Otherrisk factor not reported or

identifiedg 7 22 75 2 4 7 93 2 11 13 168 2Subtotal 32 100 4855 100 54 100 4667 100 86 100 9522 100

Total 28410 100 796481 100 10591 100 196381 100 39002 100 992865 100a From the beginning of the epidemic through 2006b From the beginning of the epidemic through 2006 Includes 3 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infectiond AIDS developed in 47 adultsadolescents after they received blood that had tested negative for HIV antibodies AIDS developed in 14 additional adults

after they received tissue organs or artificial insemination from HIV-infected donors Four of the 14 received tissue or organs from a donor who was negative for HIV antibody at the time of donation

e Includes 37 adultsadolescents who were exposed to HIV-infected blood body fluids or concentrated virus in health care laboratory or household settings as supported by seroconversion epidemiologic andor laboratory evidence One person was infected after intentional inoculation with HIV-infected blood Includes an additional 740 persons who acquired HIV infection perinatally but who were more than 12 years of age when AIDS was diagnosed These 740 persons are not counted in the values for the pediatric transmission category

f AIDS developed in 3 children after they received blood that had tested negative for HIV antibodiesg Includes 5 children who were exposed to HIV-infected blood as supported by seroconversion epidemiologic andor laboratory evidence 1 child was

infected after intentional inoculation with HIV-infected blood and 5 children were exposed to HIV-infected blood in a household setting Of the 168 children 26 had sexual contact with an adult with or at high risk for HIV infection

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 37

Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No

Adult or adolescentMale-to-male sexual contact 22912 59 103679 52 mdash mdash mdash mdash 22912 44 103679 37

Injection drug use 3503 9 24255 12 2124 16 13925 17 5627 11 38181 14

Male-to-male sexual contact and injection drug use 1946 5 10704 5 mdash mdash mdash mdash 1946 4 10704 4

Hemophiliacoagulation disorder 43 0 495 0 6 0 73 0 49 0 568 0

High-risk heterosexual contactc 2874 7 16830 8 5939 45 38315 47 8813 17 55145 20

Sex with injection drug user 308 1 2601 1 757 6 6791 8 1065 2 9392 3

Sex with bisexual male mdash mdash mdash mdash 328 2 2265 3 328 1 2265 1

Sex with person with hemophilia 4 0 31 0 16 0 201 0 20 0 232 0

Sex with HIV-infected transfusion recipient 13 0 131 0 28 0 223 0 41 0 354 0

Sex with HIV-infected person risk factor not specified 2549 7 14067 7 4810 36 28835 35 7359 14 42902 15

Receipt of blood transfusion blood components or tissue 61 0 489 0 50 0 536 1 111 0 1025 0

Otherrisk factor not reported or identified 7748 20 44021 22 5106 39 29312 36 12854 25 73338 26

Subtotal 39087 100 200473 100 13225 100 82161 100 52312 100 282640 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 8 3 106 4 0 0 1 0 8 1 107 2

Mother with documented HIV infection or 1 of the following risk factors 197 74 2195 85 254 85 2417 89 451 80 4612 87

Injection drug use 34 13 532 21 53 18 561 21 87 15 1093 21

Sex with injection drug user 12 5 208 8 21 7 213 8 33 6 421 8

Sex with bisexual male 5 2 37 1 4 1 32 1 9 2 69 1

Sex with person with hemophilia 0 0 3 0 1 0 7 0 1 0 10 0

Sex with HIV-infected transfusion recipient 0 0 4 0 0 0 4 0 0 0 8 0

Sex with HIV-infected person risk factor not specified 54 20 534 21 76 25 629 23 130 23 1163 22

Receipt of blood transfusion blood components or tissue 0 0 17 1 2 1 20 1 2 0 37 1

Has HIV infection risk factor not specified 92 35 860 33 97 32 951 35 189 33 1811 34

Receipt of blood transfusion blood components or tissue 6 2 28 1 3 1 24 1 9 2 52 1

Otherrisk factor not reported or identified 55 21 260 10 43 14 283 10 98 17 543 10

Subtotal 266 100 2589 100 300 100 2725 100 566 100 5314 100

Total 39353 100 203062 100 13525 100 84886 100 52878 100 287954 100

Note See Table 16 for the list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006b From the beginning of the epidemic through December 2006 Includes 6 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infection

38 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity

2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 6251 65 253927 73Injection drug use 733 8 31737 9Male-to-male sexual contact and injection drug use 732 8 31434 9Hemophiliacoagulation disorder 26 0 3989 1High-risk heterosexual contactb 416 4 7850 2

Sex with injection drug user 74 1 2310 1

Sex with person with hemophilia 0 0 36 0

Sex with HIV-infected transfusion recipient 2 0 176 0

Sex with HIV-infected person risk factor not specified 340 4 5328 2Receipt of blood transfusion blood components or tissue 20 0 3194 1Otherrisk factor not reported or identified 1400 15 16469 5

Total 9578 100 348600 100

Black not HispanicMale-to-male sexual contact 4309 36 103297 37Injection drug use 1635 14 83369 30Male-to-male sexual contact and injection drug use 526 4 22134 8Hemophiliacoagulation disorder 10 0 604 0High-risk heterosexual contactb 1875 16 29952 11

Sex with injection drug user 167 1 6823 2Sex with person with hemophilia 1 0 36 0Sex with HIV-infected transfusion recipient 15 0 237 0Sex with HIV-infected person risk factor not specified 1692 14 22856 8

Receipt of blood transfusion blood components or tissue 24 0 1218 0Otherrisk factor not reported or identified 3579 30 40268 14

Total 11958 100 280842 100

HispanicMale-to-male sexual contact 2816 47 64893 44Injection drug use 965 16 46337 31Male-to-male sexual contact and injection drug use 287 5 10884 7Hemophiliacoagulation disorder 6 0 466 0High-risk heterosexual contactb 638 11 10950 7

Sex with injection drug user 84 1 2409 2Sex with person with hemophilia 0 0 11 0Sex with HIV-infected transfusion recipient 5 0 125 0Sex with HIV-infected person risk factor not specified 549 9 8405 6

Receipt of blood transfusion blood components or tissue 17 0 657 0Otherrisk factor not reported or identified 1326 22 14832 10

Total 6055 100 149019 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 39

a

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulative

No No

AsianPacific IslanderMale-to-male sexual contact 225 54 4475 68Injection drug use 20 5 317 5Male-to-male sexual contact and injection drug use 17 4 284 4Hemophiliacoagulation disorder 1 0 70 1High-risk heterosexual contactb 34 8 376 6

Sex with injection drug user 1 0 54 1Sex with person with hemophilia 0 0 1 0Sex with HIV-infected transfusion recipient 0 0 8 0Sex with HIV-infected person risk factor not specified 33 8 313 5

Receipt of blood transfusion blood components or tissue 2 0 112 2Otherrisk factor not reported or identified 114 28 949 14

Total 413 100 6583 100

American IndianAlaska NativeMale-to-male sexual contact 61 49 1403 55Injection drug use 15 12 395 15Male-to-male sexual contact and injection drug use 23 19 457 18Hemophiliacoagulation disorder 0 0 27 1High-risk heterosexual contactb 9 7 118 5

Sex with injection drug user 1 1 33 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 8 6 82 3

Receipt of blood transfusion blood components or tissue 0 0 8 0Otherrisk factor not reported or identified 16 13 155 6

Total 124 100 2563 100

Total casesMale-to-male sexual contact 13775 49 429897 54Injection drug use 3413 12 163070 21Male-to-male sexual contact and injection drug use 1603 6 65524 8Hemophiliacoagulation disorder 43 0 5176 1High-risk heterosexual contactb 2997 11 49610 6

Sex with injection drug user 330 1 11683 1Sex with person with hemophilia 1 0 84 0Sex with HIV-infected transfusion recipient 22 0 553 0Sex with HIV-infected person risk factor not specified 2644 9 37290 5

Receipt of blood transfusion blood components or tissue 63 0 5213 1Otherrisk factor not reported or identified 6484 23 73136 9

Total 28378c 100 791626d 100a From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 4019 males of unknown race or multiple races

40 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 11963 73 55725 69Injection drug use 858 5 5512 7Male-to-male sexual contact and injection drug use 1092 7 5578 7Hemophiliacoagulation disorder 29 0 355 0High-risk heterosexual contactb 522 3 2658 3

Sex with injection drug user 65 0 544 1Sex with person with hemophilia 0 0 8 0Sex with HIV-infected transfusion recipient 3 0 33 0Sex with HIV-infected person risk factor not specified 454 3 2073 3

Receipt of blood transfusion blood components or tissue 14 0 197 0Otherrisk factor not reported or identified 1956 12 11147 14

Total 16434 100 81172 100

Black not HispanicMale-to-male sexual contact 6203 44 30148 37Injection drug use 1594 11 11997 15Male-to-male sexual contact and injection drug use 483 3 3489 4Hemophiliacoagulation disorder 10 0 109 0High-risk heterosexual contactb 1714 12 10905 13

Sex with injection drug user 169 1 1554 2Sex with person with hemophilia 4 0 17 0Sex with HIV-infected transfusion recipient 6 0 77 0Sex with HIV-infected person risk factor not specified 1535 11 9257 11

Receipt of blood transfusion blood components or tissue 32 0 223 0Otherrisk factor not reported or identified 4151 29 24632 30

Total 14187 100 81503 100

HispanicMale-to-male sexual contact 4094 55 15623 47Injection drug use 993 13 6407 19Male-to-male sexual contact and injection drug use 316 4 1402 4Hemophiliacoagulation disorder 3 0 26 0High-risk heterosexual contactb 582 8 2963 9

Sex with injection drug user 65 1 455 1Sex with person with hemophilia 0 0 6 0Sex with HIV-infected transfusion recipient 4 0 18 0Sex with HIV-infected person risk factor not specified 513 7 2484 7

Receipt of blood transfusion blood components or tissue 11 0 55 0Otherrisk factor not reported or identified 1475 20 6977 21

Total 7474 100 33453 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 41

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderMale-to-male sexual contact 402 70 1006 63Injection drug use 17 3 55 3Male-to-male sexual contact and injection drug use 15 3 38 2Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 25 4 96 6

Sex with injection drug user 3 1 10 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 22 4 83 5

Receipt of blood transfusion blood components or tissue 4 1 7 0Otherrisk factor not reported or identified 109 19 397 25

Total 572 100 1600 100

American IndianAlaska NativeMale-to-male sexual contact 104 61 516 57Injection drug use 13 8 101 11Male-to-male sexual contact and injection drug use 19 11 110 12Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 10 6 53 6

Sex with injection drug user 2 1 14 2Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 8 5 39 4

Receipt of blood transfusion blood components or tissue 0 0 2 0Otherrisk factor not reported or identified 24 14 125 14

Total 170 100 907 100

Total casesMale-to-male sexual contact 22912 59 103679 52Injection drug use 3503 9 24255 12Male-to-male sexual contact and injection drug use 1946 5 10704 5Hemophiliacoagulation disorder 43 0 495 0High-risk heterosexual contactb 2874 7 16830 8

Sex with injection drug user 308 1 2601 1Sex with person with hemophilia 4 0 31 0Sex with HIV-infected transfusion recipient 13 0 131 0Sex with HIV-infected person risk factor not specified 2549 7 14067 7

Receipt of blood transfusion blood components or tissue 61 0 489 0Otherrisk factor not reported or identified 7748 20 44021 22

Total 39087c 100 200473d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 1838 males of unknown race or multiple races

42 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race

ethnicity 2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 482 28 14981 40Hemophiliacoagulation disorder 4 0 123 0High-risk heterosexual contactb 725 42 15799 42

Sex with injection drug user 153 9 5650 15Sex with bisexual male 63 4 1859 5Sex with person with hemophilia 5 0 329 1Sex with HIV-infected transfusion recipient 5 0 338 1Sex with HIV-infected person risk factor not specified 499 29 7623 20

Receipt of blood transfusion blood components or tissue 15 1 1870 5Otherrisk factor not reported or identified 499 29 4801 13

Total 1725 100 37574 100

Black not HispanicInjection drug use 982 15 38914 34Hemophiliacoagulation disorder 3 0 145 0High-risk heterosexual contactb 3103 46 49876 44

Sex with injection drug user 373 6 13530 12Sex with bisexual male 136 2 2352 2Sex with person with hemophilia 4 0 121 0Sex with HIV-infected transfusion recipient 8 0 277 0Sex with HIV-infected person risk factor not specified 2582 38 33596 29

Receipt of blood transfusion blood components or tissue 39 1 1546 1Otherrisk factor not reported or identified 2612 39 23894 21

Total 6739 100 114375 100

HispanicInjection drug use 322 18 12892 35Hemophiliacoagulation disorder 4 0 67 0High-risk heterosexual contactb 894 49 17995 49

Sex with injection drug user 166 9 6522 18Sex with bisexual male 32 2 818 2Sex with person with hemophilia 1 0 45 0Sex with HIV-infected transfusion recipient 7 0 141 0Sex with HIV-infected person risk factor not specified 688 38 10469 29

Receipt of blood transfusion blood components or tissue 12 1 619 2Otherrisk factor not reported or identified 592 32 5023 14

Total 1824 100 36596 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 43

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 8 8 125 12Hemophiliacoagulation disorder 0 0 7 1High-risk heterosexual contactb 49 47 574 53

Sex with injection drug user 4 4 114 11Sex with bisexual male 2 2 80 7Sex with person with hemophilia 0 0 4 0Sex with HIV-infected transfusion recipient 1 1 25 2Sex with HIV-infected person risk factor not specified 42 40 351 33

Receipt of blood transfusion blood components or tissue 1 1 93 9Otherrisk factor not reported or identified 46 44 279 26

Total 104 100 1078 100

American IndianAlaska NativeInjection drug use 13 32 280 42Hemophiliacoagulation disorder 0 0 3 0High-risk heterosexual contactb 15 37 277 41

Sex with injection drug user 4 10 107 16Sex with bisexual male 1 2 27 4Sex with person with hemophilia 0 0 2 0Sex with HIV-infected transfusion recipient 0 0 6 1Sex with HIV-infected person risk factor not specified 10 24 135 20

Receipt of blood transfusion blood components or tissue 1 2 17 3Otherrisk factor not reported or identified 12 29 95 14

Total 41 100 672 100

Total casesInjection drug use 1826 17 67693 35Hemophiliacoagulation disorder 11 0 348 0High-risk heterosexual contactb 4839 46 85186 44

Sex with injection drug user 706 7 26073 14Sex with bisexual male 234 2 5162 3Sex with person with hemophilia 11 0 502 0Sex with HIV-infected transfusion recipient 21 0 793 0Sex with HIV-infected person risk factor not specified 3867 37 52656 27

Receipt of blood transfusion blood components or tissue 68 1 4176 2Otherrisk factor not reported or identified 3793 36 34311 18

Total 10537c 100 191714d 100a From the beginning of the epidemic through 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 104 females of unknown race or multiple racesd Includes 1419 females of unknown race or multiple races

44 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 690 26 4260 26Hemophiliacoagulation disorder 3 0 24 0

bHigh-risk heterosexual contact 1132 42 7593 46Sex with injection drug user 205 8 1876 11Sex with bisexual male 98 4 659 4Sex with person with hemophilia 10 0 115 1Sex with HIV-infected transfusion recipient 7 0 64 0Sex with HIV-infected person risk factor not specified 812 30 4879 29

Receipt of blood transfusion blood components or tissue 12 0 146 1Otherrisk factor not reported or identified 850 32 4567 28

Total 2687 100 16590 100

Black not HispanicInjection drug use 1034 13 7105 14Hemophiliacoagulation disorder 1 0 35 0

bHigh-risk heterosexual contact 3451 44 23732 46Sex with injection drug user 313 4 3473 7Sex with bisexual male 155 2 1294 3Sex with person with hemophilia 5 0 71 0Sex with HIV-infected transfusion recipient 14 0 120 0Sex with HIV-infected person risk factor not specified 2964 38 18774 36

Receipt of blood transfusion blood components or tissue 26 0 324 1Otherrisk factor not reported or identified 3370 43 20244 39

Total 7882 100 51440 100

HispanicInjection drug use 339 15 2280 18Hemophiliacoagulation disorder 2 0 11 0

bHigh-risk heterosexual contact 1198 52 6264 50Sex with injection drug user 218 9 1324 11Sex with bisexual male 62 3 266 2Sex with person with hemophilia 1 0 11 0Sex with HIV-infected transfusion recipient 7 0 39 0Sex with HIV-infected person risk factor not specified 910 39 4624 37

Receipt of blood transfusion blood components or tissue 12 1 58 0Otherrisk factor not reported or identified 767 33 3843 31

Total 2318 100 12456 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 45

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 13: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas

Year of diagnosis2002 2003 2004 2005 2006 Cumulativea

Data for 50 states and the District of ColumbiaAge at diagnosis (yrs)lt13 106 70 53 53 38 915613ndash14 62 74 70 66 73 107815ndash19 316 302 334 410 401 562620ndash24 1399 1568 1624 1675 1669 3622525ndash29 3137 3059 3196 3110 3423 11709930ndash34 5701 5521 5144 4668 4349 19753035ndash39 8217 8017 7072 6479 6402 21357340ndash44 7404 7626 7703 7378 7298 17053145ndash49 5358 5617 5498 5727 5628 10720750ndash54 3271 3364 3491 3527 3687 5990755ndash59 1607 1693 1836 1861 2071 3219060ndash64 872 864 913 872 955 17303gt65 682 763 791 727 835 15074

RaceethnicityWhite not Hispanic 11233 10948 11066 10676 10929 394024Black not Hispanic 19246 19512 18909 18081 17960 409982Hispanic 6712 7102 6771 6823 6907 161505AsianPacific Islander 425 450 444 450 519 7951American IndianAlaska Native 177 176 182 170 155 3345

Transmission categoryMale adult or adolescentMale-to-male sexual contact 15709 16078 16054 15711 16001 465965Injection drug use 5483 5275 4818 4603 4410 170171Male-to-male sexual contact and injection drug use 2075 2029 1925 1930 1803 68516High-risk heterosexual contactb 4547 4471 4506 4306 4558 65241Otherc 253 226 228 237 217 13893Subtotal 28067 28079 27532 26787 26989 783786

Female adult or adolescentInjection drug use 2897 2836 2810 2586 2385 74718High-risk heterosexual contactb 6855 7336 7113 6922 7196 108252Otherc 207 217 217 205 220 6596Subtotal 9959 10389 10141 9713 9801 189566

Child (lt13 yrs at diagnosis)Perinatal 104 70 53 52 37 8508Otherd 2 0 0 0 0 636Subtotal 106 70 53 53 38 9144

Region of residenceNortheast 10092 10342 9412 9396 9486 306241Midwest 4125 4226 4089 4371 4164 101479South 17198 17630 18225 16894 17104 374800West 6718 6339 6000 5891 6074 199978Subtotal for 50 states and the District of Columbia 38132 38538 37726 36552 36828 982498

Data for US dependent areas 1058 1060 921 955 833 31217

Totale 39250 39690 38807 37662 37852 1014797Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes persons of unknown race or multiple races and persons of unknown sex Cumulative total includes 5691 persons of unknown race or multiple

races 3 persons of unknown sex 1079 persons of unknown state of residence and 3 persons who were residents of other areas Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Cases of HIVAIDS and AIDS 13

Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002ndash2006 and cumulativemdash50 states and the District of Columbia

Year of diagnosisCumulativea2002 2003 2004 2005 2006

RaceethnicityWhite not Hispanic 14 12 7 4 4 1599Black not Hispanic 70 46 33 38 30 5654Hispanic 18 10 9 8 3 1748AsianPacific Islander 1 0 1 1 1 54American IndianAlaska Native 1 0 1 0 0 31

Transmission categoryHemophiliacoagulation disorder 0 0 0 0 0 226Mother with documented HIV infection or 1 of the following risk factors 104 70 53 52 37 8508

Injection drug use 12 8 5 3 4 3220Sex with injection drug user 4 6 3 2 1 1397Sex with bisexual male 2 0 3 1 1 209Sex with person with hemophilia 0 0 0 0 0 35Sex with HIV-infected transfusion recipient 0 0 0 0 0 22Sex with HIV-infected person risk factor not specified 36 20 20 25 13 1530Receipt of blood transfusion blood components or tissue 2 1 0 0 0 144Has HIV infection risk factor not specified 47 34 21 21 17 1951

Receipt of blood transfusion blood components or tissue 2 0 0 0 0 374Otherrisk factor not reported or identified 0 0 0 0 0 36

Totalb 106 70 53 53 38 9144

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga From the beginning of the epidemic through 2006b Includes children of unknown race or multiple races Cumulative total includes 58 children of unknown race or multiple races Because column totals

were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992ndash2006mdash50 states and the District of Columbia

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reporting

14 Cases of HIVAIDS and AIDS

Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006mdash50 states and the District of Columbia

Raceethnicity

Adults or adolescents

Children (lt13 yrs) TotalaMales Females Totala

No Rate No Rate No Rate No Rate No Rate

White not Hispanic 9267 112 1659 19 10926 64 4 00 10929 54Black not Hispanic 11540 829 6391 404 17930 603 30 04 17960 476Hispanic 5388 313 1516 95 6903 208 3 00 6907 156AsianPacific Islander 423 75 95 16 518 44 1 00 519 37American IndianAlaska Native 118 122 37 36 155 78 0 00 155 62

Totalb 26989 224 9801 78 36790 149 38 01 36828c 123

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reportingData exclude cases in persons whose state or area of residence is unknown as well as cases from US dependent areas for which census information about race and age categories is lackinga Because row totals were calculated independently of the values for the subpopulations the values in each row may not sum to the row totalb Includes person of unknown race or multiple races Because column totals were calculated independently of the values for the subpopulations the

values in each column may not sum to the column totalc Includes 358 persons of unknown race or multiple races

Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006mdash33 states with confidential name-based HIV infection reporting

Raceethnicity

Adults or adolescents

Children (lt13 yrs) TotalaMales Females Totala

No Rate No Rate No Rate No Rate No Rate

White not Hispanic 9078 167 1664 29 10742 96 16 01 10758 82Black not Hispanic 11230 1191 6033 562 17263 856 93 17 17356 677Hispanic 5058 509 1400 151 6458 337 23 04 6481 255AsianPacific Islander 318 135 79 32 397 82 0 00 397 67American IndianAlaska Native 129 177 35 46 164 110 2 06 166 88

Totalb 25928 338 9252 115 35180 224 135 04 35314c 185

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Because row totals were calculated independently of the values for the subpopulations the values in each row may not sum to the row totalb Includes persons of unknown race or multiple races Because column totals were calculated independently of the values for the subpopulations the

values in each column may not sum to the column totalc Includes 156 persons of unknown race or multiple races

Cases of HIVAIDS and AIDS 15

Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006mdashUnited States and dependent areas

Transmission category

Place of birth

United StatesCentralSouth

America Cuba Mexico Puerto Rico Totala

No No No No No No

Male-to-male sexual contact 1172 45 402 49 89 62 790 59 249 18 3337 43Injection drug use 569 22 83 10 13 9 133 10 533 40 1650 21Male-to-male sexual contact

and injection drug use 158 6 25 3 6 4 59 4 63 5 357 5High-risk heterosexual

contactb 661 25 296 36 35 24 342 26 487 36 2282 30Otherc 47 2 8 1 0 0 9 1 14 1 103 1

Totald 2608 100 814 100 145 100 1334 100 1346 100 7728 100Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Includes 222 persons whose place of birth is not among those listed and 1260 persons whose place of birth is unknownb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the

column total

16 Cases of HIVAIDS and AIDS

Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas

Year of death

Cumulativea2002 2003 2004 2005 2006

Data for 50 states and the District of ColumbiaAge at death (yrs)lt13 25 22 15 7 13 4889

13ndash14 10 6 15 12 5 276

15ndash19 39 36 36 38 44 1104

20ndash24 151 157 175 147 162 8716

25ndash29 553 512 482 458 405 43671

30ndash34 1480 1272 1128 1069 785 95351

35ndash39 2967 2763 2425 2096 1682 116746

40ndash44 3595 3516 3393 3317 2636 104133

45ndash49 3294 3234 3251 3275 2886 72831

50ndash54 2318 2373 2502 2645 2343 44255

55ndash59 1209 1322 1425 1543 1480 25123

60ndash64 616 705 741 797 771 14315

gt65 691 773 807 865 805 14393

RaceethnicityWhite not Hispanic 5214 5097 4836 4758 3860 239529

Black not Hispanic 9037 8675 8581 8679 7426 218392

Hispanic 2429 2632 2641 2513 2425 80690

AsianPacific Islander 97 84 111 87 114 3426

American IndianAlaska Native 83 73 80 65 66 1693

Transmission categoryMale adult or adolescentMale-to-male sexual contact 5960 5937 5735 5641 4930 266272

Injection drug use 3738 3547 3315 3314 2641 107173

Male-to-male sexual contact and injection drug use 1278 1299 1237 1289 1064 40993

High-risk heterosexual contactb 1465 1501 1625 1571 1470 26236

Otherc 160 149 125 117 80 9867

Subtotal 12601 12431 12038 11932 10184 450541

Female adult or adolescentInjection drug use 1923 1825 1855 1768 1456 43143

High-risk heterosexual contactb 2281 2292 2373 2458 2258 42620

Otherc 84 87 72 68 70 4131

Subtotal 4289 4204 4300 4295 3784 89895

Child (lt13 yrs at diagnosis)Perinatal 53 49 56 39 42 4848

Otherd 4 5 1 2 7 521

Subtotal 57 54 57 41 48 5369

Deaths 17

Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas (cont)

Year of death

Cumulativea2002 2003 2004 2005 2006

Region of residenceNortheast 5313 5012 4779 4750 4074 180623

Midwest 1726 1666 1482 1378 1325 54468

South 7337 7427 7535 7907 6475 197209

West 2571 2585 2600 2234 2141 113506

Subtotal for 50 states and the District of Columbia 16948 16690 16395 16268 14016 545805

Data for US dependent areas 667 575 572 562 580 19858

Totale 17628 17283 16982 16865 14627 565927f

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column totalf Includes 2082 persons of unknown race or multiple races 261 persons of unknown state of residence and 2 persons who were residents

of other areas

18 Deaths

Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003ndash2006mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

2003 2004 2005 2006Data for 33 states

Age at end of year (yrs)lt13 4154 3700 3294 286713ndash14 1130 1238 1212 113915ndash19 3298 3627 4024 453920ndash24 12389 12826 13411 1430125ndash29 26167 26924 28164 2960030ndash34 49602 47577 45109 4418935ndash39 80703 77871 75842 7363440ndash44 92040 97109 100102 10176445ndash49 71345 77490 83816 9028350ndash54 45133 51033 56640 6319555ndash59 22793 26610 31186 3600860ndash64 10820 12642 14422 16658gt65 8531 9959 11657 13551

RaceethnicityWhite not Hispanic 145081 151694 158375 166000Black not Hispanic 202951 212425 221439 231957Hispanic 72612 76503 80491 84720AsianPacific Islander 2234 2529 2858 3187American IndianAlaska Native 1788 1889 2008 2119

Transmission categoryMale adult or adolescentMale-to-male sexual contact 181771 193245 205423 218676Injection drug use 57651 58149 58369 59077Male-to-male sexual contact and injection drug use 23965 24434 24725 25085High-risk heterosexual contacta 40084 42559 44915 47562Otherb 3218 3278 3325 3424Subtotal 306689 321665 336756 353825

Female adult or adolescentInjection drug use 32346 32735 32973 33470High-risk heterosexual contacta 80324 85348 90185 95403Otherb 2036 2123 2212 2321Subtotal 114705 120206 125370 131195

Child (lt13 yrs at diagnosis)Perinatal 6137 6154 6178 6143Otherc 570 575 571 560Subtotal 6707 6730 6748 6703

Subtotal for 33 states 428107 448605 468879 491727Data for US dependent areas 15809 16399 17150 17955

Totald 443916 465005 486028 509681Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 19

Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission categorymdash33 states with confidential name-based HIV infection reporting

Transmission category

White not Hispanic

Black not Hispanic Hispanic

AsianPacific Islander

American IndianAlaska

Native Totala

No No No No No No

Male adult or adolescentMale-to-male sexual contact 108259 77 70242 49 36043 57 1669 68 938 62 218676 62Injection drug use 12328 9 31339 22 14472 23 264 11 216 14 59077 17Male-to-male sexual contact

and injection drug use 11283 8 9587 7 3720 6 93 4 205 13 25085 7High-risk heterosexual contactb 6667 5 31140 22 8788 14 395 16 143 9 47562 13Otherc 1458 1 1492 1 404 1 30 1 17 1 3424 1Subtotal 139994 100 143799 100 63427 100 2450 100 1519 100 353825 100

Female adult or adolescentInjection drug use 8262 33 19136 23 5528 28 106 15 175 30 33470 26High-risk heterosexual contactb 16338 65 63204 75 14132 71 573 82 392 68 95403 73Otherc 450 2 1469 2 344 2 24 3 12 2 2321 2Subtotal 25050 100 83809 100 20004 100 703 100 578 100 131195 100

Child (lt13 yrs at diagnosis)Perinatal 801 84 4064 93 1183 92 28 82 20 95 6143 92Otherd 154 16 283 7 107 8 6 18 1 5 560 8Subtotal 955 100 4347 100 1290 100 34 100 21 100 6703 100

Totale 166000 231957 84720 3187 2119 491727Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of 33 states that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Includes 3745 persons of unknown race or multiple racesb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes 5 persons of unknown sex Because column totals were calculated independently of the values for the subpopulations the values

in each column may not sum to the column total

20 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Map 1 Estimated rates (per 100000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

Note Rates adjusted for reporting delays Rates of HIV infection include only persons living with HIV infection that has not progressed to AIDSSince 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 Islandsa Includes persons whose area of residence is unknown

Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

Note Rates adjusted for reporting delays Rates of HIV infection include only persons living with HIV infection that has not progressed to AIDSSince 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 Islandsa Includes persons whose area of residence is unknown

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 21

Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002ndash2006mdashUnited States and dependent areas

2002 2003 2004 2005 2006Data for 50 states and the District of Columbia

Age at end of year (yrs)lt13 2308 2006 1684 1394 111513ndash14 685 747 784 762 71115ndash19 1465 1694 1974 2243 248720ndash24 3910 4292 4629 5033 536725ndash29 12725 12743 13045 13505 1435930ndash34 35558 33870 32057 29949 2882435ndash39 70107 68106 65076 62235 5964940ndash44 80377 86294 91335 94021 9517445ndash49 64702 71276 77417 84153 9077550ndash54 41270 46855 53333 59256 6647655ndash59 20113 24145 28356 33522 3901460ndash64 9681 11293 13305 15380 18072gt65 7520 8946 10604 12430 14669

RaceethnicityWhite not Hispanic 129426 135278 141508 147426 154495Black not Hispanic 150488 161326 171654 181056 191590Hispanic 63424 67895 72024 76334 80815AsianPacific Islander 3060 3426 3759 4121 4526American IndianAlaska Native 1254 1356 1458 1562 1651

Transmission categoryMale adult or adolescentMale-to-male sexual contact 158092 168233 178551 188622 199693Injection drug use 56708 58436 59940 61229 62998Male-to-male sexual contact and injection drug use 24726 25457 26144 26785 27523High-risk heterosexual contacta 27329 30300 33181 35916 39004Otherb 3588 3665 3769 3888 4026Subtotal 270444 286091 301585 316440 333244

Female adult or adolescentInjection drug use 27863 28874 29828 30646 31575High-risk heterosexual contacta 46445 51489 56229 60693 65631Otherb 1903 2033 2178 2315 2465Subtotal 76210 82395 88236 93653 99671

Child (lt13 yrs at diagnosis)Perinatal 3633 3654 3651 3664 3660Otherc 129 124 123 122 115Subtotal 3762 3778 3774 3786 3775

Region of residenceNortheast 105599 110929 115562 120208 125620Midwest 36011 38571 41178 44171 47010South 137081 147284 157975 166962 177591West 71729 75483 78883 82540 86473

Subtotal for 50 states and the District of Columbia 350419 372267 393598 413882 436693

Data for US dependent areas 9880 10365 10713 11106 11359

Totald 360617 383024 404849 425646 448871Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

22 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission categorymdash50 states and the District of Columbia

Transmission category

White not Hispanic

Black not Hispanic Hispanic

AsianPacific Islander

American IndianAlaska

Native Totala

No No No No No No

Male adult or adolescentMale-to-male sexual contact 101299 75 57520 45 36087 57 2715 72 704 57 199693 60Injection drug use 13168 10 33911 27 14795 23 325 9 201 16 62998 19Male-to-male sexual contact and

injection drug use 12393 9 10121 8 4352 7 198 5 220 18 27523 8High-risk heterosexual contactb 6081 5 24205 19 7816 12 444 12 105 8 39004 12Otherc 1743 1 1602 1 574 1 69 2 16 1 4026 1Subtotal 134683 100 127359 100 63623 100 3752 100 1246 100 333244 100

Female adult or adolescentInjection drug use 7407 38 18531 30 5025 30 115 15 153 39 31575 32High-risk heterosexual contactb 11350 59 41741 68 11092 67 588 78 227 58 65631 66Otherc 508 3 1456 2 413 2 51 7 13 3 2465 2Subtotal 19264 100 61728 100 16531 100 753 100 393 100 99671 100

Child (lt13 yrs at diagnosis)Perinatal 500 92 2468 99 629 95 20 94 12 100 3660 97Otherd 46 8 34 1 33 5 1 6 0 0 115 3Subtotal 546 100 2503 100 662 100 21 100 12 100 3775 100

Totale 154495 191590 80815 4526 1651 436693

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Includes 3616 persons of unknown race or multiple racesb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes 3 person of unknown sex Because column totals were calculated independently of the values for the subpopulations the values in each column

may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 23

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by

area of residence and age categorymdashUnited States and dependent areas

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

Alabama 5469 17 5486 3744 11 3755Alaska 272 1 273 330 1 331Arizona 5744 49 5793 4922 7 4929Arkansas 2291 7 2298 2139 6 2145California mdash mdash mdash 61451 105 61555Colorado 5855 13 5869 4083 2 4085Connecticut mdash mdash mdash 7406 15 7421Delaware mdash mdash mdash 1753 7 1760District of Columbia mdash mdash mdash 10059 30 10089Floridab 35461 263 35723 46469 194 46663Georgia mdash mdash mdash 17336 47 17383Hawaii mdash mdash mdash 1234 3 1237Idaho 356 0 356 313 0 313Illinois mdash mdash mdash 16139 46 16185Indiana 3849 21 3870 3996 14 4010Iowa 588 2 590 869 3 872Kansas 1230 7 1237 1272 2 1274Kentucky mdash mdash mdash 2589 13 2602Louisiana 7361 101 7462 8052 21 8074Maine mdash mdash mdash 512 2 514Maryland mdash mdash mdash 14540 41 14581Massachusetts mdash mdash mdash 8806 20 8826Michigan 6118 55 6173 6615 12 6627Minnesota 3227 21 3248 2314 9 2323Mississippi 4200 32 4232 3155 13 3168Missouri 4999 33 5033 5479 7 5486Montana mdash mdash mdash 205 0 205Nebraska 688 12 700 771 2 773Nevada 3402 13 3415 2969 3 2972New Hampshire mdash mdash mdash 556 3 559New Jersey 16059 153 16212 17168 57 17226New Mexico 910 0 909 1252 3 1255New York 42220 801 43021 70697 148 70845North Carolina 11700 60 11760 8451 12 8463North Dakota 87 2 89 73 1 74Ohio 8266 57 8323 7054 30 7084Oklahoma 2191 17 2208 2191 3 2194Oregon mdash mdash mdash 2840 4 2844Pennsylvania mdash mdash mdash 18633 71 18703Rhode Island mdash mdash mdash 1296 7 1303South Carolina 6349 45 6394 7035 23 7058South Dakota 195 4 199 139 1 140Tennessee 6579 51 6631 6403 11 6414Texas 24741 262 25003 34010 53 34063Utah 893 10 903 1164 0 1164Vermont mdash mdash mdash 238 2 240Virginia 9937 41 9978 8423 24 8447Washington mdash mdash mdash 5471 5 5476West Virginia 660 5 665 749 5 754Wisconsin 2322 15 2337 2153 12 2165Wyoming 86 2 88 102 1 103

Subtotal 224303 2174 226477 435621 1115 436736

24 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age categorymdashUnited States and dependent areas (cont)

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

US dependent areasAmerican Samoa 2 0 2 1 0 1Guam 63 0 63 36 0 36Northern Mariana Islands 7 0 7 3 0 3Puerto Rico 6269 31 6300 10971 26 10997US Virgin Islands 228 2 230 312 2 314Otherc mdash mdash mdash 1 0 1

Totald 230872 2207 233079 447724 1147 448871

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reporting a See Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at

least 2003b Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterc Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasd Total number of persons living with HIV infection (not AIDS) includes persons reported from areas with confidential name-based HIV

infection reporting who were residents of other states or whose area of residence is unknown Total number of persons living with AIDS includes persons whose area of residence is unknown Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 25

Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristicsmdashUnited States and dependent areas

No of persons

Survival in months

gt12 gt24 gt36Data for 50 states and the District of Columbia

Age at diagnosis (yrs)lt13 101 096 094 09413ndash14 60 098 098 09515ndash19 305 098 096 09520ndash24 1351 096 093 09225ndash29 3034 095 092 09130ndash34 5499 094 091 08935ndash39 7888 093 090 08740ndash44 7085 092 088 08545ndash49 5090 089 085 08250ndash54 3067 086 081 07855ndash59 1505 083 078 07460ndash64 806 080 073 069gt65 614 073 068 065

RaceethnicityWhite not Hispanic 10706 092 089 087Black not Hispanic 18406 090 086 082Hispanic 6398 092 090 088AsianPacific Islander 404 094 092 090American IndianAlaska Native 167 084 081 075

Transmission categoryMale adult or adolescentMale-to-male sexual contact 12830 093 090 088Injection drug use 4048 089 084 081Male-to-male sexual contact and injection drug use 1701 093 089 086High-risk heterosexual contacta 3170 091 088 085Otherb 5019 086 083 080Subtotal 26768 091 088 085

Female adult or adolescentInjection drug use 2101 089 083 078High-risk heterosexual contacta 4686 093 089 086Otherb 2749 090 085 083Subtotal 9536 091 087 083

Child (lt13 yrs at diagnosis)Perinatal 98 096 095 095Otherc 3 100 067 067Subtotal 101 096 094 094

Subtotal for 50 states and the District of Columbia 36405 091 087 085

Data for US dependent areas 891 083 078 075

Total 37352d 091 087 084Note Excludes persons whose date of death was before or in the same month as date of diagnosis Excludes persons whose month of diagnosis or month of death is unknowna Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes 325 persons of unknown race or multiple races

26 Survival after AIDS Diagnosis

Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by year of diagnosismdashUnited States and dependent areas

Months after AIDS diagnosis

Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by age groupmdashUnited States and dependent areas

Months after AIDS diagnosis

Survival after AIDS Diagnosis 27

Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by raceethnicitymdashUnited States and dependent areas

Months after AIDS diagnosis

28 Survival after AIDS Diagnosis

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006

and cumulativemdashUnited States and dependent areas

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Alabama 510 112 462 100 8626 76 8702Alaska 24 36 38 57 648 7 655Arizona 626 105 539 87 10396 46 10442Arkansas 237 85 252 90 3891 36 3927California 4069 113 3960 109 142254 664 142918Colorado 351 75 322 68 8742 31 8773Connecticut 658 188 422 120 14716 183 14899Delaware 177 210 116 136 3547 26 3573District of Columbia 672 1155 853 1467 17372 189 17561Florida 4921 277 4932 273 104084 1530 105614Georgia 2325 255 1605 171 31734 231 31965Hawaii 105 82 93 72 2927 17 2944Idaho 24 17 26 18 604 2 606Illinois 1886 148 1382 108 33620 282 33902Indiana 407 65 346 55 8239 56 8295Iowa 93 31 86 29 1727 13 1740Kansas 105 38 120 43 2781 14 2795Kentucky 249 60 207 49 4600 32 4632Louisiana 936 208 824 192 17612 128 17740Maine 21 16 68 51 1110 8 1118Maryland 1558 279 1626 290 30252 319 30571Massachusetts 666 104 533 83 19181 214 19395Michigan 821 81 672 67 14941 113 15054Minnesota 226 44 212 41 4817 28 4845Mississippi 368 127 365 125 6642 56 6698Missouri 385 66 469 80 11016 61 11077Montana 21 22 7 07 373 3 376Nebraska 53 30 118 67 1479 11 1490Nevada 293 121 294 118 5733 29 5762New Hampshire 33 25 55 42 1074 10 1084New Jersey 1262 145 1065 122 48750 778 49528New Mexico 134 70 93 48 2603 7 2610New York 6201 321 5495 285 174908 2354 177262North Carolina 916 106 1229 139 15954 118 16072North Dakota 10 16 6 09 144 1 145Ohio 753 66 767 67 14957 138 15095Oklahoma 281 79 205 57 4836 26 4862Oregon 217 60 281 76 5995 20 6015Pennsylvania 1486 120 1893 152 33417 365 33782Rhode Island 87 81 111 104 2580 28 2608South Carolina 682 161 705 163 13301 105 13406South Dakota 18 23 18 23 255 5 260Tennessee 818 137 680 113 12457 59 12516Texas 3045 133 2998 128 69735 392 70127Utah 63 25 57 22 2295 20 2315Vermont 5 08 18 29 461 6 467Virginia 638 84 605 79 16802 177 16979Washington 485 77 389 61 11792 34 11826West Virginia 74 41 67 37 1500 11 1511Wisconsin 122 22 217 39 4513 33 4546Wyoming 6 12 8 16 228 2 230

Subtotal 40123 135 37911 127 952221 9094 961315

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 29

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulativemdashUnited States and dependent areas (cont)

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

US dependent areasAmerican Samoa 0 0 0 0 1 0 1Guam 0 0 0 0 68 1 69Northern Mariana Islands 0 0 0 0 3 0 3Puerto Rico 1029 263 850 216 29511 400 29911US Virgin Islands 17 156 32 295 629 18 647Otherb 0 0 0 0 3 0 3

Totalc 41357 138 39002 129 983343 9522 992865d

a From the beginning of the epidemic through 2006b Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasc Includes persons whose state or area of residence is unknownd Includes 916 persons whose state or area of residence is unknown

30 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

MSA (population gt 500000)

Akron Ohio 66 94 32 46 762 1 763

AlbanyndashSchenectadyndashTroy NY 97 114 105 123 2253 24 2277

Albuquerque N Mex 70 88 50 61 1404 2 1406

AllentownndashBethlehemndashEaston PandashNJ 72 91 119 149 1352 17 1369

AtlantandashSandy SpringsndashMarietta Ga 1586 319 1006 196 21896 128 22024

AugustandashRichmond County GandashSC 106 205 32 61 1851 24 1875

AustinndashRound Rock Tex 227 156 186 123 4830 26 4856

Bakersfield Calif 76 100 122 156 1528 8 1536

BaltimorendashTowson Md 1064 401 1001 377 20352 218 20570

Baton Rouge La 222 304 231 301 3732 20 3752

BirminghamndashHoover Ala 151 139 110 100 2614 25 2639

Boise CityndashNampa Idaho 14 26 14 25 281 0 281

Boston MassndashNHa 441 99 355 80 13476 147 13623

Boston Division 269 146 185 101 8451 91 8542

Cambridge Division 108 74 102 70 3126 35 3161

Essex Division 52 71 51 69 1577 20 1597

BridgeportndashStamfordndashNorwalk Conn 181 201 135 150 3733 57 3790

BuffalondashNiagara Falls NY 117 102 96 84 2476 20 2496

Cape CoralndashFort Myers Fla 44 81 91 159 1692 24 1716

CharlestonndashNorth Charleston SC 92 155 91 151 2034 18 2052

CharlottendashGastoniandashConcord NCndashSC 214 141 285 180 3242 22 3264

Chicago IllndashIndndashWis 1716 182 1159 122 30118 261 30379

Chicago Division 1604 203 1073 135 28300 248 28548

Gary Division 61 88 50 71 1038 8 1046

Lake Division 51 59 36 41 780 5 785

CincinnatindashMiddletown OhiondashKyndashInd 111 53 199 95 2735 17 2752

ClevelandndashElyriandashMentor Ohio 228 107 170 80 4226 48 4274

Colorado Springs Colo 19 32 21 35 576 5 581

Columbia SC 177 256 197 280 3274 24 3298

Columbus Ohio 166 97 165 96 3112 15 3127

Dallas Tex 874 150 929 155 20238 63 20301

Dallas Division 681 175 714 178 16038 37 16075

Fort Worth Division 193 100 215 108 4200 26 4226

Dayton Ohio 58 69 54 64 1217 15 1232

DenverndashAurora Colo 274 116 236 98 6899 22 6921

Des Moines Iowa 30 57 23 43 530 4 534

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 31

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Detroit Mich 570 127 445 100 10373 73 10446

Detroit Division 443 223 330 167 8268 57 8325

Warren Division 127 51 115 46 2105 16 2121

El Paso Tex 56 78 40 54 1476 10 1486

Fresno Calif 52 59 64 72 1430 11 1441

Grand RapidsndashWyoming Mich 46 60 51 66 816 6 822

GreensborondashHigh Point NC 52 77 66 96 1265 14 1279

Greenville SC 70 119 67 111 1292 4 1296

HarrisburgndashCarlisle Pa 23 44 67 128 1224 8 1232

HartfordndashWest HartfordndashEast Hartford Conn 256 216 135 114 5126 46 5172

Honolulu Hawaii 54 60 69 76 2121 14 2135

HoustonndashBaytownndashSugar Land Tex 1017 190 1092 197 25821 172 25993

Indianapolis Ind 191 116 150 90 3824 25 3849

Jackson Miss 134 257 117 221 2419 30 2449

Jacksonville Fla 309 248 315 246 6020 75 6095

Kansas City MondashKans 183 94 160 81 4669 15 4684

Knoxville Tenn 47 72 35 52 882 5 887

Lakeland Fla 103 190 112 199 1811 21 1832

Las VegasndashParadise Nev 245 143 258 145 4616 28 4644

Little RockndashNorth Little Rock Ark 87 135 75 115 1383 14 1397

Los Angeles Calif 1529 118 1684 130 57953 293 58246

Los Angeles Division 1339 135 1435 144 51098 250 51348

Santa Anna Division 190 63 249 83 6855 43 6898

Louisville KyndashInd 123 102 97 79 2286 22 2308

Madison Wis 10 19 29 53 520 4 524

McAllenndashEdinburgndashPharr Tex 57 84 45 64 630 11 641

Memphis TennndashMissndashArk 402 320 346 271 5128 19 5147

Miami Fla 2420 446 2289 419 55807 997 56804

Fort Lauderdale Division 810 455 769 430 16412 262 16674

Miami Division 1243 523 1165 485 29703 512 30215

West Palm Beach Division 367 290 355 279 9692 223 9915

MilwaukeendashWaukeshandashWest Allis Wis 68 45 109 72 2507 18 2525

MinneapolisndashSt PaulndashBloomington MinnndashWis 186 59 184 58 4259 22 4281

Modesto Calif 36 71 22 43 671 6 677

NashvillendashDavidsonndashMurfreesboro Tenn 224 158 172 118 3848 20 3868

New HavenndashMilford Conn 169 200 107 127 4573 73 4646

New OrleansndashMetairiendashKenner La 393 299 271 264 8835 67 8902

32 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

New York NYndashNJndashPa 6215 330 5500 292 195177 2906 198083

Edison Division 191 83 130 56 6709 139 6848

Nassau Division 262 93 246 88 8141 110 8251

New York Division 5266 456 4716 408 160408 2323 162731

Newark Division 496 231 408 190 19919 334 20253

Oklahoma City Okla 125 108 88 75 2255 5 2260

OmahandashCouncil Bluffs NebndashIowa 37 46 80 97 1035 3 1038

Orlando Fla 544 282 517 260 8653 92 8745

OxnardndashThousand OaksndashVentura Calif 49 62 21 26 1008 3 1011

Palm BayndashMelbournendashTitusville Fla 68 129 61 114 1512 11 1523

Philadelphia PandashNJndashDelndashMd 1261 217 1348 231 28221 313 28534

Camden Division 108 87 111 89 3118 42 3160

Philadelphia Division 1022 263 1144 294 22112 250 22362

Wilmington Division 131 191 93 134 2991 21 3012

PhoenixndashMesandashScottsdale Ariz 460 119 376 93 7459 31 7490

Pittsburgh Pa 143 60 135 57 3182 19 3201

PortlandndashSouth Portland Maine 9 18 34 66 562 1 563

PortlandndashVancouverndashBeaverton OrendashWash 170 81 215 101 4825 10 4835

PoughkeepsiendashNewburghndashMiddletown NY 136 204 113 168 3162 24 3186

ProvidencendashNew BedfordndashFall River RIndashMass 132 82 155 96 3900 44 3944

RaleighndashCary NC 138 145 201 202 1987 13 2000

Richmond Va 119 101 122 102 3371 35 3406

RiversidendashSan BernardinondashOntario Calif 361 92 306 76 8568 60 8628

Rochester NY 165 159 124 120 3134 13 3147

SacramentondashArden-ArcadendashRoseville Calif 154 75 169 82 4000 26 4026

St Louis MondashIll 192 69 366 131 5965 40 6005

Salt Lake City Utah 46 44 40 37 1743 10 1753

San Antonio Tex 215 114 247 127 4987 30 5017

San DiegondashCarlsbadndashSan Marcos Calif 491 167 384 131 12934 61 12995

San Francisco Calif 867 209 690 165 40152 96 40248

Oakland Division 312 126 246 99 9546 48 9594

San Francisco Division 555 329 444 261 30606 48 30654

San JosendashSunnyvalendashSanta Clara Calif 88 50 145 81 3747 15 3762

San JuanndashCaguasndashGuaynabo PR 745 289 578 223 21402 277 21679

SarasotandashBradentonndashVenice Fla 82 122 104 152 1978 27 2005

ScrantonndashWilkes-Barre Pa 27 49 47 85 572 6 578

Seattle Wash 353 110 280 86 9172 27 9199

Seattle Division 316 129 255 102 8161 18 8179

Tacoma Division 37 49 25 33 1011 9 1020

Springfield Mass 88 128 45 66 2075 26 2101

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 33

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Stockton Calif 52 78 52 77 1076 15 1091

Syracuse NY 52 80 49 75 1317 8 1325

TampandashSt PetersburgndashClearwater Fla 559 211 605 224 11174 112 11286

Toledo Ohio 25 38 66 101 812 14 826

Tucson Ariz 103 111 100 106 2010 10 2020

Tulsa Okla 83 94 65 72 1494 10 1504

Virginia BeachndashNorfolkndashNewport News VandashNC 183 111 132 80 4711 63 4774

Washington DCndashVandashMdndashWV 1322 252 1684 318 31130 315 31445

Bethesda Division 135 118 173 150 2774 23 2797

Washington Division 1187 289 1511 365 28356 292 28648

Wichita Kans 35 60 38 64 851 2 853

Worcester Mass 76 97 79 101 1783 20 1803

YoungstownndashWarrenndashBoardman OhiondashPa 27 46 26 44 519 0 519

Subtotal for MSAs (population gt500000) 33602 173 31274 159 829633 8171 837804

Metropolitan areas (population of 50000 to 499999) 4477 80 4466 79 94829 847 95676

Nonmetropolitan areas 2666 54 2732 55 52063 445 52508

Totalb 41144 137 38749 128 981708 9494 991202

Note Because of the lack of census information for all US dependent areas includes data for only the 50 states the District of Columbia and Puerto RicoMSA metropolitan statistical areaMSA definitions for this report can be found at httpwwwcensusgovpopulationwwwestimatesmetrodefhtmla Reported case counts for the metropolitan divisions do not sum to the MSA total MSA total includes data from 1 metropolitan division with

population of lt500000b Includes persons whose county of residence is unknown

34 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Alabama (January 1988) 502 6041 48 6089

Alaska (February 1999) 38 285 2 287

Arizona (January 1987) 617 5877 80 5957

Arkansas (July 1989) 206 2349 20 2369

California (April 2006) 6581 7056 92 7148

Colorado (November 1985) 319 6084 31 6115

Connecticut (January 2005)b 826 2500 101 2601

Delaware (February 2006) 788 801 18 819

Florida (July 1997)c 4163 36386 397 36783

Georgia (December 2003) 2245 8197 194 8391

Idaho (June 1986) 35 340 4 344

Illinois (January 2006) 6241 6661 162 6823

Indiana (July 1988) 399 4027 43 4070

Iowa (July 1998) 69 586 5 591

Kansas (July 1999) 142 1225 15 1240

Kentucky (October 2004) 333 1303 13 1316

Louisiana (February 1993) 728 8149 166 8315

Maine (January 2006) 386 393 3 396

Michigan (April 1992) 635 6702 134 6836

Minnesota (October 1985) 309 3356 40 3396

Mississippi (August 1988) 352 4549 59 4608

Missouri (October 1987) 502 5086 55 5141

Nebraska (September 1995) 91 672 14 686

Nevada (February 1992) 339 3532 24 3556

New Hampshire (January 2005) 59 466 9 475

New Jersey (January 1992) 1477 17513 325 17838

New Mexico (January 1998) 114 949 4 953

New York (June 2000) 5326 42345 1820 44165

North Carolina (February 1990) 1615 13879 143 14022

North Dakota (January 1988) 4 82 1 83

Ohio (June 1990) 867 8222 101 8323

Oklahoma (June 1988) 229 2401 30 2431

Oregon (April 2006) 49 95 19 114

Pennsylvania (October 2002)d 4269 9537 179 9716

Rhode Island (July 2006) 14 21 0 21

South Carolina (February 1986) 493 6970 93 7063

South Dakota (January 1988) 18 215 6 221

Tennessee (January 1992) 732 7115 90 7205

Texas (January 1999)e 3370 24282 417 24699

Utah (April 1989) 106 893 14 907

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 35

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Virginia (July 1989) 864 10257 95 10352

Washington (March 2006) 4048 4157 40 4197

West Virginia (January 1989) 66 673 8 681

Wisconsin (November 1985) 261 2500 31 2531

Wyoming (June 1989) 7 93 1 94

Subtotal 50834 274822 5146 279968

US dependent areas

American Samoa (August 2001) 0 1 0 1

Guam (March 2000) 2 66 0 66

Northern Mariana Islands (October 2001) 2 7 0 7

Puerto Rico (January 2003) 1471 5610 91 5701

US Virgin Islands (December 1998) 22 247 6 253

Persons reported from areas with confidential name-based HIV infection reporting but who were residents of other areas 132 685 21 706

Totalf 52878 282640 5314 287954

Note Includes data from 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through 2006b Beginning in 1992 Connecticut had name-based HIV reporting for cases in children only From January 2002 through December 2004

Connecticut had name- or code-based HIV reporting for cases in adolescents and adults As of January 2005 Connecticut has name-based reporting of all cases of HIV infection

c Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterd On October 18 2002 Pennsylvania initiated confidential name-based HIV infection reporting in all areas except Philadelphia Code-based

reporting was implemented in Philadelphia in March 2004 and the switch to name-based reporting was made in October 2005e From February 1994 through December 1998 Texas reported HIV infection in children onlyf Includes 1252 persons reported from areas with confidential name-based HIV infection reporting but whose area of residence is unknown

36 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulativemdashUnited States and dependent areas

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No Adult or adolescentMale-to-male sexual contact 13775 49 429897 54 mdash mdash mdash mdash 13775 35 429897 44Injection drug use 3413 12 163070 21 1826 17 67693 35 5239 13 230763 23Male-to-male sexual contact and

injection drug use 1603 6 65524 8 mdash mdash mdash mdash 1603 4 65524 7Hemophiliacoagulation disorder 43 0 5176 1 11 0 348 0 54 0 5524 1High-risk heterosexual contactc 2997 11 49610 6 4839 46 85186 44 7836 20 134796 14

Sex with injection drug user 330 1 11683 1 706 7 26073 14 1036 3 37756 4Sex with bisexual male mdash mdash mdash mdash 234 2 5162 3 234 1 5162 1Sex with person with hemophilia 1 0 84 0 11 0 502 0 12 0 586 0Sex with HIV-infected transfusion

recipient 22 0 553 0 21 0 793 0 43 0 1346 0Sex with HIV-infected person risk

factor not specified 2644 9 37290 5 3867 37 52656 27 6511 17 89946 9Receipt of blood transfusion blood

d components or tissue 63 0 5213 1 68 1 4176 2 131 0 9389 1Otherrisk factor not reported or

identifiede 6484 23 73136 9 3793 36 34311 18 10278 26 107450 11Subtotal 28378 100 791626 100 10537 100 191714 100 38916 100 983343 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 0 0 222 5 0 0 7 0 0 0 229 2Mother with documented HIV infection or

1 of the following risk factors 24 75 4315 89 50 93 4423 95 74 86 8738 92Injection drug use 4 13 1676 35 4 7 1665 36 8 9 3341 35Sex with injection drug user 4 13 789 16 4 7 750 16 8 9 1539 16Sex with bisexual male 1 3 101 2 2 4 110 2 3 3 211 2Sex with person with hemophilia 0 0 20 0 0 0 16 0 0 0 36 0Sex with HIV-infected transfusion

recipient 0 0 11 0 0 0 15 0 0 0 26 0Sex with HIV-infected person risk

factor not specified 6 19 742 15 17 31 790 17 23 27 1532 16Receipt of blood transfusion blood

components or tissue 0 0 70 1 0 0 82 2 0 0 152 2Has HIV infection risk factor not

specified 9 28 906 19 23 43 995 21 32 37 1901 20Receipt of blood transfusion blood

fcomponents or tissue 1 3 243 5 0 0 144 3 1 1 387 4Otherrisk factor not reported or

identifiedg 7 22 75 2 4 7 93 2 11 13 168 2Subtotal 32 100 4855 100 54 100 4667 100 86 100 9522 100

Total 28410 100 796481 100 10591 100 196381 100 39002 100 992865 100a From the beginning of the epidemic through 2006b From the beginning of the epidemic through 2006 Includes 3 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infectiond AIDS developed in 47 adultsadolescents after they received blood that had tested negative for HIV antibodies AIDS developed in 14 additional adults

after they received tissue organs or artificial insemination from HIV-infected donors Four of the 14 received tissue or organs from a donor who was negative for HIV antibody at the time of donation

e Includes 37 adultsadolescents who were exposed to HIV-infected blood body fluids or concentrated virus in health care laboratory or household settings as supported by seroconversion epidemiologic andor laboratory evidence One person was infected after intentional inoculation with HIV-infected blood Includes an additional 740 persons who acquired HIV infection perinatally but who were more than 12 years of age when AIDS was diagnosed These 740 persons are not counted in the values for the pediatric transmission category

f AIDS developed in 3 children after they received blood that had tested negative for HIV antibodiesg Includes 5 children who were exposed to HIV-infected blood as supported by seroconversion epidemiologic andor laboratory evidence 1 child was

infected after intentional inoculation with HIV-infected blood and 5 children were exposed to HIV-infected blood in a household setting Of the 168 children 26 had sexual contact with an adult with or at high risk for HIV infection

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 37

Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No

Adult or adolescentMale-to-male sexual contact 22912 59 103679 52 mdash mdash mdash mdash 22912 44 103679 37

Injection drug use 3503 9 24255 12 2124 16 13925 17 5627 11 38181 14

Male-to-male sexual contact and injection drug use 1946 5 10704 5 mdash mdash mdash mdash 1946 4 10704 4

Hemophiliacoagulation disorder 43 0 495 0 6 0 73 0 49 0 568 0

High-risk heterosexual contactc 2874 7 16830 8 5939 45 38315 47 8813 17 55145 20

Sex with injection drug user 308 1 2601 1 757 6 6791 8 1065 2 9392 3

Sex with bisexual male mdash mdash mdash mdash 328 2 2265 3 328 1 2265 1

Sex with person with hemophilia 4 0 31 0 16 0 201 0 20 0 232 0

Sex with HIV-infected transfusion recipient 13 0 131 0 28 0 223 0 41 0 354 0

Sex with HIV-infected person risk factor not specified 2549 7 14067 7 4810 36 28835 35 7359 14 42902 15

Receipt of blood transfusion blood components or tissue 61 0 489 0 50 0 536 1 111 0 1025 0

Otherrisk factor not reported or identified 7748 20 44021 22 5106 39 29312 36 12854 25 73338 26

Subtotal 39087 100 200473 100 13225 100 82161 100 52312 100 282640 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 8 3 106 4 0 0 1 0 8 1 107 2

Mother with documented HIV infection or 1 of the following risk factors 197 74 2195 85 254 85 2417 89 451 80 4612 87

Injection drug use 34 13 532 21 53 18 561 21 87 15 1093 21

Sex with injection drug user 12 5 208 8 21 7 213 8 33 6 421 8

Sex with bisexual male 5 2 37 1 4 1 32 1 9 2 69 1

Sex with person with hemophilia 0 0 3 0 1 0 7 0 1 0 10 0

Sex with HIV-infected transfusion recipient 0 0 4 0 0 0 4 0 0 0 8 0

Sex with HIV-infected person risk factor not specified 54 20 534 21 76 25 629 23 130 23 1163 22

Receipt of blood transfusion blood components or tissue 0 0 17 1 2 1 20 1 2 0 37 1

Has HIV infection risk factor not specified 92 35 860 33 97 32 951 35 189 33 1811 34

Receipt of blood transfusion blood components or tissue 6 2 28 1 3 1 24 1 9 2 52 1

Otherrisk factor not reported or identified 55 21 260 10 43 14 283 10 98 17 543 10

Subtotal 266 100 2589 100 300 100 2725 100 566 100 5314 100

Total 39353 100 203062 100 13525 100 84886 100 52878 100 287954 100

Note See Table 16 for the list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006b From the beginning of the epidemic through December 2006 Includes 6 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infection

38 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity

2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 6251 65 253927 73Injection drug use 733 8 31737 9Male-to-male sexual contact and injection drug use 732 8 31434 9Hemophiliacoagulation disorder 26 0 3989 1High-risk heterosexual contactb 416 4 7850 2

Sex with injection drug user 74 1 2310 1

Sex with person with hemophilia 0 0 36 0

Sex with HIV-infected transfusion recipient 2 0 176 0

Sex with HIV-infected person risk factor not specified 340 4 5328 2Receipt of blood transfusion blood components or tissue 20 0 3194 1Otherrisk factor not reported or identified 1400 15 16469 5

Total 9578 100 348600 100

Black not HispanicMale-to-male sexual contact 4309 36 103297 37Injection drug use 1635 14 83369 30Male-to-male sexual contact and injection drug use 526 4 22134 8Hemophiliacoagulation disorder 10 0 604 0High-risk heterosexual contactb 1875 16 29952 11

Sex with injection drug user 167 1 6823 2Sex with person with hemophilia 1 0 36 0Sex with HIV-infected transfusion recipient 15 0 237 0Sex with HIV-infected person risk factor not specified 1692 14 22856 8

Receipt of blood transfusion blood components or tissue 24 0 1218 0Otherrisk factor not reported or identified 3579 30 40268 14

Total 11958 100 280842 100

HispanicMale-to-male sexual contact 2816 47 64893 44Injection drug use 965 16 46337 31Male-to-male sexual contact and injection drug use 287 5 10884 7Hemophiliacoagulation disorder 6 0 466 0High-risk heterosexual contactb 638 11 10950 7

Sex with injection drug user 84 1 2409 2Sex with person with hemophilia 0 0 11 0Sex with HIV-infected transfusion recipient 5 0 125 0Sex with HIV-infected person risk factor not specified 549 9 8405 6

Receipt of blood transfusion blood components or tissue 17 0 657 0Otherrisk factor not reported or identified 1326 22 14832 10

Total 6055 100 149019 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 39

a

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulative

No No

AsianPacific IslanderMale-to-male sexual contact 225 54 4475 68Injection drug use 20 5 317 5Male-to-male sexual contact and injection drug use 17 4 284 4Hemophiliacoagulation disorder 1 0 70 1High-risk heterosexual contactb 34 8 376 6

Sex with injection drug user 1 0 54 1Sex with person with hemophilia 0 0 1 0Sex with HIV-infected transfusion recipient 0 0 8 0Sex with HIV-infected person risk factor not specified 33 8 313 5

Receipt of blood transfusion blood components or tissue 2 0 112 2Otherrisk factor not reported or identified 114 28 949 14

Total 413 100 6583 100

American IndianAlaska NativeMale-to-male sexual contact 61 49 1403 55Injection drug use 15 12 395 15Male-to-male sexual contact and injection drug use 23 19 457 18Hemophiliacoagulation disorder 0 0 27 1High-risk heterosexual contactb 9 7 118 5

Sex with injection drug user 1 1 33 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 8 6 82 3

Receipt of blood transfusion blood components or tissue 0 0 8 0Otherrisk factor not reported or identified 16 13 155 6

Total 124 100 2563 100

Total casesMale-to-male sexual contact 13775 49 429897 54Injection drug use 3413 12 163070 21Male-to-male sexual contact and injection drug use 1603 6 65524 8Hemophiliacoagulation disorder 43 0 5176 1High-risk heterosexual contactb 2997 11 49610 6

Sex with injection drug user 330 1 11683 1Sex with person with hemophilia 1 0 84 0Sex with HIV-infected transfusion recipient 22 0 553 0Sex with HIV-infected person risk factor not specified 2644 9 37290 5

Receipt of blood transfusion blood components or tissue 63 0 5213 1Otherrisk factor not reported or identified 6484 23 73136 9

Total 28378c 100 791626d 100a From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 4019 males of unknown race or multiple races

40 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 11963 73 55725 69Injection drug use 858 5 5512 7Male-to-male sexual contact and injection drug use 1092 7 5578 7Hemophiliacoagulation disorder 29 0 355 0High-risk heterosexual contactb 522 3 2658 3

Sex with injection drug user 65 0 544 1Sex with person with hemophilia 0 0 8 0Sex with HIV-infected transfusion recipient 3 0 33 0Sex with HIV-infected person risk factor not specified 454 3 2073 3

Receipt of blood transfusion blood components or tissue 14 0 197 0Otherrisk factor not reported or identified 1956 12 11147 14

Total 16434 100 81172 100

Black not HispanicMale-to-male sexual contact 6203 44 30148 37Injection drug use 1594 11 11997 15Male-to-male sexual contact and injection drug use 483 3 3489 4Hemophiliacoagulation disorder 10 0 109 0High-risk heterosexual contactb 1714 12 10905 13

Sex with injection drug user 169 1 1554 2Sex with person with hemophilia 4 0 17 0Sex with HIV-infected transfusion recipient 6 0 77 0Sex with HIV-infected person risk factor not specified 1535 11 9257 11

Receipt of blood transfusion blood components or tissue 32 0 223 0Otherrisk factor not reported or identified 4151 29 24632 30

Total 14187 100 81503 100

HispanicMale-to-male sexual contact 4094 55 15623 47Injection drug use 993 13 6407 19Male-to-male sexual contact and injection drug use 316 4 1402 4Hemophiliacoagulation disorder 3 0 26 0High-risk heterosexual contactb 582 8 2963 9

Sex with injection drug user 65 1 455 1Sex with person with hemophilia 0 0 6 0Sex with HIV-infected transfusion recipient 4 0 18 0Sex with HIV-infected person risk factor not specified 513 7 2484 7

Receipt of blood transfusion blood components or tissue 11 0 55 0Otherrisk factor not reported or identified 1475 20 6977 21

Total 7474 100 33453 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 41

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderMale-to-male sexual contact 402 70 1006 63Injection drug use 17 3 55 3Male-to-male sexual contact and injection drug use 15 3 38 2Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 25 4 96 6

Sex with injection drug user 3 1 10 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 22 4 83 5

Receipt of blood transfusion blood components or tissue 4 1 7 0Otherrisk factor not reported or identified 109 19 397 25

Total 572 100 1600 100

American IndianAlaska NativeMale-to-male sexual contact 104 61 516 57Injection drug use 13 8 101 11Male-to-male sexual contact and injection drug use 19 11 110 12Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 10 6 53 6

Sex with injection drug user 2 1 14 2Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 8 5 39 4

Receipt of blood transfusion blood components or tissue 0 0 2 0Otherrisk factor not reported or identified 24 14 125 14

Total 170 100 907 100

Total casesMale-to-male sexual contact 22912 59 103679 52Injection drug use 3503 9 24255 12Male-to-male sexual contact and injection drug use 1946 5 10704 5Hemophiliacoagulation disorder 43 0 495 0High-risk heterosexual contactb 2874 7 16830 8

Sex with injection drug user 308 1 2601 1Sex with person with hemophilia 4 0 31 0Sex with HIV-infected transfusion recipient 13 0 131 0Sex with HIV-infected person risk factor not specified 2549 7 14067 7

Receipt of blood transfusion blood components or tissue 61 0 489 0Otherrisk factor not reported or identified 7748 20 44021 22

Total 39087c 100 200473d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 1838 males of unknown race or multiple races

42 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race

ethnicity 2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 482 28 14981 40Hemophiliacoagulation disorder 4 0 123 0High-risk heterosexual contactb 725 42 15799 42

Sex with injection drug user 153 9 5650 15Sex with bisexual male 63 4 1859 5Sex with person with hemophilia 5 0 329 1Sex with HIV-infected transfusion recipient 5 0 338 1Sex with HIV-infected person risk factor not specified 499 29 7623 20

Receipt of blood transfusion blood components or tissue 15 1 1870 5Otherrisk factor not reported or identified 499 29 4801 13

Total 1725 100 37574 100

Black not HispanicInjection drug use 982 15 38914 34Hemophiliacoagulation disorder 3 0 145 0High-risk heterosexual contactb 3103 46 49876 44

Sex with injection drug user 373 6 13530 12Sex with bisexual male 136 2 2352 2Sex with person with hemophilia 4 0 121 0Sex with HIV-infected transfusion recipient 8 0 277 0Sex with HIV-infected person risk factor not specified 2582 38 33596 29

Receipt of blood transfusion blood components or tissue 39 1 1546 1Otherrisk factor not reported or identified 2612 39 23894 21

Total 6739 100 114375 100

HispanicInjection drug use 322 18 12892 35Hemophiliacoagulation disorder 4 0 67 0High-risk heterosexual contactb 894 49 17995 49

Sex with injection drug user 166 9 6522 18Sex with bisexual male 32 2 818 2Sex with person with hemophilia 1 0 45 0Sex with HIV-infected transfusion recipient 7 0 141 0Sex with HIV-infected person risk factor not specified 688 38 10469 29

Receipt of blood transfusion blood components or tissue 12 1 619 2Otherrisk factor not reported or identified 592 32 5023 14

Total 1824 100 36596 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 43

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 8 8 125 12Hemophiliacoagulation disorder 0 0 7 1High-risk heterosexual contactb 49 47 574 53

Sex with injection drug user 4 4 114 11Sex with bisexual male 2 2 80 7Sex with person with hemophilia 0 0 4 0Sex with HIV-infected transfusion recipient 1 1 25 2Sex with HIV-infected person risk factor not specified 42 40 351 33

Receipt of blood transfusion blood components or tissue 1 1 93 9Otherrisk factor not reported or identified 46 44 279 26

Total 104 100 1078 100

American IndianAlaska NativeInjection drug use 13 32 280 42Hemophiliacoagulation disorder 0 0 3 0High-risk heterosexual contactb 15 37 277 41

Sex with injection drug user 4 10 107 16Sex with bisexual male 1 2 27 4Sex with person with hemophilia 0 0 2 0Sex with HIV-infected transfusion recipient 0 0 6 1Sex with HIV-infected person risk factor not specified 10 24 135 20

Receipt of blood transfusion blood components or tissue 1 2 17 3Otherrisk factor not reported or identified 12 29 95 14

Total 41 100 672 100

Total casesInjection drug use 1826 17 67693 35Hemophiliacoagulation disorder 11 0 348 0High-risk heterosexual contactb 4839 46 85186 44

Sex with injection drug user 706 7 26073 14Sex with bisexual male 234 2 5162 3Sex with person with hemophilia 11 0 502 0Sex with HIV-infected transfusion recipient 21 0 793 0Sex with HIV-infected person risk factor not specified 3867 37 52656 27

Receipt of blood transfusion blood components or tissue 68 1 4176 2Otherrisk factor not reported or identified 3793 36 34311 18

Total 10537c 100 191714d 100a From the beginning of the epidemic through 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 104 females of unknown race or multiple racesd Includes 1419 females of unknown race or multiple races

44 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 690 26 4260 26Hemophiliacoagulation disorder 3 0 24 0

bHigh-risk heterosexual contact 1132 42 7593 46Sex with injection drug user 205 8 1876 11Sex with bisexual male 98 4 659 4Sex with person with hemophilia 10 0 115 1Sex with HIV-infected transfusion recipient 7 0 64 0Sex with HIV-infected person risk factor not specified 812 30 4879 29

Receipt of blood transfusion blood components or tissue 12 0 146 1Otherrisk factor not reported or identified 850 32 4567 28

Total 2687 100 16590 100

Black not HispanicInjection drug use 1034 13 7105 14Hemophiliacoagulation disorder 1 0 35 0

bHigh-risk heterosexual contact 3451 44 23732 46Sex with injection drug user 313 4 3473 7Sex with bisexual male 155 2 1294 3Sex with person with hemophilia 5 0 71 0Sex with HIV-infected transfusion recipient 14 0 120 0Sex with HIV-infected person risk factor not specified 2964 38 18774 36

Receipt of blood transfusion blood components or tissue 26 0 324 1Otherrisk factor not reported or identified 3370 43 20244 39

Total 7882 100 51440 100

HispanicInjection drug use 339 15 2280 18Hemophiliacoagulation disorder 2 0 11 0

bHigh-risk heterosexual contact 1198 52 6264 50Sex with injection drug user 218 9 1324 11Sex with bisexual male 62 3 266 2Sex with person with hemophilia 1 0 11 0Sex with HIV-infected transfusion recipient 7 0 39 0Sex with HIV-infected person risk factor not specified 910 39 4624 37

Receipt of blood transfusion blood components or tissue 12 1 58 0Otherrisk factor not reported or identified 767 33 3843 31

Total 2318 100 12456 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 45

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 14: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002ndash2006 and cumulativemdash50 states and the District of Columbia

Year of diagnosisCumulativea2002 2003 2004 2005 2006

RaceethnicityWhite not Hispanic 14 12 7 4 4 1599Black not Hispanic 70 46 33 38 30 5654Hispanic 18 10 9 8 3 1748AsianPacific Islander 1 0 1 1 1 54American IndianAlaska Native 1 0 1 0 0 31

Transmission categoryHemophiliacoagulation disorder 0 0 0 0 0 226Mother with documented HIV infection or 1 of the following risk factors 104 70 53 52 37 8508

Injection drug use 12 8 5 3 4 3220Sex with injection drug user 4 6 3 2 1 1397Sex with bisexual male 2 0 3 1 1 209Sex with person with hemophilia 0 0 0 0 0 35Sex with HIV-infected transfusion recipient 0 0 0 0 0 22Sex with HIV-infected person risk factor not specified 36 20 20 25 13 1530Receipt of blood transfusion blood components or tissue 2 1 0 0 0 144Has HIV infection risk factor not specified 47 34 21 21 17 1951

Receipt of blood transfusion blood components or tissue 2 0 0 0 0 374Otherrisk factor not reported or identified 0 0 0 0 0 36

Totalb 106 70 53 53 38 9144

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga From the beginning of the epidemic through 2006b Includes children of unknown race or multiple races Cumulative total includes 58 children of unknown race or multiple races Because column totals

were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992ndash2006mdash50 states and the District of Columbia

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reporting

14 Cases of HIVAIDS and AIDS

Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006mdash50 states and the District of Columbia

Raceethnicity

Adults or adolescents

Children (lt13 yrs) TotalaMales Females Totala

No Rate No Rate No Rate No Rate No Rate

White not Hispanic 9267 112 1659 19 10926 64 4 00 10929 54Black not Hispanic 11540 829 6391 404 17930 603 30 04 17960 476Hispanic 5388 313 1516 95 6903 208 3 00 6907 156AsianPacific Islander 423 75 95 16 518 44 1 00 519 37American IndianAlaska Native 118 122 37 36 155 78 0 00 155 62

Totalb 26989 224 9801 78 36790 149 38 01 36828c 123

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reportingData exclude cases in persons whose state or area of residence is unknown as well as cases from US dependent areas for which census information about race and age categories is lackinga Because row totals were calculated independently of the values for the subpopulations the values in each row may not sum to the row totalb Includes person of unknown race or multiple races Because column totals were calculated independently of the values for the subpopulations the

values in each column may not sum to the column totalc Includes 358 persons of unknown race or multiple races

Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006mdash33 states with confidential name-based HIV infection reporting

Raceethnicity

Adults or adolescents

Children (lt13 yrs) TotalaMales Females Totala

No Rate No Rate No Rate No Rate No Rate

White not Hispanic 9078 167 1664 29 10742 96 16 01 10758 82Black not Hispanic 11230 1191 6033 562 17263 856 93 17 17356 677Hispanic 5058 509 1400 151 6458 337 23 04 6481 255AsianPacific Islander 318 135 79 32 397 82 0 00 397 67American IndianAlaska Native 129 177 35 46 164 110 2 06 166 88

Totalb 25928 338 9252 115 35180 224 135 04 35314c 185

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Because row totals were calculated independently of the values for the subpopulations the values in each row may not sum to the row totalb Includes persons of unknown race or multiple races Because column totals were calculated independently of the values for the subpopulations the

values in each column may not sum to the column totalc Includes 156 persons of unknown race or multiple races

Cases of HIVAIDS and AIDS 15

Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006mdashUnited States and dependent areas

Transmission category

Place of birth

United StatesCentralSouth

America Cuba Mexico Puerto Rico Totala

No No No No No No

Male-to-male sexual contact 1172 45 402 49 89 62 790 59 249 18 3337 43Injection drug use 569 22 83 10 13 9 133 10 533 40 1650 21Male-to-male sexual contact

and injection drug use 158 6 25 3 6 4 59 4 63 5 357 5High-risk heterosexual

contactb 661 25 296 36 35 24 342 26 487 36 2282 30Otherc 47 2 8 1 0 0 9 1 14 1 103 1

Totald 2608 100 814 100 145 100 1334 100 1346 100 7728 100Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Includes 222 persons whose place of birth is not among those listed and 1260 persons whose place of birth is unknownb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the

column total

16 Cases of HIVAIDS and AIDS

Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas

Year of death

Cumulativea2002 2003 2004 2005 2006

Data for 50 states and the District of ColumbiaAge at death (yrs)lt13 25 22 15 7 13 4889

13ndash14 10 6 15 12 5 276

15ndash19 39 36 36 38 44 1104

20ndash24 151 157 175 147 162 8716

25ndash29 553 512 482 458 405 43671

30ndash34 1480 1272 1128 1069 785 95351

35ndash39 2967 2763 2425 2096 1682 116746

40ndash44 3595 3516 3393 3317 2636 104133

45ndash49 3294 3234 3251 3275 2886 72831

50ndash54 2318 2373 2502 2645 2343 44255

55ndash59 1209 1322 1425 1543 1480 25123

60ndash64 616 705 741 797 771 14315

gt65 691 773 807 865 805 14393

RaceethnicityWhite not Hispanic 5214 5097 4836 4758 3860 239529

Black not Hispanic 9037 8675 8581 8679 7426 218392

Hispanic 2429 2632 2641 2513 2425 80690

AsianPacific Islander 97 84 111 87 114 3426

American IndianAlaska Native 83 73 80 65 66 1693

Transmission categoryMale adult or adolescentMale-to-male sexual contact 5960 5937 5735 5641 4930 266272

Injection drug use 3738 3547 3315 3314 2641 107173

Male-to-male sexual contact and injection drug use 1278 1299 1237 1289 1064 40993

High-risk heterosexual contactb 1465 1501 1625 1571 1470 26236

Otherc 160 149 125 117 80 9867

Subtotal 12601 12431 12038 11932 10184 450541

Female adult or adolescentInjection drug use 1923 1825 1855 1768 1456 43143

High-risk heterosexual contactb 2281 2292 2373 2458 2258 42620

Otherc 84 87 72 68 70 4131

Subtotal 4289 4204 4300 4295 3784 89895

Child (lt13 yrs at diagnosis)Perinatal 53 49 56 39 42 4848

Otherd 4 5 1 2 7 521

Subtotal 57 54 57 41 48 5369

Deaths 17

Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas (cont)

Year of death

Cumulativea2002 2003 2004 2005 2006

Region of residenceNortheast 5313 5012 4779 4750 4074 180623

Midwest 1726 1666 1482 1378 1325 54468

South 7337 7427 7535 7907 6475 197209

West 2571 2585 2600 2234 2141 113506

Subtotal for 50 states and the District of Columbia 16948 16690 16395 16268 14016 545805

Data for US dependent areas 667 575 572 562 580 19858

Totale 17628 17283 16982 16865 14627 565927f

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column totalf Includes 2082 persons of unknown race or multiple races 261 persons of unknown state of residence and 2 persons who were residents

of other areas

18 Deaths

Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003ndash2006mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

2003 2004 2005 2006Data for 33 states

Age at end of year (yrs)lt13 4154 3700 3294 286713ndash14 1130 1238 1212 113915ndash19 3298 3627 4024 453920ndash24 12389 12826 13411 1430125ndash29 26167 26924 28164 2960030ndash34 49602 47577 45109 4418935ndash39 80703 77871 75842 7363440ndash44 92040 97109 100102 10176445ndash49 71345 77490 83816 9028350ndash54 45133 51033 56640 6319555ndash59 22793 26610 31186 3600860ndash64 10820 12642 14422 16658gt65 8531 9959 11657 13551

RaceethnicityWhite not Hispanic 145081 151694 158375 166000Black not Hispanic 202951 212425 221439 231957Hispanic 72612 76503 80491 84720AsianPacific Islander 2234 2529 2858 3187American IndianAlaska Native 1788 1889 2008 2119

Transmission categoryMale adult or adolescentMale-to-male sexual contact 181771 193245 205423 218676Injection drug use 57651 58149 58369 59077Male-to-male sexual contact and injection drug use 23965 24434 24725 25085High-risk heterosexual contacta 40084 42559 44915 47562Otherb 3218 3278 3325 3424Subtotal 306689 321665 336756 353825

Female adult or adolescentInjection drug use 32346 32735 32973 33470High-risk heterosexual contacta 80324 85348 90185 95403Otherb 2036 2123 2212 2321Subtotal 114705 120206 125370 131195

Child (lt13 yrs at diagnosis)Perinatal 6137 6154 6178 6143Otherc 570 575 571 560Subtotal 6707 6730 6748 6703

Subtotal for 33 states 428107 448605 468879 491727Data for US dependent areas 15809 16399 17150 17955

Totald 443916 465005 486028 509681Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 19

Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission categorymdash33 states with confidential name-based HIV infection reporting

Transmission category

White not Hispanic

Black not Hispanic Hispanic

AsianPacific Islander

American IndianAlaska

Native Totala

No No No No No No

Male adult or adolescentMale-to-male sexual contact 108259 77 70242 49 36043 57 1669 68 938 62 218676 62Injection drug use 12328 9 31339 22 14472 23 264 11 216 14 59077 17Male-to-male sexual contact

and injection drug use 11283 8 9587 7 3720 6 93 4 205 13 25085 7High-risk heterosexual contactb 6667 5 31140 22 8788 14 395 16 143 9 47562 13Otherc 1458 1 1492 1 404 1 30 1 17 1 3424 1Subtotal 139994 100 143799 100 63427 100 2450 100 1519 100 353825 100

Female adult or adolescentInjection drug use 8262 33 19136 23 5528 28 106 15 175 30 33470 26High-risk heterosexual contactb 16338 65 63204 75 14132 71 573 82 392 68 95403 73Otherc 450 2 1469 2 344 2 24 3 12 2 2321 2Subtotal 25050 100 83809 100 20004 100 703 100 578 100 131195 100

Child (lt13 yrs at diagnosis)Perinatal 801 84 4064 93 1183 92 28 82 20 95 6143 92Otherd 154 16 283 7 107 8 6 18 1 5 560 8Subtotal 955 100 4347 100 1290 100 34 100 21 100 6703 100

Totale 166000 231957 84720 3187 2119 491727Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of 33 states that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Includes 3745 persons of unknown race or multiple racesb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes 5 persons of unknown sex Because column totals were calculated independently of the values for the subpopulations the values

in each column may not sum to the column total

20 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Map 1 Estimated rates (per 100000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

Note Rates adjusted for reporting delays Rates of HIV infection include only persons living with HIV infection that has not progressed to AIDSSince 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 Islandsa Includes persons whose area of residence is unknown

Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

Note Rates adjusted for reporting delays Rates of HIV infection include only persons living with HIV infection that has not progressed to AIDSSince 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 Islandsa Includes persons whose area of residence is unknown

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 21

Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002ndash2006mdashUnited States and dependent areas

2002 2003 2004 2005 2006Data for 50 states and the District of Columbia

Age at end of year (yrs)lt13 2308 2006 1684 1394 111513ndash14 685 747 784 762 71115ndash19 1465 1694 1974 2243 248720ndash24 3910 4292 4629 5033 536725ndash29 12725 12743 13045 13505 1435930ndash34 35558 33870 32057 29949 2882435ndash39 70107 68106 65076 62235 5964940ndash44 80377 86294 91335 94021 9517445ndash49 64702 71276 77417 84153 9077550ndash54 41270 46855 53333 59256 6647655ndash59 20113 24145 28356 33522 3901460ndash64 9681 11293 13305 15380 18072gt65 7520 8946 10604 12430 14669

RaceethnicityWhite not Hispanic 129426 135278 141508 147426 154495Black not Hispanic 150488 161326 171654 181056 191590Hispanic 63424 67895 72024 76334 80815AsianPacific Islander 3060 3426 3759 4121 4526American IndianAlaska Native 1254 1356 1458 1562 1651

Transmission categoryMale adult or adolescentMale-to-male sexual contact 158092 168233 178551 188622 199693Injection drug use 56708 58436 59940 61229 62998Male-to-male sexual contact and injection drug use 24726 25457 26144 26785 27523High-risk heterosexual contacta 27329 30300 33181 35916 39004Otherb 3588 3665 3769 3888 4026Subtotal 270444 286091 301585 316440 333244

Female adult or adolescentInjection drug use 27863 28874 29828 30646 31575High-risk heterosexual contacta 46445 51489 56229 60693 65631Otherb 1903 2033 2178 2315 2465Subtotal 76210 82395 88236 93653 99671

Child (lt13 yrs at diagnosis)Perinatal 3633 3654 3651 3664 3660Otherc 129 124 123 122 115Subtotal 3762 3778 3774 3786 3775

Region of residenceNortheast 105599 110929 115562 120208 125620Midwest 36011 38571 41178 44171 47010South 137081 147284 157975 166962 177591West 71729 75483 78883 82540 86473

Subtotal for 50 states and the District of Columbia 350419 372267 393598 413882 436693

Data for US dependent areas 9880 10365 10713 11106 11359

Totald 360617 383024 404849 425646 448871Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

22 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission categorymdash50 states and the District of Columbia

Transmission category

White not Hispanic

Black not Hispanic Hispanic

AsianPacific Islander

American IndianAlaska

Native Totala

No No No No No No

Male adult or adolescentMale-to-male sexual contact 101299 75 57520 45 36087 57 2715 72 704 57 199693 60Injection drug use 13168 10 33911 27 14795 23 325 9 201 16 62998 19Male-to-male sexual contact and

injection drug use 12393 9 10121 8 4352 7 198 5 220 18 27523 8High-risk heterosexual contactb 6081 5 24205 19 7816 12 444 12 105 8 39004 12Otherc 1743 1 1602 1 574 1 69 2 16 1 4026 1Subtotal 134683 100 127359 100 63623 100 3752 100 1246 100 333244 100

Female adult or adolescentInjection drug use 7407 38 18531 30 5025 30 115 15 153 39 31575 32High-risk heterosexual contactb 11350 59 41741 68 11092 67 588 78 227 58 65631 66Otherc 508 3 1456 2 413 2 51 7 13 3 2465 2Subtotal 19264 100 61728 100 16531 100 753 100 393 100 99671 100

Child (lt13 yrs at diagnosis)Perinatal 500 92 2468 99 629 95 20 94 12 100 3660 97Otherd 46 8 34 1 33 5 1 6 0 0 115 3Subtotal 546 100 2503 100 662 100 21 100 12 100 3775 100

Totale 154495 191590 80815 4526 1651 436693

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Includes 3616 persons of unknown race or multiple racesb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes 3 person of unknown sex Because column totals were calculated independently of the values for the subpopulations the values in each column

may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 23

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by

area of residence and age categorymdashUnited States and dependent areas

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

Alabama 5469 17 5486 3744 11 3755Alaska 272 1 273 330 1 331Arizona 5744 49 5793 4922 7 4929Arkansas 2291 7 2298 2139 6 2145California mdash mdash mdash 61451 105 61555Colorado 5855 13 5869 4083 2 4085Connecticut mdash mdash mdash 7406 15 7421Delaware mdash mdash mdash 1753 7 1760District of Columbia mdash mdash mdash 10059 30 10089Floridab 35461 263 35723 46469 194 46663Georgia mdash mdash mdash 17336 47 17383Hawaii mdash mdash mdash 1234 3 1237Idaho 356 0 356 313 0 313Illinois mdash mdash mdash 16139 46 16185Indiana 3849 21 3870 3996 14 4010Iowa 588 2 590 869 3 872Kansas 1230 7 1237 1272 2 1274Kentucky mdash mdash mdash 2589 13 2602Louisiana 7361 101 7462 8052 21 8074Maine mdash mdash mdash 512 2 514Maryland mdash mdash mdash 14540 41 14581Massachusetts mdash mdash mdash 8806 20 8826Michigan 6118 55 6173 6615 12 6627Minnesota 3227 21 3248 2314 9 2323Mississippi 4200 32 4232 3155 13 3168Missouri 4999 33 5033 5479 7 5486Montana mdash mdash mdash 205 0 205Nebraska 688 12 700 771 2 773Nevada 3402 13 3415 2969 3 2972New Hampshire mdash mdash mdash 556 3 559New Jersey 16059 153 16212 17168 57 17226New Mexico 910 0 909 1252 3 1255New York 42220 801 43021 70697 148 70845North Carolina 11700 60 11760 8451 12 8463North Dakota 87 2 89 73 1 74Ohio 8266 57 8323 7054 30 7084Oklahoma 2191 17 2208 2191 3 2194Oregon mdash mdash mdash 2840 4 2844Pennsylvania mdash mdash mdash 18633 71 18703Rhode Island mdash mdash mdash 1296 7 1303South Carolina 6349 45 6394 7035 23 7058South Dakota 195 4 199 139 1 140Tennessee 6579 51 6631 6403 11 6414Texas 24741 262 25003 34010 53 34063Utah 893 10 903 1164 0 1164Vermont mdash mdash mdash 238 2 240Virginia 9937 41 9978 8423 24 8447Washington mdash mdash mdash 5471 5 5476West Virginia 660 5 665 749 5 754Wisconsin 2322 15 2337 2153 12 2165Wyoming 86 2 88 102 1 103

Subtotal 224303 2174 226477 435621 1115 436736

24 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age categorymdashUnited States and dependent areas (cont)

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

US dependent areasAmerican Samoa 2 0 2 1 0 1Guam 63 0 63 36 0 36Northern Mariana Islands 7 0 7 3 0 3Puerto Rico 6269 31 6300 10971 26 10997US Virgin Islands 228 2 230 312 2 314Otherc mdash mdash mdash 1 0 1

Totald 230872 2207 233079 447724 1147 448871

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reporting a See Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at

least 2003b Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterc Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasd Total number of persons living with HIV infection (not AIDS) includes persons reported from areas with confidential name-based HIV

infection reporting who were residents of other states or whose area of residence is unknown Total number of persons living with AIDS includes persons whose area of residence is unknown Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 25

Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristicsmdashUnited States and dependent areas

No of persons

Survival in months

gt12 gt24 gt36Data for 50 states and the District of Columbia

Age at diagnosis (yrs)lt13 101 096 094 09413ndash14 60 098 098 09515ndash19 305 098 096 09520ndash24 1351 096 093 09225ndash29 3034 095 092 09130ndash34 5499 094 091 08935ndash39 7888 093 090 08740ndash44 7085 092 088 08545ndash49 5090 089 085 08250ndash54 3067 086 081 07855ndash59 1505 083 078 07460ndash64 806 080 073 069gt65 614 073 068 065

RaceethnicityWhite not Hispanic 10706 092 089 087Black not Hispanic 18406 090 086 082Hispanic 6398 092 090 088AsianPacific Islander 404 094 092 090American IndianAlaska Native 167 084 081 075

Transmission categoryMale adult or adolescentMale-to-male sexual contact 12830 093 090 088Injection drug use 4048 089 084 081Male-to-male sexual contact and injection drug use 1701 093 089 086High-risk heterosexual contacta 3170 091 088 085Otherb 5019 086 083 080Subtotal 26768 091 088 085

Female adult or adolescentInjection drug use 2101 089 083 078High-risk heterosexual contacta 4686 093 089 086Otherb 2749 090 085 083Subtotal 9536 091 087 083

Child (lt13 yrs at diagnosis)Perinatal 98 096 095 095Otherc 3 100 067 067Subtotal 101 096 094 094

Subtotal for 50 states and the District of Columbia 36405 091 087 085

Data for US dependent areas 891 083 078 075

Total 37352d 091 087 084Note Excludes persons whose date of death was before or in the same month as date of diagnosis Excludes persons whose month of diagnosis or month of death is unknowna Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes 325 persons of unknown race or multiple races

26 Survival after AIDS Diagnosis

Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by year of diagnosismdashUnited States and dependent areas

Months after AIDS diagnosis

Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by age groupmdashUnited States and dependent areas

Months after AIDS diagnosis

Survival after AIDS Diagnosis 27

Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by raceethnicitymdashUnited States and dependent areas

Months after AIDS diagnosis

28 Survival after AIDS Diagnosis

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006

and cumulativemdashUnited States and dependent areas

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Alabama 510 112 462 100 8626 76 8702Alaska 24 36 38 57 648 7 655Arizona 626 105 539 87 10396 46 10442Arkansas 237 85 252 90 3891 36 3927California 4069 113 3960 109 142254 664 142918Colorado 351 75 322 68 8742 31 8773Connecticut 658 188 422 120 14716 183 14899Delaware 177 210 116 136 3547 26 3573District of Columbia 672 1155 853 1467 17372 189 17561Florida 4921 277 4932 273 104084 1530 105614Georgia 2325 255 1605 171 31734 231 31965Hawaii 105 82 93 72 2927 17 2944Idaho 24 17 26 18 604 2 606Illinois 1886 148 1382 108 33620 282 33902Indiana 407 65 346 55 8239 56 8295Iowa 93 31 86 29 1727 13 1740Kansas 105 38 120 43 2781 14 2795Kentucky 249 60 207 49 4600 32 4632Louisiana 936 208 824 192 17612 128 17740Maine 21 16 68 51 1110 8 1118Maryland 1558 279 1626 290 30252 319 30571Massachusetts 666 104 533 83 19181 214 19395Michigan 821 81 672 67 14941 113 15054Minnesota 226 44 212 41 4817 28 4845Mississippi 368 127 365 125 6642 56 6698Missouri 385 66 469 80 11016 61 11077Montana 21 22 7 07 373 3 376Nebraska 53 30 118 67 1479 11 1490Nevada 293 121 294 118 5733 29 5762New Hampshire 33 25 55 42 1074 10 1084New Jersey 1262 145 1065 122 48750 778 49528New Mexico 134 70 93 48 2603 7 2610New York 6201 321 5495 285 174908 2354 177262North Carolina 916 106 1229 139 15954 118 16072North Dakota 10 16 6 09 144 1 145Ohio 753 66 767 67 14957 138 15095Oklahoma 281 79 205 57 4836 26 4862Oregon 217 60 281 76 5995 20 6015Pennsylvania 1486 120 1893 152 33417 365 33782Rhode Island 87 81 111 104 2580 28 2608South Carolina 682 161 705 163 13301 105 13406South Dakota 18 23 18 23 255 5 260Tennessee 818 137 680 113 12457 59 12516Texas 3045 133 2998 128 69735 392 70127Utah 63 25 57 22 2295 20 2315Vermont 5 08 18 29 461 6 467Virginia 638 84 605 79 16802 177 16979Washington 485 77 389 61 11792 34 11826West Virginia 74 41 67 37 1500 11 1511Wisconsin 122 22 217 39 4513 33 4546Wyoming 6 12 8 16 228 2 230

Subtotal 40123 135 37911 127 952221 9094 961315

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 29

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulativemdashUnited States and dependent areas (cont)

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

US dependent areasAmerican Samoa 0 0 0 0 1 0 1Guam 0 0 0 0 68 1 69Northern Mariana Islands 0 0 0 0 3 0 3Puerto Rico 1029 263 850 216 29511 400 29911US Virgin Islands 17 156 32 295 629 18 647Otherb 0 0 0 0 3 0 3

Totalc 41357 138 39002 129 983343 9522 992865d

a From the beginning of the epidemic through 2006b Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasc Includes persons whose state or area of residence is unknownd Includes 916 persons whose state or area of residence is unknown

30 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

MSA (population gt 500000)

Akron Ohio 66 94 32 46 762 1 763

AlbanyndashSchenectadyndashTroy NY 97 114 105 123 2253 24 2277

Albuquerque N Mex 70 88 50 61 1404 2 1406

AllentownndashBethlehemndashEaston PandashNJ 72 91 119 149 1352 17 1369

AtlantandashSandy SpringsndashMarietta Ga 1586 319 1006 196 21896 128 22024

AugustandashRichmond County GandashSC 106 205 32 61 1851 24 1875

AustinndashRound Rock Tex 227 156 186 123 4830 26 4856

Bakersfield Calif 76 100 122 156 1528 8 1536

BaltimorendashTowson Md 1064 401 1001 377 20352 218 20570

Baton Rouge La 222 304 231 301 3732 20 3752

BirminghamndashHoover Ala 151 139 110 100 2614 25 2639

Boise CityndashNampa Idaho 14 26 14 25 281 0 281

Boston MassndashNHa 441 99 355 80 13476 147 13623

Boston Division 269 146 185 101 8451 91 8542

Cambridge Division 108 74 102 70 3126 35 3161

Essex Division 52 71 51 69 1577 20 1597

BridgeportndashStamfordndashNorwalk Conn 181 201 135 150 3733 57 3790

BuffalondashNiagara Falls NY 117 102 96 84 2476 20 2496

Cape CoralndashFort Myers Fla 44 81 91 159 1692 24 1716

CharlestonndashNorth Charleston SC 92 155 91 151 2034 18 2052

CharlottendashGastoniandashConcord NCndashSC 214 141 285 180 3242 22 3264

Chicago IllndashIndndashWis 1716 182 1159 122 30118 261 30379

Chicago Division 1604 203 1073 135 28300 248 28548

Gary Division 61 88 50 71 1038 8 1046

Lake Division 51 59 36 41 780 5 785

CincinnatindashMiddletown OhiondashKyndashInd 111 53 199 95 2735 17 2752

ClevelandndashElyriandashMentor Ohio 228 107 170 80 4226 48 4274

Colorado Springs Colo 19 32 21 35 576 5 581

Columbia SC 177 256 197 280 3274 24 3298

Columbus Ohio 166 97 165 96 3112 15 3127

Dallas Tex 874 150 929 155 20238 63 20301

Dallas Division 681 175 714 178 16038 37 16075

Fort Worth Division 193 100 215 108 4200 26 4226

Dayton Ohio 58 69 54 64 1217 15 1232

DenverndashAurora Colo 274 116 236 98 6899 22 6921

Des Moines Iowa 30 57 23 43 530 4 534

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 31

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Detroit Mich 570 127 445 100 10373 73 10446

Detroit Division 443 223 330 167 8268 57 8325

Warren Division 127 51 115 46 2105 16 2121

El Paso Tex 56 78 40 54 1476 10 1486

Fresno Calif 52 59 64 72 1430 11 1441

Grand RapidsndashWyoming Mich 46 60 51 66 816 6 822

GreensborondashHigh Point NC 52 77 66 96 1265 14 1279

Greenville SC 70 119 67 111 1292 4 1296

HarrisburgndashCarlisle Pa 23 44 67 128 1224 8 1232

HartfordndashWest HartfordndashEast Hartford Conn 256 216 135 114 5126 46 5172

Honolulu Hawaii 54 60 69 76 2121 14 2135

HoustonndashBaytownndashSugar Land Tex 1017 190 1092 197 25821 172 25993

Indianapolis Ind 191 116 150 90 3824 25 3849

Jackson Miss 134 257 117 221 2419 30 2449

Jacksonville Fla 309 248 315 246 6020 75 6095

Kansas City MondashKans 183 94 160 81 4669 15 4684

Knoxville Tenn 47 72 35 52 882 5 887

Lakeland Fla 103 190 112 199 1811 21 1832

Las VegasndashParadise Nev 245 143 258 145 4616 28 4644

Little RockndashNorth Little Rock Ark 87 135 75 115 1383 14 1397

Los Angeles Calif 1529 118 1684 130 57953 293 58246

Los Angeles Division 1339 135 1435 144 51098 250 51348

Santa Anna Division 190 63 249 83 6855 43 6898

Louisville KyndashInd 123 102 97 79 2286 22 2308

Madison Wis 10 19 29 53 520 4 524

McAllenndashEdinburgndashPharr Tex 57 84 45 64 630 11 641

Memphis TennndashMissndashArk 402 320 346 271 5128 19 5147

Miami Fla 2420 446 2289 419 55807 997 56804

Fort Lauderdale Division 810 455 769 430 16412 262 16674

Miami Division 1243 523 1165 485 29703 512 30215

West Palm Beach Division 367 290 355 279 9692 223 9915

MilwaukeendashWaukeshandashWest Allis Wis 68 45 109 72 2507 18 2525

MinneapolisndashSt PaulndashBloomington MinnndashWis 186 59 184 58 4259 22 4281

Modesto Calif 36 71 22 43 671 6 677

NashvillendashDavidsonndashMurfreesboro Tenn 224 158 172 118 3848 20 3868

New HavenndashMilford Conn 169 200 107 127 4573 73 4646

New OrleansndashMetairiendashKenner La 393 299 271 264 8835 67 8902

32 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

New York NYndashNJndashPa 6215 330 5500 292 195177 2906 198083

Edison Division 191 83 130 56 6709 139 6848

Nassau Division 262 93 246 88 8141 110 8251

New York Division 5266 456 4716 408 160408 2323 162731

Newark Division 496 231 408 190 19919 334 20253

Oklahoma City Okla 125 108 88 75 2255 5 2260

OmahandashCouncil Bluffs NebndashIowa 37 46 80 97 1035 3 1038

Orlando Fla 544 282 517 260 8653 92 8745

OxnardndashThousand OaksndashVentura Calif 49 62 21 26 1008 3 1011

Palm BayndashMelbournendashTitusville Fla 68 129 61 114 1512 11 1523

Philadelphia PandashNJndashDelndashMd 1261 217 1348 231 28221 313 28534

Camden Division 108 87 111 89 3118 42 3160

Philadelphia Division 1022 263 1144 294 22112 250 22362

Wilmington Division 131 191 93 134 2991 21 3012

PhoenixndashMesandashScottsdale Ariz 460 119 376 93 7459 31 7490

Pittsburgh Pa 143 60 135 57 3182 19 3201

PortlandndashSouth Portland Maine 9 18 34 66 562 1 563

PortlandndashVancouverndashBeaverton OrendashWash 170 81 215 101 4825 10 4835

PoughkeepsiendashNewburghndashMiddletown NY 136 204 113 168 3162 24 3186

ProvidencendashNew BedfordndashFall River RIndashMass 132 82 155 96 3900 44 3944

RaleighndashCary NC 138 145 201 202 1987 13 2000

Richmond Va 119 101 122 102 3371 35 3406

RiversidendashSan BernardinondashOntario Calif 361 92 306 76 8568 60 8628

Rochester NY 165 159 124 120 3134 13 3147

SacramentondashArden-ArcadendashRoseville Calif 154 75 169 82 4000 26 4026

St Louis MondashIll 192 69 366 131 5965 40 6005

Salt Lake City Utah 46 44 40 37 1743 10 1753

San Antonio Tex 215 114 247 127 4987 30 5017

San DiegondashCarlsbadndashSan Marcos Calif 491 167 384 131 12934 61 12995

San Francisco Calif 867 209 690 165 40152 96 40248

Oakland Division 312 126 246 99 9546 48 9594

San Francisco Division 555 329 444 261 30606 48 30654

San JosendashSunnyvalendashSanta Clara Calif 88 50 145 81 3747 15 3762

San JuanndashCaguasndashGuaynabo PR 745 289 578 223 21402 277 21679

SarasotandashBradentonndashVenice Fla 82 122 104 152 1978 27 2005

ScrantonndashWilkes-Barre Pa 27 49 47 85 572 6 578

Seattle Wash 353 110 280 86 9172 27 9199

Seattle Division 316 129 255 102 8161 18 8179

Tacoma Division 37 49 25 33 1011 9 1020

Springfield Mass 88 128 45 66 2075 26 2101

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 33

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Stockton Calif 52 78 52 77 1076 15 1091

Syracuse NY 52 80 49 75 1317 8 1325

TampandashSt PetersburgndashClearwater Fla 559 211 605 224 11174 112 11286

Toledo Ohio 25 38 66 101 812 14 826

Tucson Ariz 103 111 100 106 2010 10 2020

Tulsa Okla 83 94 65 72 1494 10 1504

Virginia BeachndashNorfolkndashNewport News VandashNC 183 111 132 80 4711 63 4774

Washington DCndashVandashMdndashWV 1322 252 1684 318 31130 315 31445

Bethesda Division 135 118 173 150 2774 23 2797

Washington Division 1187 289 1511 365 28356 292 28648

Wichita Kans 35 60 38 64 851 2 853

Worcester Mass 76 97 79 101 1783 20 1803

YoungstownndashWarrenndashBoardman OhiondashPa 27 46 26 44 519 0 519

Subtotal for MSAs (population gt500000) 33602 173 31274 159 829633 8171 837804

Metropolitan areas (population of 50000 to 499999) 4477 80 4466 79 94829 847 95676

Nonmetropolitan areas 2666 54 2732 55 52063 445 52508

Totalb 41144 137 38749 128 981708 9494 991202

Note Because of the lack of census information for all US dependent areas includes data for only the 50 states the District of Columbia and Puerto RicoMSA metropolitan statistical areaMSA definitions for this report can be found at httpwwwcensusgovpopulationwwwestimatesmetrodefhtmla Reported case counts for the metropolitan divisions do not sum to the MSA total MSA total includes data from 1 metropolitan division with

population of lt500000b Includes persons whose county of residence is unknown

34 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Alabama (January 1988) 502 6041 48 6089

Alaska (February 1999) 38 285 2 287

Arizona (January 1987) 617 5877 80 5957

Arkansas (July 1989) 206 2349 20 2369

California (April 2006) 6581 7056 92 7148

Colorado (November 1985) 319 6084 31 6115

Connecticut (January 2005)b 826 2500 101 2601

Delaware (February 2006) 788 801 18 819

Florida (July 1997)c 4163 36386 397 36783

Georgia (December 2003) 2245 8197 194 8391

Idaho (June 1986) 35 340 4 344

Illinois (January 2006) 6241 6661 162 6823

Indiana (July 1988) 399 4027 43 4070

Iowa (July 1998) 69 586 5 591

Kansas (July 1999) 142 1225 15 1240

Kentucky (October 2004) 333 1303 13 1316

Louisiana (February 1993) 728 8149 166 8315

Maine (January 2006) 386 393 3 396

Michigan (April 1992) 635 6702 134 6836

Minnesota (October 1985) 309 3356 40 3396

Mississippi (August 1988) 352 4549 59 4608

Missouri (October 1987) 502 5086 55 5141

Nebraska (September 1995) 91 672 14 686

Nevada (February 1992) 339 3532 24 3556

New Hampshire (January 2005) 59 466 9 475

New Jersey (January 1992) 1477 17513 325 17838

New Mexico (January 1998) 114 949 4 953

New York (June 2000) 5326 42345 1820 44165

North Carolina (February 1990) 1615 13879 143 14022

North Dakota (January 1988) 4 82 1 83

Ohio (June 1990) 867 8222 101 8323

Oklahoma (June 1988) 229 2401 30 2431

Oregon (April 2006) 49 95 19 114

Pennsylvania (October 2002)d 4269 9537 179 9716

Rhode Island (July 2006) 14 21 0 21

South Carolina (February 1986) 493 6970 93 7063

South Dakota (January 1988) 18 215 6 221

Tennessee (January 1992) 732 7115 90 7205

Texas (January 1999)e 3370 24282 417 24699

Utah (April 1989) 106 893 14 907

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 35

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Virginia (July 1989) 864 10257 95 10352

Washington (March 2006) 4048 4157 40 4197

West Virginia (January 1989) 66 673 8 681

Wisconsin (November 1985) 261 2500 31 2531

Wyoming (June 1989) 7 93 1 94

Subtotal 50834 274822 5146 279968

US dependent areas

American Samoa (August 2001) 0 1 0 1

Guam (March 2000) 2 66 0 66

Northern Mariana Islands (October 2001) 2 7 0 7

Puerto Rico (January 2003) 1471 5610 91 5701

US Virgin Islands (December 1998) 22 247 6 253

Persons reported from areas with confidential name-based HIV infection reporting but who were residents of other areas 132 685 21 706

Totalf 52878 282640 5314 287954

Note Includes data from 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through 2006b Beginning in 1992 Connecticut had name-based HIV reporting for cases in children only From January 2002 through December 2004

Connecticut had name- or code-based HIV reporting for cases in adolescents and adults As of January 2005 Connecticut has name-based reporting of all cases of HIV infection

c Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterd On October 18 2002 Pennsylvania initiated confidential name-based HIV infection reporting in all areas except Philadelphia Code-based

reporting was implemented in Philadelphia in March 2004 and the switch to name-based reporting was made in October 2005e From February 1994 through December 1998 Texas reported HIV infection in children onlyf Includes 1252 persons reported from areas with confidential name-based HIV infection reporting but whose area of residence is unknown

36 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulativemdashUnited States and dependent areas

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No Adult or adolescentMale-to-male sexual contact 13775 49 429897 54 mdash mdash mdash mdash 13775 35 429897 44Injection drug use 3413 12 163070 21 1826 17 67693 35 5239 13 230763 23Male-to-male sexual contact and

injection drug use 1603 6 65524 8 mdash mdash mdash mdash 1603 4 65524 7Hemophiliacoagulation disorder 43 0 5176 1 11 0 348 0 54 0 5524 1High-risk heterosexual contactc 2997 11 49610 6 4839 46 85186 44 7836 20 134796 14

Sex with injection drug user 330 1 11683 1 706 7 26073 14 1036 3 37756 4Sex with bisexual male mdash mdash mdash mdash 234 2 5162 3 234 1 5162 1Sex with person with hemophilia 1 0 84 0 11 0 502 0 12 0 586 0Sex with HIV-infected transfusion

recipient 22 0 553 0 21 0 793 0 43 0 1346 0Sex with HIV-infected person risk

factor not specified 2644 9 37290 5 3867 37 52656 27 6511 17 89946 9Receipt of blood transfusion blood

d components or tissue 63 0 5213 1 68 1 4176 2 131 0 9389 1Otherrisk factor not reported or

identifiede 6484 23 73136 9 3793 36 34311 18 10278 26 107450 11Subtotal 28378 100 791626 100 10537 100 191714 100 38916 100 983343 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 0 0 222 5 0 0 7 0 0 0 229 2Mother with documented HIV infection or

1 of the following risk factors 24 75 4315 89 50 93 4423 95 74 86 8738 92Injection drug use 4 13 1676 35 4 7 1665 36 8 9 3341 35Sex with injection drug user 4 13 789 16 4 7 750 16 8 9 1539 16Sex with bisexual male 1 3 101 2 2 4 110 2 3 3 211 2Sex with person with hemophilia 0 0 20 0 0 0 16 0 0 0 36 0Sex with HIV-infected transfusion

recipient 0 0 11 0 0 0 15 0 0 0 26 0Sex with HIV-infected person risk

factor not specified 6 19 742 15 17 31 790 17 23 27 1532 16Receipt of blood transfusion blood

components or tissue 0 0 70 1 0 0 82 2 0 0 152 2Has HIV infection risk factor not

specified 9 28 906 19 23 43 995 21 32 37 1901 20Receipt of blood transfusion blood

fcomponents or tissue 1 3 243 5 0 0 144 3 1 1 387 4Otherrisk factor not reported or

identifiedg 7 22 75 2 4 7 93 2 11 13 168 2Subtotal 32 100 4855 100 54 100 4667 100 86 100 9522 100

Total 28410 100 796481 100 10591 100 196381 100 39002 100 992865 100a From the beginning of the epidemic through 2006b From the beginning of the epidemic through 2006 Includes 3 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infectiond AIDS developed in 47 adultsadolescents after they received blood that had tested negative for HIV antibodies AIDS developed in 14 additional adults

after they received tissue organs or artificial insemination from HIV-infected donors Four of the 14 received tissue or organs from a donor who was negative for HIV antibody at the time of donation

e Includes 37 adultsadolescents who were exposed to HIV-infected blood body fluids or concentrated virus in health care laboratory or household settings as supported by seroconversion epidemiologic andor laboratory evidence One person was infected after intentional inoculation with HIV-infected blood Includes an additional 740 persons who acquired HIV infection perinatally but who were more than 12 years of age when AIDS was diagnosed These 740 persons are not counted in the values for the pediatric transmission category

f AIDS developed in 3 children after they received blood that had tested negative for HIV antibodiesg Includes 5 children who were exposed to HIV-infected blood as supported by seroconversion epidemiologic andor laboratory evidence 1 child was

infected after intentional inoculation with HIV-infected blood and 5 children were exposed to HIV-infected blood in a household setting Of the 168 children 26 had sexual contact with an adult with or at high risk for HIV infection

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 37

Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No

Adult or adolescentMale-to-male sexual contact 22912 59 103679 52 mdash mdash mdash mdash 22912 44 103679 37

Injection drug use 3503 9 24255 12 2124 16 13925 17 5627 11 38181 14

Male-to-male sexual contact and injection drug use 1946 5 10704 5 mdash mdash mdash mdash 1946 4 10704 4

Hemophiliacoagulation disorder 43 0 495 0 6 0 73 0 49 0 568 0

High-risk heterosexual contactc 2874 7 16830 8 5939 45 38315 47 8813 17 55145 20

Sex with injection drug user 308 1 2601 1 757 6 6791 8 1065 2 9392 3

Sex with bisexual male mdash mdash mdash mdash 328 2 2265 3 328 1 2265 1

Sex with person with hemophilia 4 0 31 0 16 0 201 0 20 0 232 0

Sex with HIV-infected transfusion recipient 13 0 131 0 28 0 223 0 41 0 354 0

Sex with HIV-infected person risk factor not specified 2549 7 14067 7 4810 36 28835 35 7359 14 42902 15

Receipt of blood transfusion blood components or tissue 61 0 489 0 50 0 536 1 111 0 1025 0

Otherrisk factor not reported or identified 7748 20 44021 22 5106 39 29312 36 12854 25 73338 26

Subtotal 39087 100 200473 100 13225 100 82161 100 52312 100 282640 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 8 3 106 4 0 0 1 0 8 1 107 2

Mother with documented HIV infection or 1 of the following risk factors 197 74 2195 85 254 85 2417 89 451 80 4612 87

Injection drug use 34 13 532 21 53 18 561 21 87 15 1093 21

Sex with injection drug user 12 5 208 8 21 7 213 8 33 6 421 8

Sex with bisexual male 5 2 37 1 4 1 32 1 9 2 69 1

Sex with person with hemophilia 0 0 3 0 1 0 7 0 1 0 10 0

Sex with HIV-infected transfusion recipient 0 0 4 0 0 0 4 0 0 0 8 0

Sex with HIV-infected person risk factor not specified 54 20 534 21 76 25 629 23 130 23 1163 22

Receipt of blood transfusion blood components or tissue 0 0 17 1 2 1 20 1 2 0 37 1

Has HIV infection risk factor not specified 92 35 860 33 97 32 951 35 189 33 1811 34

Receipt of blood transfusion blood components or tissue 6 2 28 1 3 1 24 1 9 2 52 1

Otherrisk factor not reported or identified 55 21 260 10 43 14 283 10 98 17 543 10

Subtotal 266 100 2589 100 300 100 2725 100 566 100 5314 100

Total 39353 100 203062 100 13525 100 84886 100 52878 100 287954 100

Note See Table 16 for the list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006b From the beginning of the epidemic through December 2006 Includes 6 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infection

38 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity

2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 6251 65 253927 73Injection drug use 733 8 31737 9Male-to-male sexual contact and injection drug use 732 8 31434 9Hemophiliacoagulation disorder 26 0 3989 1High-risk heterosexual contactb 416 4 7850 2

Sex with injection drug user 74 1 2310 1

Sex with person with hemophilia 0 0 36 0

Sex with HIV-infected transfusion recipient 2 0 176 0

Sex with HIV-infected person risk factor not specified 340 4 5328 2Receipt of blood transfusion blood components or tissue 20 0 3194 1Otherrisk factor not reported or identified 1400 15 16469 5

Total 9578 100 348600 100

Black not HispanicMale-to-male sexual contact 4309 36 103297 37Injection drug use 1635 14 83369 30Male-to-male sexual contact and injection drug use 526 4 22134 8Hemophiliacoagulation disorder 10 0 604 0High-risk heterosexual contactb 1875 16 29952 11

Sex with injection drug user 167 1 6823 2Sex with person with hemophilia 1 0 36 0Sex with HIV-infected transfusion recipient 15 0 237 0Sex with HIV-infected person risk factor not specified 1692 14 22856 8

Receipt of blood transfusion blood components or tissue 24 0 1218 0Otherrisk factor not reported or identified 3579 30 40268 14

Total 11958 100 280842 100

HispanicMale-to-male sexual contact 2816 47 64893 44Injection drug use 965 16 46337 31Male-to-male sexual contact and injection drug use 287 5 10884 7Hemophiliacoagulation disorder 6 0 466 0High-risk heterosexual contactb 638 11 10950 7

Sex with injection drug user 84 1 2409 2Sex with person with hemophilia 0 0 11 0Sex with HIV-infected transfusion recipient 5 0 125 0Sex with HIV-infected person risk factor not specified 549 9 8405 6

Receipt of blood transfusion blood components or tissue 17 0 657 0Otherrisk factor not reported or identified 1326 22 14832 10

Total 6055 100 149019 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 39

a

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulative

No No

AsianPacific IslanderMale-to-male sexual contact 225 54 4475 68Injection drug use 20 5 317 5Male-to-male sexual contact and injection drug use 17 4 284 4Hemophiliacoagulation disorder 1 0 70 1High-risk heterosexual contactb 34 8 376 6

Sex with injection drug user 1 0 54 1Sex with person with hemophilia 0 0 1 0Sex with HIV-infected transfusion recipient 0 0 8 0Sex with HIV-infected person risk factor not specified 33 8 313 5

Receipt of blood transfusion blood components or tissue 2 0 112 2Otherrisk factor not reported or identified 114 28 949 14

Total 413 100 6583 100

American IndianAlaska NativeMale-to-male sexual contact 61 49 1403 55Injection drug use 15 12 395 15Male-to-male sexual contact and injection drug use 23 19 457 18Hemophiliacoagulation disorder 0 0 27 1High-risk heterosexual contactb 9 7 118 5

Sex with injection drug user 1 1 33 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 8 6 82 3

Receipt of blood transfusion blood components or tissue 0 0 8 0Otherrisk factor not reported or identified 16 13 155 6

Total 124 100 2563 100

Total casesMale-to-male sexual contact 13775 49 429897 54Injection drug use 3413 12 163070 21Male-to-male sexual contact and injection drug use 1603 6 65524 8Hemophiliacoagulation disorder 43 0 5176 1High-risk heterosexual contactb 2997 11 49610 6

Sex with injection drug user 330 1 11683 1Sex with person with hemophilia 1 0 84 0Sex with HIV-infected transfusion recipient 22 0 553 0Sex with HIV-infected person risk factor not specified 2644 9 37290 5

Receipt of blood transfusion blood components or tissue 63 0 5213 1Otherrisk factor not reported or identified 6484 23 73136 9

Total 28378c 100 791626d 100a From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 4019 males of unknown race or multiple races

40 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 11963 73 55725 69Injection drug use 858 5 5512 7Male-to-male sexual contact and injection drug use 1092 7 5578 7Hemophiliacoagulation disorder 29 0 355 0High-risk heterosexual contactb 522 3 2658 3

Sex with injection drug user 65 0 544 1Sex with person with hemophilia 0 0 8 0Sex with HIV-infected transfusion recipient 3 0 33 0Sex with HIV-infected person risk factor not specified 454 3 2073 3

Receipt of blood transfusion blood components or tissue 14 0 197 0Otherrisk factor not reported or identified 1956 12 11147 14

Total 16434 100 81172 100

Black not HispanicMale-to-male sexual contact 6203 44 30148 37Injection drug use 1594 11 11997 15Male-to-male sexual contact and injection drug use 483 3 3489 4Hemophiliacoagulation disorder 10 0 109 0High-risk heterosexual contactb 1714 12 10905 13

Sex with injection drug user 169 1 1554 2Sex with person with hemophilia 4 0 17 0Sex with HIV-infected transfusion recipient 6 0 77 0Sex with HIV-infected person risk factor not specified 1535 11 9257 11

Receipt of blood transfusion blood components or tissue 32 0 223 0Otherrisk factor not reported or identified 4151 29 24632 30

Total 14187 100 81503 100

HispanicMale-to-male sexual contact 4094 55 15623 47Injection drug use 993 13 6407 19Male-to-male sexual contact and injection drug use 316 4 1402 4Hemophiliacoagulation disorder 3 0 26 0High-risk heterosexual contactb 582 8 2963 9

Sex with injection drug user 65 1 455 1Sex with person with hemophilia 0 0 6 0Sex with HIV-infected transfusion recipient 4 0 18 0Sex with HIV-infected person risk factor not specified 513 7 2484 7

Receipt of blood transfusion blood components or tissue 11 0 55 0Otherrisk factor not reported or identified 1475 20 6977 21

Total 7474 100 33453 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 41

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderMale-to-male sexual contact 402 70 1006 63Injection drug use 17 3 55 3Male-to-male sexual contact and injection drug use 15 3 38 2Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 25 4 96 6

Sex with injection drug user 3 1 10 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 22 4 83 5

Receipt of blood transfusion blood components or tissue 4 1 7 0Otherrisk factor not reported or identified 109 19 397 25

Total 572 100 1600 100

American IndianAlaska NativeMale-to-male sexual contact 104 61 516 57Injection drug use 13 8 101 11Male-to-male sexual contact and injection drug use 19 11 110 12Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 10 6 53 6

Sex with injection drug user 2 1 14 2Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 8 5 39 4

Receipt of blood transfusion blood components or tissue 0 0 2 0Otherrisk factor not reported or identified 24 14 125 14

Total 170 100 907 100

Total casesMale-to-male sexual contact 22912 59 103679 52Injection drug use 3503 9 24255 12Male-to-male sexual contact and injection drug use 1946 5 10704 5Hemophiliacoagulation disorder 43 0 495 0High-risk heterosexual contactb 2874 7 16830 8

Sex with injection drug user 308 1 2601 1Sex with person with hemophilia 4 0 31 0Sex with HIV-infected transfusion recipient 13 0 131 0Sex with HIV-infected person risk factor not specified 2549 7 14067 7

Receipt of blood transfusion blood components or tissue 61 0 489 0Otherrisk factor not reported or identified 7748 20 44021 22

Total 39087c 100 200473d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 1838 males of unknown race or multiple races

42 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race

ethnicity 2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 482 28 14981 40Hemophiliacoagulation disorder 4 0 123 0High-risk heterosexual contactb 725 42 15799 42

Sex with injection drug user 153 9 5650 15Sex with bisexual male 63 4 1859 5Sex with person with hemophilia 5 0 329 1Sex with HIV-infected transfusion recipient 5 0 338 1Sex with HIV-infected person risk factor not specified 499 29 7623 20

Receipt of blood transfusion blood components or tissue 15 1 1870 5Otherrisk factor not reported or identified 499 29 4801 13

Total 1725 100 37574 100

Black not HispanicInjection drug use 982 15 38914 34Hemophiliacoagulation disorder 3 0 145 0High-risk heterosexual contactb 3103 46 49876 44

Sex with injection drug user 373 6 13530 12Sex with bisexual male 136 2 2352 2Sex with person with hemophilia 4 0 121 0Sex with HIV-infected transfusion recipient 8 0 277 0Sex with HIV-infected person risk factor not specified 2582 38 33596 29

Receipt of blood transfusion blood components or tissue 39 1 1546 1Otherrisk factor not reported or identified 2612 39 23894 21

Total 6739 100 114375 100

HispanicInjection drug use 322 18 12892 35Hemophiliacoagulation disorder 4 0 67 0High-risk heterosexual contactb 894 49 17995 49

Sex with injection drug user 166 9 6522 18Sex with bisexual male 32 2 818 2Sex with person with hemophilia 1 0 45 0Sex with HIV-infected transfusion recipient 7 0 141 0Sex with HIV-infected person risk factor not specified 688 38 10469 29

Receipt of blood transfusion blood components or tissue 12 1 619 2Otherrisk factor not reported or identified 592 32 5023 14

Total 1824 100 36596 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 43

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 8 8 125 12Hemophiliacoagulation disorder 0 0 7 1High-risk heterosexual contactb 49 47 574 53

Sex with injection drug user 4 4 114 11Sex with bisexual male 2 2 80 7Sex with person with hemophilia 0 0 4 0Sex with HIV-infected transfusion recipient 1 1 25 2Sex with HIV-infected person risk factor not specified 42 40 351 33

Receipt of blood transfusion blood components or tissue 1 1 93 9Otherrisk factor not reported or identified 46 44 279 26

Total 104 100 1078 100

American IndianAlaska NativeInjection drug use 13 32 280 42Hemophiliacoagulation disorder 0 0 3 0High-risk heterosexual contactb 15 37 277 41

Sex with injection drug user 4 10 107 16Sex with bisexual male 1 2 27 4Sex with person with hemophilia 0 0 2 0Sex with HIV-infected transfusion recipient 0 0 6 1Sex with HIV-infected person risk factor not specified 10 24 135 20

Receipt of blood transfusion blood components or tissue 1 2 17 3Otherrisk factor not reported or identified 12 29 95 14

Total 41 100 672 100

Total casesInjection drug use 1826 17 67693 35Hemophiliacoagulation disorder 11 0 348 0High-risk heterosexual contactb 4839 46 85186 44

Sex with injection drug user 706 7 26073 14Sex with bisexual male 234 2 5162 3Sex with person with hemophilia 11 0 502 0Sex with HIV-infected transfusion recipient 21 0 793 0Sex with HIV-infected person risk factor not specified 3867 37 52656 27

Receipt of blood transfusion blood components or tissue 68 1 4176 2Otherrisk factor not reported or identified 3793 36 34311 18

Total 10537c 100 191714d 100a From the beginning of the epidemic through 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 104 females of unknown race or multiple racesd Includes 1419 females of unknown race or multiple races

44 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 690 26 4260 26Hemophiliacoagulation disorder 3 0 24 0

bHigh-risk heterosexual contact 1132 42 7593 46Sex with injection drug user 205 8 1876 11Sex with bisexual male 98 4 659 4Sex with person with hemophilia 10 0 115 1Sex with HIV-infected transfusion recipient 7 0 64 0Sex with HIV-infected person risk factor not specified 812 30 4879 29

Receipt of blood transfusion blood components or tissue 12 0 146 1Otherrisk factor not reported or identified 850 32 4567 28

Total 2687 100 16590 100

Black not HispanicInjection drug use 1034 13 7105 14Hemophiliacoagulation disorder 1 0 35 0

bHigh-risk heterosexual contact 3451 44 23732 46Sex with injection drug user 313 4 3473 7Sex with bisexual male 155 2 1294 3Sex with person with hemophilia 5 0 71 0Sex with HIV-infected transfusion recipient 14 0 120 0Sex with HIV-infected person risk factor not specified 2964 38 18774 36

Receipt of blood transfusion blood components or tissue 26 0 324 1Otherrisk factor not reported or identified 3370 43 20244 39

Total 7882 100 51440 100

HispanicInjection drug use 339 15 2280 18Hemophiliacoagulation disorder 2 0 11 0

bHigh-risk heterosexual contact 1198 52 6264 50Sex with injection drug user 218 9 1324 11Sex with bisexual male 62 3 266 2Sex with person with hemophilia 1 0 11 0Sex with HIV-infected transfusion recipient 7 0 39 0Sex with HIV-infected person risk factor not specified 910 39 4624 37

Receipt of blood transfusion blood components or tissue 12 1 58 0Otherrisk factor not reported or identified 767 33 3843 31

Total 2318 100 12456 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 45

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 15: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006mdash50 states and the District of Columbia

Raceethnicity

Adults or adolescents

Children (lt13 yrs) TotalaMales Females Totala

No Rate No Rate No Rate No Rate No Rate

White not Hispanic 9267 112 1659 19 10926 64 4 00 10929 54Black not Hispanic 11540 829 6391 404 17930 603 30 04 17960 476Hispanic 5388 313 1516 95 6903 208 3 00 6907 156AsianPacific Islander 423 75 95 16 518 44 1 00 519 37American IndianAlaska Native 118 122 37 36 155 78 0 00 155 62

Totalb 26989 224 9801 78 36790 149 38 01 36828c 123

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reportingData exclude cases in persons whose state or area of residence is unknown as well as cases from US dependent areas for which census information about race and age categories is lackinga Because row totals were calculated independently of the values for the subpopulations the values in each row may not sum to the row totalb Includes person of unknown race or multiple races Because column totals were calculated independently of the values for the subpopulations the

values in each column may not sum to the column totalc Includes 358 persons of unknown race or multiple races

Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006mdash33 states with confidential name-based HIV infection reporting

Raceethnicity

Adults or adolescents

Children (lt13 yrs) TotalaMales Females Totala

No Rate No Rate No Rate No Rate No Rate

White not Hispanic 9078 167 1664 29 10742 96 16 01 10758 82Black not Hispanic 11230 1191 6033 562 17263 856 93 17 17356 677Hispanic 5058 509 1400 151 6458 337 23 04 6481 255AsianPacific Islander 318 135 79 32 397 82 0 00 397 67American IndianAlaska Native 129 177 35 46 164 110 2 06 166 88

Totalb 25928 338 9252 115 35180 224 135 04 35314c 185

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Because row totals were calculated independently of the values for the subpopulations the values in each row may not sum to the row totalb Includes persons of unknown race or multiple races Because column totals were calculated independently of the values for the subpopulations the

values in each column may not sum to the column totalc Includes 156 persons of unknown race or multiple races

Cases of HIVAIDS and AIDS 15

Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006mdashUnited States and dependent areas

Transmission category

Place of birth

United StatesCentralSouth

America Cuba Mexico Puerto Rico Totala

No No No No No No

Male-to-male sexual contact 1172 45 402 49 89 62 790 59 249 18 3337 43Injection drug use 569 22 83 10 13 9 133 10 533 40 1650 21Male-to-male sexual contact

and injection drug use 158 6 25 3 6 4 59 4 63 5 357 5High-risk heterosexual

contactb 661 25 296 36 35 24 342 26 487 36 2282 30Otherc 47 2 8 1 0 0 9 1 14 1 103 1

Totald 2608 100 814 100 145 100 1334 100 1346 100 7728 100Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Includes 222 persons whose place of birth is not among those listed and 1260 persons whose place of birth is unknownb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the

column total

16 Cases of HIVAIDS and AIDS

Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas

Year of death

Cumulativea2002 2003 2004 2005 2006

Data for 50 states and the District of ColumbiaAge at death (yrs)lt13 25 22 15 7 13 4889

13ndash14 10 6 15 12 5 276

15ndash19 39 36 36 38 44 1104

20ndash24 151 157 175 147 162 8716

25ndash29 553 512 482 458 405 43671

30ndash34 1480 1272 1128 1069 785 95351

35ndash39 2967 2763 2425 2096 1682 116746

40ndash44 3595 3516 3393 3317 2636 104133

45ndash49 3294 3234 3251 3275 2886 72831

50ndash54 2318 2373 2502 2645 2343 44255

55ndash59 1209 1322 1425 1543 1480 25123

60ndash64 616 705 741 797 771 14315

gt65 691 773 807 865 805 14393

RaceethnicityWhite not Hispanic 5214 5097 4836 4758 3860 239529

Black not Hispanic 9037 8675 8581 8679 7426 218392

Hispanic 2429 2632 2641 2513 2425 80690

AsianPacific Islander 97 84 111 87 114 3426

American IndianAlaska Native 83 73 80 65 66 1693

Transmission categoryMale adult or adolescentMale-to-male sexual contact 5960 5937 5735 5641 4930 266272

Injection drug use 3738 3547 3315 3314 2641 107173

Male-to-male sexual contact and injection drug use 1278 1299 1237 1289 1064 40993

High-risk heterosexual contactb 1465 1501 1625 1571 1470 26236

Otherc 160 149 125 117 80 9867

Subtotal 12601 12431 12038 11932 10184 450541

Female adult or adolescentInjection drug use 1923 1825 1855 1768 1456 43143

High-risk heterosexual contactb 2281 2292 2373 2458 2258 42620

Otherc 84 87 72 68 70 4131

Subtotal 4289 4204 4300 4295 3784 89895

Child (lt13 yrs at diagnosis)Perinatal 53 49 56 39 42 4848

Otherd 4 5 1 2 7 521

Subtotal 57 54 57 41 48 5369

Deaths 17

Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas (cont)

Year of death

Cumulativea2002 2003 2004 2005 2006

Region of residenceNortheast 5313 5012 4779 4750 4074 180623

Midwest 1726 1666 1482 1378 1325 54468

South 7337 7427 7535 7907 6475 197209

West 2571 2585 2600 2234 2141 113506

Subtotal for 50 states and the District of Columbia 16948 16690 16395 16268 14016 545805

Data for US dependent areas 667 575 572 562 580 19858

Totale 17628 17283 16982 16865 14627 565927f

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column totalf Includes 2082 persons of unknown race or multiple races 261 persons of unknown state of residence and 2 persons who were residents

of other areas

18 Deaths

Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003ndash2006mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

2003 2004 2005 2006Data for 33 states

Age at end of year (yrs)lt13 4154 3700 3294 286713ndash14 1130 1238 1212 113915ndash19 3298 3627 4024 453920ndash24 12389 12826 13411 1430125ndash29 26167 26924 28164 2960030ndash34 49602 47577 45109 4418935ndash39 80703 77871 75842 7363440ndash44 92040 97109 100102 10176445ndash49 71345 77490 83816 9028350ndash54 45133 51033 56640 6319555ndash59 22793 26610 31186 3600860ndash64 10820 12642 14422 16658gt65 8531 9959 11657 13551

RaceethnicityWhite not Hispanic 145081 151694 158375 166000Black not Hispanic 202951 212425 221439 231957Hispanic 72612 76503 80491 84720AsianPacific Islander 2234 2529 2858 3187American IndianAlaska Native 1788 1889 2008 2119

Transmission categoryMale adult or adolescentMale-to-male sexual contact 181771 193245 205423 218676Injection drug use 57651 58149 58369 59077Male-to-male sexual contact and injection drug use 23965 24434 24725 25085High-risk heterosexual contacta 40084 42559 44915 47562Otherb 3218 3278 3325 3424Subtotal 306689 321665 336756 353825

Female adult or adolescentInjection drug use 32346 32735 32973 33470High-risk heterosexual contacta 80324 85348 90185 95403Otherb 2036 2123 2212 2321Subtotal 114705 120206 125370 131195

Child (lt13 yrs at diagnosis)Perinatal 6137 6154 6178 6143Otherc 570 575 571 560Subtotal 6707 6730 6748 6703

Subtotal for 33 states 428107 448605 468879 491727Data for US dependent areas 15809 16399 17150 17955

Totald 443916 465005 486028 509681Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 19

Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission categorymdash33 states with confidential name-based HIV infection reporting

Transmission category

White not Hispanic

Black not Hispanic Hispanic

AsianPacific Islander

American IndianAlaska

Native Totala

No No No No No No

Male adult or adolescentMale-to-male sexual contact 108259 77 70242 49 36043 57 1669 68 938 62 218676 62Injection drug use 12328 9 31339 22 14472 23 264 11 216 14 59077 17Male-to-male sexual contact

and injection drug use 11283 8 9587 7 3720 6 93 4 205 13 25085 7High-risk heterosexual contactb 6667 5 31140 22 8788 14 395 16 143 9 47562 13Otherc 1458 1 1492 1 404 1 30 1 17 1 3424 1Subtotal 139994 100 143799 100 63427 100 2450 100 1519 100 353825 100

Female adult or adolescentInjection drug use 8262 33 19136 23 5528 28 106 15 175 30 33470 26High-risk heterosexual contactb 16338 65 63204 75 14132 71 573 82 392 68 95403 73Otherc 450 2 1469 2 344 2 24 3 12 2 2321 2Subtotal 25050 100 83809 100 20004 100 703 100 578 100 131195 100

Child (lt13 yrs at diagnosis)Perinatal 801 84 4064 93 1183 92 28 82 20 95 6143 92Otherd 154 16 283 7 107 8 6 18 1 5 560 8Subtotal 955 100 4347 100 1290 100 34 100 21 100 6703 100

Totale 166000 231957 84720 3187 2119 491727Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of 33 states that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Includes 3745 persons of unknown race or multiple racesb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes 5 persons of unknown sex Because column totals were calculated independently of the values for the subpopulations the values

in each column may not sum to the column total

20 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Map 1 Estimated rates (per 100000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

Note Rates adjusted for reporting delays Rates of HIV infection include only persons living with HIV infection that has not progressed to AIDSSince 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 Islandsa Includes persons whose area of residence is unknown

Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

Note Rates adjusted for reporting delays Rates of HIV infection include only persons living with HIV infection that has not progressed to AIDSSince 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 Islandsa Includes persons whose area of residence is unknown

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 21

Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002ndash2006mdashUnited States and dependent areas

2002 2003 2004 2005 2006Data for 50 states and the District of Columbia

Age at end of year (yrs)lt13 2308 2006 1684 1394 111513ndash14 685 747 784 762 71115ndash19 1465 1694 1974 2243 248720ndash24 3910 4292 4629 5033 536725ndash29 12725 12743 13045 13505 1435930ndash34 35558 33870 32057 29949 2882435ndash39 70107 68106 65076 62235 5964940ndash44 80377 86294 91335 94021 9517445ndash49 64702 71276 77417 84153 9077550ndash54 41270 46855 53333 59256 6647655ndash59 20113 24145 28356 33522 3901460ndash64 9681 11293 13305 15380 18072gt65 7520 8946 10604 12430 14669

RaceethnicityWhite not Hispanic 129426 135278 141508 147426 154495Black not Hispanic 150488 161326 171654 181056 191590Hispanic 63424 67895 72024 76334 80815AsianPacific Islander 3060 3426 3759 4121 4526American IndianAlaska Native 1254 1356 1458 1562 1651

Transmission categoryMale adult or adolescentMale-to-male sexual contact 158092 168233 178551 188622 199693Injection drug use 56708 58436 59940 61229 62998Male-to-male sexual contact and injection drug use 24726 25457 26144 26785 27523High-risk heterosexual contacta 27329 30300 33181 35916 39004Otherb 3588 3665 3769 3888 4026Subtotal 270444 286091 301585 316440 333244

Female adult or adolescentInjection drug use 27863 28874 29828 30646 31575High-risk heterosexual contacta 46445 51489 56229 60693 65631Otherb 1903 2033 2178 2315 2465Subtotal 76210 82395 88236 93653 99671

Child (lt13 yrs at diagnosis)Perinatal 3633 3654 3651 3664 3660Otherc 129 124 123 122 115Subtotal 3762 3778 3774 3786 3775

Region of residenceNortheast 105599 110929 115562 120208 125620Midwest 36011 38571 41178 44171 47010South 137081 147284 157975 166962 177591West 71729 75483 78883 82540 86473

Subtotal for 50 states and the District of Columbia 350419 372267 393598 413882 436693

Data for US dependent areas 9880 10365 10713 11106 11359

Totald 360617 383024 404849 425646 448871Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

22 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission categorymdash50 states and the District of Columbia

Transmission category

White not Hispanic

Black not Hispanic Hispanic

AsianPacific Islander

American IndianAlaska

Native Totala

No No No No No No

Male adult or adolescentMale-to-male sexual contact 101299 75 57520 45 36087 57 2715 72 704 57 199693 60Injection drug use 13168 10 33911 27 14795 23 325 9 201 16 62998 19Male-to-male sexual contact and

injection drug use 12393 9 10121 8 4352 7 198 5 220 18 27523 8High-risk heterosexual contactb 6081 5 24205 19 7816 12 444 12 105 8 39004 12Otherc 1743 1 1602 1 574 1 69 2 16 1 4026 1Subtotal 134683 100 127359 100 63623 100 3752 100 1246 100 333244 100

Female adult or adolescentInjection drug use 7407 38 18531 30 5025 30 115 15 153 39 31575 32High-risk heterosexual contactb 11350 59 41741 68 11092 67 588 78 227 58 65631 66Otherc 508 3 1456 2 413 2 51 7 13 3 2465 2Subtotal 19264 100 61728 100 16531 100 753 100 393 100 99671 100

Child (lt13 yrs at diagnosis)Perinatal 500 92 2468 99 629 95 20 94 12 100 3660 97Otherd 46 8 34 1 33 5 1 6 0 0 115 3Subtotal 546 100 2503 100 662 100 21 100 12 100 3775 100

Totale 154495 191590 80815 4526 1651 436693

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Includes 3616 persons of unknown race or multiple racesb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes 3 person of unknown sex Because column totals were calculated independently of the values for the subpopulations the values in each column

may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 23

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by

area of residence and age categorymdashUnited States and dependent areas

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

Alabama 5469 17 5486 3744 11 3755Alaska 272 1 273 330 1 331Arizona 5744 49 5793 4922 7 4929Arkansas 2291 7 2298 2139 6 2145California mdash mdash mdash 61451 105 61555Colorado 5855 13 5869 4083 2 4085Connecticut mdash mdash mdash 7406 15 7421Delaware mdash mdash mdash 1753 7 1760District of Columbia mdash mdash mdash 10059 30 10089Floridab 35461 263 35723 46469 194 46663Georgia mdash mdash mdash 17336 47 17383Hawaii mdash mdash mdash 1234 3 1237Idaho 356 0 356 313 0 313Illinois mdash mdash mdash 16139 46 16185Indiana 3849 21 3870 3996 14 4010Iowa 588 2 590 869 3 872Kansas 1230 7 1237 1272 2 1274Kentucky mdash mdash mdash 2589 13 2602Louisiana 7361 101 7462 8052 21 8074Maine mdash mdash mdash 512 2 514Maryland mdash mdash mdash 14540 41 14581Massachusetts mdash mdash mdash 8806 20 8826Michigan 6118 55 6173 6615 12 6627Minnesota 3227 21 3248 2314 9 2323Mississippi 4200 32 4232 3155 13 3168Missouri 4999 33 5033 5479 7 5486Montana mdash mdash mdash 205 0 205Nebraska 688 12 700 771 2 773Nevada 3402 13 3415 2969 3 2972New Hampshire mdash mdash mdash 556 3 559New Jersey 16059 153 16212 17168 57 17226New Mexico 910 0 909 1252 3 1255New York 42220 801 43021 70697 148 70845North Carolina 11700 60 11760 8451 12 8463North Dakota 87 2 89 73 1 74Ohio 8266 57 8323 7054 30 7084Oklahoma 2191 17 2208 2191 3 2194Oregon mdash mdash mdash 2840 4 2844Pennsylvania mdash mdash mdash 18633 71 18703Rhode Island mdash mdash mdash 1296 7 1303South Carolina 6349 45 6394 7035 23 7058South Dakota 195 4 199 139 1 140Tennessee 6579 51 6631 6403 11 6414Texas 24741 262 25003 34010 53 34063Utah 893 10 903 1164 0 1164Vermont mdash mdash mdash 238 2 240Virginia 9937 41 9978 8423 24 8447Washington mdash mdash mdash 5471 5 5476West Virginia 660 5 665 749 5 754Wisconsin 2322 15 2337 2153 12 2165Wyoming 86 2 88 102 1 103

Subtotal 224303 2174 226477 435621 1115 436736

24 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age categorymdashUnited States and dependent areas (cont)

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

US dependent areasAmerican Samoa 2 0 2 1 0 1Guam 63 0 63 36 0 36Northern Mariana Islands 7 0 7 3 0 3Puerto Rico 6269 31 6300 10971 26 10997US Virgin Islands 228 2 230 312 2 314Otherc mdash mdash mdash 1 0 1

Totald 230872 2207 233079 447724 1147 448871

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reporting a See Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at

least 2003b Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterc Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasd Total number of persons living with HIV infection (not AIDS) includes persons reported from areas with confidential name-based HIV

infection reporting who were residents of other states or whose area of residence is unknown Total number of persons living with AIDS includes persons whose area of residence is unknown Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 25

Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristicsmdashUnited States and dependent areas

No of persons

Survival in months

gt12 gt24 gt36Data for 50 states and the District of Columbia

Age at diagnosis (yrs)lt13 101 096 094 09413ndash14 60 098 098 09515ndash19 305 098 096 09520ndash24 1351 096 093 09225ndash29 3034 095 092 09130ndash34 5499 094 091 08935ndash39 7888 093 090 08740ndash44 7085 092 088 08545ndash49 5090 089 085 08250ndash54 3067 086 081 07855ndash59 1505 083 078 07460ndash64 806 080 073 069gt65 614 073 068 065

RaceethnicityWhite not Hispanic 10706 092 089 087Black not Hispanic 18406 090 086 082Hispanic 6398 092 090 088AsianPacific Islander 404 094 092 090American IndianAlaska Native 167 084 081 075

Transmission categoryMale adult or adolescentMale-to-male sexual contact 12830 093 090 088Injection drug use 4048 089 084 081Male-to-male sexual contact and injection drug use 1701 093 089 086High-risk heterosexual contacta 3170 091 088 085Otherb 5019 086 083 080Subtotal 26768 091 088 085

Female adult or adolescentInjection drug use 2101 089 083 078High-risk heterosexual contacta 4686 093 089 086Otherb 2749 090 085 083Subtotal 9536 091 087 083

Child (lt13 yrs at diagnosis)Perinatal 98 096 095 095Otherc 3 100 067 067Subtotal 101 096 094 094

Subtotal for 50 states and the District of Columbia 36405 091 087 085

Data for US dependent areas 891 083 078 075

Total 37352d 091 087 084Note Excludes persons whose date of death was before or in the same month as date of diagnosis Excludes persons whose month of diagnosis or month of death is unknowna Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes 325 persons of unknown race or multiple races

26 Survival after AIDS Diagnosis

Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by year of diagnosismdashUnited States and dependent areas

Months after AIDS diagnosis

Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by age groupmdashUnited States and dependent areas

Months after AIDS diagnosis

Survival after AIDS Diagnosis 27

Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by raceethnicitymdashUnited States and dependent areas

Months after AIDS diagnosis

28 Survival after AIDS Diagnosis

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006

and cumulativemdashUnited States and dependent areas

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Alabama 510 112 462 100 8626 76 8702Alaska 24 36 38 57 648 7 655Arizona 626 105 539 87 10396 46 10442Arkansas 237 85 252 90 3891 36 3927California 4069 113 3960 109 142254 664 142918Colorado 351 75 322 68 8742 31 8773Connecticut 658 188 422 120 14716 183 14899Delaware 177 210 116 136 3547 26 3573District of Columbia 672 1155 853 1467 17372 189 17561Florida 4921 277 4932 273 104084 1530 105614Georgia 2325 255 1605 171 31734 231 31965Hawaii 105 82 93 72 2927 17 2944Idaho 24 17 26 18 604 2 606Illinois 1886 148 1382 108 33620 282 33902Indiana 407 65 346 55 8239 56 8295Iowa 93 31 86 29 1727 13 1740Kansas 105 38 120 43 2781 14 2795Kentucky 249 60 207 49 4600 32 4632Louisiana 936 208 824 192 17612 128 17740Maine 21 16 68 51 1110 8 1118Maryland 1558 279 1626 290 30252 319 30571Massachusetts 666 104 533 83 19181 214 19395Michigan 821 81 672 67 14941 113 15054Minnesota 226 44 212 41 4817 28 4845Mississippi 368 127 365 125 6642 56 6698Missouri 385 66 469 80 11016 61 11077Montana 21 22 7 07 373 3 376Nebraska 53 30 118 67 1479 11 1490Nevada 293 121 294 118 5733 29 5762New Hampshire 33 25 55 42 1074 10 1084New Jersey 1262 145 1065 122 48750 778 49528New Mexico 134 70 93 48 2603 7 2610New York 6201 321 5495 285 174908 2354 177262North Carolina 916 106 1229 139 15954 118 16072North Dakota 10 16 6 09 144 1 145Ohio 753 66 767 67 14957 138 15095Oklahoma 281 79 205 57 4836 26 4862Oregon 217 60 281 76 5995 20 6015Pennsylvania 1486 120 1893 152 33417 365 33782Rhode Island 87 81 111 104 2580 28 2608South Carolina 682 161 705 163 13301 105 13406South Dakota 18 23 18 23 255 5 260Tennessee 818 137 680 113 12457 59 12516Texas 3045 133 2998 128 69735 392 70127Utah 63 25 57 22 2295 20 2315Vermont 5 08 18 29 461 6 467Virginia 638 84 605 79 16802 177 16979Washington 485 77 389 61 11792 34 11826West Virginia 74 41 67 37 1500 11 1511Wisconsin 122 22 217 39 4513 33 4546Wyoming 6 12 8 16 228 2 230

Subtotal 40123 135 37911 127 952221 9094 961315

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 29

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulativemdashUnited States and dependent areas (cont)

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

US dependent areasAmerican Samoa 0 0 0 0 1 0 1Guam 0 0 0 0 68 1 69Northern Mariana Islands 0 0 0 0 3 0 3Puerto Rico 1029 263 850 216 29511 400 29911US Virgin Islands 17 156 32 295 629 18 647Otherb 0 0 0 0 3 0 3

Totalc 41357 138 39002 129 983343 9522 992865d

a From the beginning of the epidemic through 2006b Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasc Includes persons whose state or area of residence is unknownd Includes 916 persons whose state or area of residence is unknown

30 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

MSA (population gt 500000)

Akron Ohio 66 94 32 46 762 1 763

AlbanyndashSchenectadyndashTroy NY 97 114 105 123 2253 24 2277

Albuquerque N Mex 70 88 50 61 1404 2 1406

AllentownndashBethlehemndashEaston PandashNJ 72 91 119 149 1352 17 1369

AtlantandashSandy SpringsndashMarietta Ga 1586 319 1006 196 21896 128 22024

AugustandashRichmond County GandashSC 106 205 32 61 1851 24 1875

AustinndashRound Rock Tex 227 156 186 123 4830 26 4856

Bakersfield Calif 76 100 122 156 1528 8 1536

BaltimorendashTowson Md 1064 401 1001 377 20352 218 20570

Baton Rouge La 222 304 231 301 3732 20 3752

BirminghamndashHoover Ala 151 139 110 100 2614 25 2639

Boise CityndashNampa Idaho 14 26 14 25 281 0 281

Boston MassndashNHa 441 99 355 80 13476 147 13623

Boston Division 269 146 185 101 8451 91 8542

Cambridge Division 108 74 102 70 3126 35 3161

Essex Division 52 71 51 69 1577 20 1597

BridgeportndashStamfordndashNorwalk Conn 181 201 135 150 3733 57 3790

BuffalondashNiagara Falls NY 117 102 96 84 2476 20 2496

Cape CoralndashFort Myers Fla 44 81 91 159 1692 24 1716

CharlestonndashNorth Charleston SC 92 155 91 151 2034 18 2052

CharlottendashGastoniandashConcord NCndashSC 214 141 285 180 3242 22 3264

Chicago IllndashIndndashWis 1716 182 1159 122 30118 261 30379

Chicago Division 1604 203 1073 135 28300 248 28548

Gary Division 61 88 50 71 1038 8 1046

Lake Division 51 59 36 41 780 5 785

CincinnatindashMiddletown OhiondashKyndashInd 111 53 199 95 2735 17 2752

ClevelandndashElyriandashMentor Ohio 228 107 170 80 4226 48 4274

Colorado Springs Colo 19 32 21 35 576 5 581

Columbia SC 177 256 197 280 3274 24 3298

Columbus Ohio 166 97 165 96 3112 15 3127

Dallas Tex 874 150 929 155 20238 63 20301

Dallas Division 681 175 714 178 16038 37 16075

Fort Worth Division 193 100 215 108 4200 26 4226

Dayton Ohio 58 69 54 64 1217 15 1232

DenverndashAurora Colo 274 116 236 98 6899 22 6921

Des Moines Iowa 30 57 23 43 530 4 534

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 31

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Detroit Mich 570 127 445 100 10373 73 10446

Detroit Division 443 223 330 167 8268 57 8325

Warren Division 127 51 115 46 2105 16 2121

El Paso Tex 56 78 40 54 1476 10 1486

Fresno Calif 52 59 64 72 1430 11 1441

Grand RapidsndashWyoming Mich 46 60 51 66 816 6 822

GreensborondashHigh Point NC 52 77 66 96 1265 14 1279

Greenville SC 70 119 67 111 1292 4 1296

HarrisburgndashCarlisle Pa 23 44 67 128 1224 8 1232

HartfordndashWest HartfordndashEast Hartford Conn 256 216 135 114 5126 46 5172

Honolulu Hawaii 54 60 69 76 2121 14 2135

HoustonndashBaytownndashSugar Land Tex 1017 190 1092 197 25821 172 25993

Indianapolis Ind 191 116 150 90 3824 25 3849

Jackson Miss 134 257 117 221 2419 30 2449

Jacksonville Fla 309 248 315 246 6020 75 6095

Kansas City MondashKans 183 94 160 81 4669 15 4684

Knoxville Tenn 47 72 35 52 882 5 887

Lakeland Fla 103 190 112 199 1811 21 1832

Las VegasndashParadise Nev 245 143 258 145 4616 28 4644

Little RockndashNorth Little Rock Ark 87 135 75 115 1383 14 1397

Los Angeles Calif 1529 118 1684 130 57953 293 58246

Los Angeles Division 1339 135 1435 144 51098 250 51348

Santa Anna Division 190 63 249 83 6855 43 6898

Louisville KyndashInd 123 102 97 79 2286 22 2308

Madison Wis 10 19 29 53 520 4 524

McAllenndashEdinburgndashPharr Tex 57 84 45 64 630 11 641

Memphis TennndashMissndashArk 402 320 346 271 5128 19 5147

Miami Fla 2420 446 2289 419 55807 997 56804

Fort Lauderdale Division 810 455 769 430 16412 262 16674

Miami Division 1243 523 1165 485 29703 512 30215

West Palm Beach Division 367 290 355 279 9692 223 9915

MilwaukeendashWaukeshandashWest Allis Wis 68 45 109 72 2507 18 2525

MinneapolisndashSt PaulndashBloomington MinnndashWis 186 59 184 58 4259 22 4281

Modesto Calif 36 71 22 43 671 6 677

NashvillendashDavidsonndashMurfreesboro Tenn 224 158 172 118 3848 20 3868

New HavenndashMilford Conn 169 200 107 127 4573 73 4646

New OrleansndashMetairiendashKenner La 393 299 271 264 8835 67 8902

32 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

New York NYndashNJndashPa 6215 330 5500 292 195177 2906 198083

Edison Division 191 83 130 56 6709 139 6848

Nassau Division 262 93 246 88 8141 110 8251

New York Division 5266 456 4716 408 160408 2323 162731

Newark Division 496 231 408 190 19919 334 20253

Oklahoma City Okla 125 108 88 75 2255 5 2260

OmahandashCouncil Bluffs NebndashIowa 37 46 80 97 1035 3 1038

Orlando Fla 544 282 517 260 8653 92 8745

OxnardndashThousand OaksndashVentura Calif 49 62 21 26 1008 3 1011

Palm BayndashMelbournendashTitusville Fla 68 129 61 114 1512 11 1523

Philadelphia PandashNJndashDelndashMd 1261 217 1348 231 28221 313 28534

Camden Division 108 87 111 89 3118 42 3160

Philadelphia Division 1022 263 1144 294 22112 250 22362

Wilmington Division 131 191 93 134 2991 21 3012

PhoenixndashMesandashScottsdale Ariz 460 119 376 93 7459 31 7490

Pittsburgh Pa 143 60 135 57 3182 19 3201

PortlandndashSouth Portland Maine 9 18 34 66 562 1 563

PortlandndashVancouverndashBeaverton OrendashWash 170 81 215 101 4825 10 4835

PoughkeepsiendashNewburghndashMiddletown NY 136 204 113 168 3162 24 3186

ProvidencendashNew BedfordndashFall River RIndashMass 132 82 155 96 3900 44 3944

RaleighndashCary NC 138 145 201 202 1987 13 2000

Richmond Va 119 101 122 102 3371 35 3406

RiversidendashSan BernardinondashOntario Calif 361 92 306 76 8568 60 8628

Rochester NY 165 159 124 120 3134 13 3147

SacramentondashArden-ArcadendashRoseville Calif 154 75 169 82 4000 26 4026

St Louis MondashIll 192 69 366 131 5965 40 6005

Salt Lake City Utah 46 44 40 37 1743 10 1753

San Antonio Tex 215 114 247 127 4987 30 5017

San DiegondashCarlsbadndashSan Marcos Calif 491 167 384 131 12934 61 12995

San Francisco Calif 867 209 690 165 40152 96 40248

Oakland Division 312 126 246 99 9546 48 9594

San Francisco Division 555 329 444 261 30606 48 30654

San JosendashSunnyvalendashSanta Clara Calif 88 50 145 81 3747 15 3762

San JuanndashCaguasndashGuaynabo PR 745 289 578 223 21402 277 21679

SarasotandashBradentonndashVenice Fla 82 122 104 152 1978 27 2005

ScrantonndashWilkes-Barre Pa 27 49 47 85 572 6 578

Seattle Wash 353 110 280 86 9172 27 9199

Seattle Division 316 129 255 102 8161 18 8179

Tacoma Division 37 49 25 33 1011 9 1020

Springfield Mass 88 128 45 66 2075 26 2101

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 33

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Stockton Calif 52 78 52 77 1076 15 1091

Syracuse NY 52 80 49 75 1317 8 1325

TampandashSt PetersburgndashClearwater Fla 559 211 605 224 11174 112 11286

Toledo Ohio 25 38 66 101 812 14 826

Tucson Ariz 103 111 100 106 2010 10 2020

Tulsa Okla 83 94 65 72 1494 10 1504

Virginia BeachndashNorfolkndashNewport News VandashNC 183 111 132 80 4711 63 4774

Washington DCndashVandashMdndashWV 1322 252 1684 318 31130 315 31445

Bethesda Division 135 118 173 150 2774 23 2797

Washington Division 1187 289 1511 365 28356 292 28648

Wichita Kans 35 60 38 64 851 2 853

Worcester Mass 76 97 79 101 1783 20 1803

YoungstownndashWarrenndashBoardman OhiondashPa 27 46 26 44 519 0 519

Subtotal for MSAs (population gt500000) 33602 173 31274 159 829633 8171 837804

Metropolitan areas (population of 50000 to 499999) 4477 80 4466 79 94829 847 95676

Nonmetropolitan areas 2666 54 2732 55 52063 445 52508

Totalb 41144 137 38749 128 981708 9494 991202

Note Because of the lack of census information for all US dependent areas includes data for only the 50 states the District of Columbia and Puerto RicoMSA metropolitan statistical areaMSA definitions for this report can be found at httpwwwcensusgovpopulationwwwestimatesmetrodefhtmla Reported case counts for the metropolitan divisions do not sum to the MSA total MSA total includes data from 1 metropolitan division with

population of lt500000b Includes persons whose county of residence is unknown

34 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Alabama (January 1988) 502 6041 48 6089

Alaska (February 1999) 38 285 2 287

Arizona (January 1987) 617 5877 80 5957

Arkansas (July 1989) 206 2349 20 2369

California (April 2006) 6581 7056 92 7148

Colorado (November 1985) 319 6084 31 6115

Connecticut (January 2005)b 826 2500 101 2601

Delaware (February 2006) 788 801 18 819

Florida (July 1997)c 4163 36386 397 36783

Georgia (December 2003) 2245 8197 194 8391

Idaho (June 1986) 35 340 4 344

Illinois (January 2006) 6241 6661 162 6823

Indiana (July 1988) 399 4027 43 4070

Iowa (July 1998) 69 586 5 591

Kansas (July 1999) 142 1225 15 1240

Kentucky (October 2004) 333 1303 13 1316

Louisiana (February 1993) 728 8149 166 8315

Maine (January 2006) 386 393 3 396

Michigan (April 1992) 635 6702 134 6836

Minnesota (October 1985) 309 3356 40 3396

Mississippi (August 1988) 352 4549 59 4608

Missouri (October 1987) 502 5086 55 5141

Nebraska (September 1995) 91 672 14 686

Nevada (February 1992) 339 3532 24 3556

New Hampshire (January 2005) 59 466 9 475

New Jersey (January 1992) 1477 17513 325 17838

New Mexico (January 1998) 114 949 4 953

New York (June 2000) 5326 42345 1820 44165

North Carolina (February 1990) 1615 13879 143 14022

North Dakota (January 1988) 4 82 1 83

Ohio (June 1990) 867 8222 101 8323

Oklahoma (June 1988) 229 2401 30 2431

Oregon (April 2006) 49 95 19 114

Pennsylvania (October 2002)d 4269 9537 179 9716

Rhode Island (July 2006) 14 21 0 21

South Carolina (February 1986) 493 6970 93 7063

South Dakota (January 1988) 18 215 6 221

Tennessee (January 1992) 732 7115 90 7205

Texas (January 1999)e 3370 24282 417 24699

Utah (April 1989) 106 893 14 907

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 35

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Virginia (July 1989) 864 10257 95 10352

Washington (March 2006) 4048 4157 40 4197

West Virginia (January 1989) 66 673 8 681

Wisconsin (November 1985) 261 2500 31 2531

Wyoming (June 1989) 7 93 1 94

Subtotal 50834 274822 5146 279968

US dependent areas

American Samoa (August 2001) 0 1 0 1

Guam (March 2000) 2 66 0 66

Northern Mariana Islands (October 2001) 2 7 0 7

Puerto Rico (January 2003) 1471 5610 91 5701

US Virgin Islands (December 1998) 22 247 6 253

Persons reported from areas with confidential name-based HIV infection reporting but who were residents of other areas 132 685 21 706

Totalf 52878 282640 5314 287954

Note Includes data from 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through 2006b Beginning in 1992 Connecticut had name-based HIV reporting for cases in children only From January 2002 through December 2004

Connecticut had name- or code-based HIV reporting for cases in adolescents and adults As of January 2005 Connecticut has name-based reporting of all cases of HIV infection

c Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterd On October 18 2002 Pennsylvania initiated confidential name-based HIV infection reporting in all areas except Philadelphia Code-based

reporting was implemented in Philadelphia in March 2004 and the switch to name-based reporting was made in October 2005e From February 1994 through December 1998 Texas reported HIV infection in children onlyf Includes 1252 persons reported from areas with confidential name-based HIV infection reporting but whose area of residence is unknown

36 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulativemdashUnited States and dependent areas

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No Adult or adolescentMale-to-male sexual contact 13775 49 429897 54 mdash mdash mdash mdash 13775 35 429897 44Injection drug use 3413 12 163070 21 1826 17 67693 35 5239 13 230763 23Male-to-male sexual contact and

injection drug use 1603 6 65524 8 mdash mdash mdash mdash 1603 4 65524 7Hemophiliacoagulation disorder 43 0 5176 1 11 0 348 0 54 0 5524 1High-risk heterosexual contactc 2997 11 49610 6 4839 46 85186 44 7836 20 134796 14

Sex with injection drug user 330 1 11683 1 706 7 26073 14 1036 3 37756 4Sex with bisexual male mdash mdash mdash mdash 234 2 5162 3 234 1 5162 1Sex with person with hemophilia 1 0 84 0 11 0 502 0 12 0 586 0Sex with HIV-infected transfusion

recipient 22 0 553 0 21 0 793 0 43 0 1346 0Sex with HIV-infected person risk

factor not specified 2644 9 37290 5 3867 37 52656 27 6511 17 89946 9Receipt of blood transfusion blood

d components or tissue 63 0 5213 1 68 1 4176 2 131 0 9389 1Otherrisk factor not reported or

identifiede 6484 23 73136 9 3793 36 34311 18 10278 26 107450 11Subtotal 28378 100 791626 100 10537 100 191714 100 38916 100 983343 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 0 0 222 5 0 0 7 0 0 0 229 2Mother with documented HIV infection or

1 of the following risk factors 24 75 4315 89 50 93 4423 95 74 86 8738 92Injection drug use 4 13 1676 35 4 7 1665 36 8 9 3341 35Sex with injection drug user 4 13 789 16 4 7 750 16 8 9 1539 16Sex with bisexual male 1 3 101 2 2 4 110 2 3 3 211 2Sex with person with hemophilia 0 0 20 0 0 0 16 0 0 0 36 0Sex with HIV-infected transfusion

recipient 0 0 11 0 0 0 15 0 0 0 26 0Sex with HIV-infected person risk

factor not specified 6 19 742 15 17 31 790 17 23 27 1532 16Receipt of blood transfusion blood

components or tissue 0 0 70 1 0 0 82 2 0 0 152 2Has HIV infection risk factor not

specified 9 28 906 19 23 43 995 21 32 37 1901 20Receipt of blood transfusion blood

fcomponents or tissue 1 3 243 5 0 0 144 3 1 1 387 4Otherrisk factor not reported or

identifiedg 7 22 75 2 4 7 93 2 11 13 168 2Subtotal 32 100 4855 100 54 100 4667 100 86 100 9522 100

Total 28410 100 796481 100 10591 100 196381 100 39002 100 992865 100a From the beginning of the epidemic through 2006b From the beginning of the epidemic through 2006 Includes 3 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infectiond AIDS developed in 47 adultsadolescents after they received blood that had tested negative for HIV antibodies AIDS developed in 14 additional adults

after they received tissue organs or artificial insemination from HIV-infected donors Four of the 14 received tissue or organs from a donor who was negative for HIV antibody at the time of donation

e Includes 37 adultsadolescents who were exposed to HIV-infected blood body fluids or concentrated virus in health care laboratory or household settings as supported by seroconversion epidemiologic andor laboratory evidence One person was infected after intentional inoculation with HIV-infected blood Includes an additional 740 persons who acquired HIV infection perinatally but who were more than 12 years of age when AIDS was diagnosed These 740 persons are not counted in the values for the pediatric transmission category

f AIDS developed in 3 children after they received blood that had tested negative for HIV antibodiesg Includes 5 children who were exposed to HIV-infected blood as supported by seroconversion epidemiologic andor laboratory evidence 1 child was

infected after intentional inoculation with HIV-infected blood and 5 children were exposed to HIV-infected blood in a household setting Of the 168 children 26 had sexual contact with an adult with or at high risk for HIV infection

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 37

Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No

Adult or adolescentMale-to-male sexual contact 22912 59 103679 52 mdash mdash mdash mdash 22912 44 103679 37

Injection drug use 3503 9 24255 12 2124 16 13925 17 5627 11 38181 14

Male-to-male sexual contact and injection drug use 1946 5 10704 5 mdash mdash mdash mdash 1946 4 10704 4

Hemophiliacoagulation disorder 43 0 495 0 6 0 73 0 49 0 568 0

High-risk heterosexual contactc 2874 7 16830 8 5939 45 38315 47 8813 17 55145 20

Sex with injection drug user 308 1 2601 1 757 6 6791 8 1065 2 9392 3

Sex with bisexual male mdash mdash mdash mdash 328 2 2265 3 328 1 2265 1

Sex with person with hemophilia 4 0 31 0 16 0 201 0 20 0 232 0

Sex with HIV-infected transfusion recipient 13 0 131 0 28 0 223 0 41 0 354 0

Sex with HIV-infected person risk factor not specified 2549 7 14067 7 4810 36 28835 35 7359 14 42902 15

Receipt of blood transfusion blood components or tissue 61 0 489 0 50 0 536 1 111 0 1025 0

Otherrisk factor not reported or identified 7748 20 44021 22 5106 39 29312 36 12854 25 73338 26

Subtotal 39087 100 200473 100 13225 100 82161 100 52312 100 282640 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 8 3 106 4 0 0 1 0 8 1 107 2

Mother with documented HIV infection or 1 of the following risk factors 197 74 2195 85 254 85 2417 89 451 80 4612 87

Injection drug use 34 13 532 21 53 18 561 21 87 15 1093 21

Sex with injection drug user 12 5 208 8 21 7 213 8 33 6 421 8

Sex with bisexual male 5 2 37 1 4 1 32 1 9 2 69 1

Sex with person with hemophilia 0 0 3 0 1 0 7 0 1 0 10 0

Sex with HIV-infected transfusion recipient 0 0 4 0 0 0 4 0 0 0 8 0

Sex with HIV-infected person risk factor not specified 54 20 534 21 76 25 629 23 130 23 1163 22

Receipt of blood transfusion blood components or tissue 0 0 17 1 2 1 20 1 2 0 37 1

Has HIV infection risk factor not specified 92 35 860 33 97 32 951 35 189 33 1811 34

Receipt of blood transfusion blood components or tissue 6 2 28 1 3 1 24 1 9 2 52 1

Otherrisk factor not reported or identified 55 21 260 10 43 14 283 10 98 17 543 10

Subtotal 266 100 2589 100 300 100 2725 100 566 100 5314 100

Total 39353 100 203062 100 13525 100 84886 100 52878 100 287954 100

Note See Table 16 for the list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006b From the beginning of the epidemic through December 2006 Includes 6 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infection

38 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity

2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 6251 65 253927 73Injection drug use 733 8 31737 9Male-to-male sexual contact and injection drug use 732 8 31434 9Hemophiliacoagulation disorder 26 0 3989 1High-risk heterosexual contactb 416 4 7850 2

Sex with injection drug user 74 1 2310 1

Sex with person with hemophilia 0 0 36 0

Sex with HIV-infected transfusion recipient 2 0 176 0

Sex with HIV-infected person risk factor not specified 340 4 5328 2Receipt of blood transfusion blood components or tissue 20 0 3194 1Otherrisk factor not reported or identified 1400 15 16469 5

Total 9578 100 348600 100

Black not HispanicMale-to-male sexual contact 4309 36 103297 37Injection drug use 1635 14 83369 30Male-to-male sexual contact and injection drug use 526 4 22134 8Hemophiliacoagulation disorder 10 0 604 0High-risk heterosexual contactb 1875 16 29952 11

Sex with injection drug user 167 1 6823 2Sex with person with hemophilia 1 0 36 0Sex with HIV-infected transfusion recipient 15 0 237 0Sex with HIV-infected person risk factor not specified 1692 14 22856 8

Receipt of blood transfusion blood components or tissue 24 0 1218 0Otherrisk factor not reported or identified 3579 30 40268 14

Total 11958 100 280842 100

HispanicMale-to-male sexual contact 2816 47 64893 44Injection drug use 965 16 46337 31Male-to-male sexual contact and injection drug use 287 5 10884 7Hemophiliacoagulation disorder 6 0 466 0High-risk heterosexual contactb 638 11 10950 7

Sex with injection drug user 84 1 2409 2Sex with person with hemophilia 0 0 11 0Sex with HIV-infected transfusion recipient 5 0 125 0Sex with HIV-infected person risk factor not specified 549 9 8405 6

Receipt of blood transfusion blood components or tissue 17 0 657 0Otherrisk factor not reported or identified 1326 22 14832 10

Total 6055 100 149019 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 39

a

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulative

No No

AsianPacific IslanderMale-to-male sexual contact 225 54 4475 68Injection drug use 20 5 317 5Male-to-male sexual contact and injection drug use 17 4 284 4Hemophiliacoagulation disorder 1 0 70 1High-risk heterosexual contactb 34 8 376 6

Sex with injection drug user 1 0 54 1Sex with person with hemophilia 0 0 1 0Sex with HIV-infected transfusion recipient 0 0 8 0Sex with HIV-infected person risk factor not specified 33 8 313 5

Receipt of blood transfusion blood components or tissue 2 0 112 2Otherrisk factor not reported or identified 114 28 949 14

Total 413 100 6583 100

American IndianAlaska NativeMale-to-male sexual contact 61 49 1403 55Injection drug use 15 12 395 15Male-to-male sexual contact and injection drug use 23 19 457 18Hemophiliacoagulation disorder 0 0 27 1High-risk heterosexual contactb 9 7 118 5

Sex with injection drug user 1 1 33 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 8 6 82 3

Receipt of blood transfusion blood components or tissue 0 0 8 0Otherrisk factor not reported or identified 16 13 155 6

Total 124 100 2563 100

Total casesMale-to-male sexual contact 13775 49 429897 54Injection drug use 3413 12 163070 21Male-to-male sexual contact and injection drug use 1603 6 65524 8Hemophiliacoagulation disorder 43 0 5176 1High-risk heterosexual contactb 2997 11 49610 6

Sex with injection drug user 330 1 11683 1Sex with person with hemophilia 1 0 84 0Sex with HIV-infected transfusion recipient 22 0 553 0Sex with HIV-infected person risk factor not specified 2644 9 37290 5

Receipt of blood transfusion blood components or tissue 63 0 5213 1Otherrisk factor not reported or identified 6484 23 73136 9

Total 28378c 100 791626d 100a From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 4019 males of unknown race or multiple races

40 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 11963 73 55725 69Injection drug use 858 5 5512 7Male-to-male sexual contact and injection drug use 1092 7 5578 7Hemophiliacoagulation disorder 29 0 355 0High-risk heterosexual contactb 522 3 2658 3

Sex with injection drug user 65 0 544 1Sex with person with hemophilia 0 0 8 0Sex with HIV-infected transfusion recipient 3 0 33 0Sex with HIV-infected person risk factor not specified 454 3 2073 3

Receipt of blood transfusion blood components or tissue 14 0 197 0Otherrisk factor not reported or identified 1956 12 11147 14

Total 16434 100 81172 100

Black not HispanicMale-to-male sexual contact 6203 44 30148 37Injection drug use 1594 11 11997 15Male-to-male sexual contact and injection drug use 483 3 3489 4Hemophiliacoagulation disorder 10 0 109 0High-risk heterosexual contactb 1714 12 10905 13

Sex with injection drug user 169 1 1554 2Sex with person with hemophilia 4 0 17 0Sex with HIV-infected transfusion recipient 6 0 77 0Sex with HIV-infected person risk factor not specified 1535 11 9257 11

Receipt of blood transfusion blood components or tissue 32 0 223 0Otherrisk factor not reported or identified 4151 29 24632 30

Total 14187 100 81503 100

HispanicMale-to-male sexual contact 4094 55 15623 47Injection drug use 993 13 6407 19Male-to-male sexual contact and injection drug use 316 4 1402 4Hemophiliacoagulation disorder 3 0 26 0High-risk heterosexual contactb 582 8 2963 9

Sex with injection drug user 65 1 455 1Sex with person with hemophilia 0 0 6 0Sex with HIV-infected transfusion recipient 4 0 18 0Sex with HIV-infected person risk factor not specified 513 7 2484 7

Receipt of blood transfusion blood components or tissue 11 0 55 0Otherrisk factor not reported or identified 1475 20 6977 21

Total 7474 100 33453 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 41

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderMale-to-male sexual contact 402 70 1006 63Injection drug use 17 3 55 3Male-to-male sexual contact and injection drug use 15 3 38 2Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 25 4 96 6

Sex with injection drug user 3 1 10 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 22 4 83 5

Receipt of blood transfusion blood components or tissue 4 1 7 0Otherrisk factor not reported or identified 109 19 397 25

Total 572 100 1600 100

American IndianAlaska NativeMale-to-male sexual contact 104 61 516 57Injection drug use 13 8 101 11Male-to-male sexual contact and injection drug use 19 11 110 12Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 10 6 53 6

Sex with injection drug user 2 1 14 2Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 8 5 39 4

Receipt of blood transfusion blood components or tissue 0 0 2 0Otherrisk factor not reported or identified 24 14 125 14

Total 170 100 907 100

Total casesMale-to-male sexual contact 22912 59 103679 52Injection drug use 3503 9 24255 12Male-to-male sexual contact and injection drug use 1946 5 10704 5Hemophiliacoagulation disorder 43 0 495 0High-risk heterosexual contactb 2874 7 16830 8

Sex with injection drug user 308 1 2601 1Sex with person with hemophilia 4 0 31 0Sex with HIV-infected transfusion recipient 13 0 131 0Sex with HIV-infected person risk factor not specified 2549 7 14067 7

Receipt of blood transfusion blood components or tissue 61 0 489 0Otherrisk factor not reported or identified 7748 20 44021 22

Total 39087c 100 200473d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 1838 males of unknown race or multiple races

42 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race

ethnicity 2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 482 28 14981 40Hemophiliacoagulation disorder 4 0 123 0High-risk heterosexual contactb 725 42 15799 42

Sex with injection drug user 153 9 5650 15Sex with bisexual male 63 4 1859 5Sex with person with hemophilia 5 0 329 1Sex with HIV-infected transfusion recipient 5 0 338 1Sex with HIV-infected person risk factor not specified 499 29 7623 20

Receipt of blood transfusion blood components or tissue 15 1 1870 5Otherrisk factor not reported or identified 499 29 4801 13

Total 1725 100 37574 100

Black not HispanicInjection drug use 982 15 38914 34Hemophiliacoagulation disorder 3 0 145 0High-risk heterosexual contactb 3103 46 49876 44

Sex with injection drug user 373 6 13530 12Sex with bisexual male 136 2 2352 2Sex with person with hemophilia 4 0 121 0Sex with HIV-infected transfusion recipient 8 0 277 0Sex with HIV-infected person risk factor not specified 2582 38 33596 29

Receipt of blood transfusion blood components or tissue 39 1 1546 1Otherrisk factor not reported or identified 2612 39 23894 21

Total 6739 100 114375 100

HispanicInjection drug use 322 18 12892 35Hemophiliacoagulation disorder 4 0 67 0High-risk heterosexual contactb 894 49 17995 49

Sex with injection drug user 166 9 6522 18Sex with bisexual male 32 2 818 2Sex with person with hemophilia 1 0 45 0Sex with HIV-infected transfusion recipient 7 0 141 0Sex with HIV-infected person risk factor not specified 688 38 10469 29

Receipt of blood transfusion blood components or tissue 12 1 619 2Otherrisk factor not reported or identified 592 32 5023 14

Total 1824 100 36596 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 43

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 8 8 125 12Hemophiliacoagulation disorder 0 0 7 1High-risk heterosexual contactb 49 47 574 53

Sex with injection drug user 4 4 114 11Sex with bisexual male 2 2 80 7Sex with person with hemophilia 0 0 4 0Sex with HIV-infected transfusion recipient 1 1 25 2Sex with HIV-infected person risk factor not specified 42 40 351 33

Receipt of blood transfusion blood components or tissue 1 1 93 9Otherrisk factor not reported or identified 46 44 279 26

Total 104 100 1078 100

American IndianAlaska NativeInjection drug use 13 32 280 42Hemophiliacoagulation disorder 0 0 3 0High-risk heterosexual contactb 15 37 277 41

Sex with injection drug user 4 10 107 16Sex with bisexual male 1 2 27 4Sex with person with hemophilia 0 0 2 0Sex with HIV-infected transfusion recipient 0 0 6 1Sex with HIV-infected person risk factor not specified 10 24 135 20

Receipt of blood transfusion blood components or tissue 1 2 17 3Otherrisk factor not reported or identified 12 29 95 14

Total 41 100 672 100

Total casesInjection drug use 1826 17 67693 35Hemophiliacoagulation disorder 11 0 348 0High-risk heterosexual contactb 4839 46 85186 44

Sex with injection drug user 706 7 26073 14Sex with bisexual male 234 2 5162 3Sex with person with hemophilia 11 0 502 0Sex with HIV-infected transfusion recipient 21 0 793 0Sex with HIV-infected person risk factor not specified 3867 37 52656 27

Receipt of blood transfusion blood components or tissue 68 1 4176 2Otherrisk factor not reported or identified 3793 36 34311 18

Total 10537c 100 191714d 100a From the beginning of the epidemic through 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 104 females of unknown race or multiple racesd Includes 1419 females of unknown race or multiple races

44 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 690 26 4260 26Hemophiliacoagulation disorder 3 0 24 0

bHigh-risk heterosexual contact 1132 42 7593 46Sex with injection drug user 205 8 1876 11Sex with bisexual male 98 4 659 4Sex with person with hemophilia 10 0 115 1Sex with HIV-infected transfusion recipient 7 0 64 0Sex with HIV-infected person risk factor not specified 812 30 4879 29

Receipt of blood transfusion blood components or tissue 12 0 146 1Otherrisk factor not reported or identified 850 32 4567 28

Total 2687 100 16590 100

Black not HispanicInjection drug use 1034 13 7105 14Hemophiliacoagulation disorder 1 0 35 0

bHigh-risk heterosexual contact 3451 44 23732 46Sex with injection drug user 313 4 3473 7Sex with bisexual male 155 2 1294 3Sex with person with hemophilia 5 0 71 0Sex with HIV-infected transfusion recipient 14 0 120 0Sex with HIV-infected person risk factor not specified 2964 38 18774 36

Receipt of blood transfusion blood components or tissue 26 0 324 1Otherrisk factor not reported or identified 3370 43 20244 39

Total 7882 100 51440 100

HispanicInjection drug use 339 15 2280 18Hemophiliacoagulation disorder 2 0 11 0

bHigh-risk heterosexual contact 1198 52 6264 50Sex with injection drug user 218 9 1324 11Sex with bisexual male 62 3 266 2Sex with person with hemophilia 1 0 11 0Sex with HIV-infected transfusion recipient 7 0 39 0Sex with HIV-infected person risk factor not specified 910 39 4624 37

Receipt of blood transfusion blood components or tissue 12 1 58 0Otherrisk factor not reported or identified 767 33 3843 31

Total 2318 100 12456 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 45

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 16: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006mdashUnited States and dependent areas

Transmission category

Place of birth

United StatesCentralSouth

America Cuba Mexico Puerto Rico Totala

No No No No No No

Male-to-male sexual contact 1172 45 402 49 89 62 790 59 249 18 3337 43Injection drug use 569 22 83 10 13 9 133 10 533 40 1650 21Male-to-male sexual contact

and injection drug use 158 6 25 3 6 4 59 4 63 5 357 5High-risk heterosexual

contactb 661 25 296 36 35 24 342 26 487 36 2282 30Otherc 47 2 8 1 0 0 9 1 14 1 103 1

Totald 2608 100 814 100 145 100 1334 100 1346 100 7728 100Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Includes 222 persons whose place of birth is not among those listed and 1260 persons whose place of birth is unknownb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the

column total

16 Cases of HIVAIDS and AIDS

Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas

Year of death

Cumulativea2002 2003 2004 2005 2006

Data for 50 states and the District of ColumbiaAge at death (yrs)lt13 25 22 15 7 13 4889

13ndash14 10 6 15 12 5 276

15ndash19 39 36 36 38 44 1104

20ndash24 151 157 175 147 162 8716

25ndash29 553 512 482 458 405 43671

30ndash34 1480 1272 1128 1069 785 95351

35ndash39 2967 2763 2425 2096 1682 116746

40ndash44 3595 3516 3393 3317 2636 104133

45ndash49 3294 3234 3251 3275 2886 72831

50ndash54 2318 2373 2502 2645 2343 44255

55ndash59 1209 1322 1425 1543 1480 25123

60ndash64 616 705 741 797 771 14315

gt65 691 773 807 865 805 14393

RaceethnicityWhite not Hispanic 5214 5097 4836 4758 3860 239529

Black not Hispanic 9037 8675 8581 8679 7426 218392

Hispanic 2429 2632 2641 2513 2425 80690

AsianPacific Islander 97 84 111 87 114 3426

American IndianAlaska Native 83 73 80 65 66 1693

Transmission categoryMale adult or adolescentMale-to-male sexual contact 5960 5937 5735 5641 4930 266272

Injection drug use 3738 3547 3315 3314 2641 107173

Male-to-male sexual contact and injection drug use 1278 1299 1237 1289 1064 40993

High-risk heterosexual contactb 1465 1501 1625 1571 1470 26236

Otherc 160 149 125 117 80 9867

Subtotal 12601 12431 12038 11932 10184 450541

Female adult or adolescentInjection drug use 1923 1825 1855 1768 1456 43143

High-risk heterosexual contactb 2281 2292 2373 2458 2258 42620

Otherc 84 87 72 68 70 4131

Subtotal 4289 4204 4300 4295 3784 89895

Child (lt13 yrs at diagnosis)Perinatal 53 49 56 39 42 4848

Otherd 4 5 1 2 7 521

Subtotal 57 54 57 41 48 5369

Deaths 17

Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas (cont)

Year of death

Cumulativea2002 2003 2004 2005 2006

Region of residenceNortheast 5313 5012 4779 4750 4074 180623

Midwest 1726 1666 1482 1378 1325 54468

South 7337 7427 7535 7907 6475 197209

West 2571 2585 2600 2234 2141 113506

Subtotal for 50 states and the District of Columbia 16948 16690 16395 16268 14016 545805

Data for US dependent areas 667 575 572 562 580 19858

Totale 17628 17283 16982 16865 14627 565927f

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column totalf Includes 2082 persons of unknown race or multiple races 261 persons of unknown state of residence and 2 persons who were residents

of other areas

18 Deaths

Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003ndash2006mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

2003 2004 2005 2006Data for 33 states

Age at end of year (yrs)lt13 4154 3700 3294 286713ndash14 1130 1238 1212 113915ndash19 3298 3627 4024 453920ndash24 12389 12826 13411 1430125ndash29 26167 26924 28164 2960030ndash34 49602 47577 45109 4418935ndash39 80703 77871 75842 7363440ndash44 92040 97109 100102 10176445ndash49 71345 77490 83816 9028350ndash54 45133 51033 56640 6319555ndash59 22793 26610 31186 3600860ndash64 10820 12642 14422 16658gt65 8531 9959 11657 13551

RaceethnicityWhite not Hispanic 145081 151694 158375 166000Black not Hispanic 202951 212425 221439 231957Hispanic 72612 76503 80491 84720AsianPacific Islander 2234 2529 2858 3187American IndianAlaska Native 1788 1889 2008 2119

Transmission categoryMale adult or adolescentMale-to-male sexual contact 181771 193245 205423 218676Injection drug use 57651 58149 58369 59077Male-to-male sexual contact and injection drug use 23965 24434 24725 25085High-risk heterosexual contacta 40084 42559 44915 47562Otherb 3218 3278 3325 3424Subtotal 306689 321665 336756 353825

Female adult or adolescentInjection drug use 32346 32735 32973 33470High-risk heterosexual contacta 80324 85348 90185 95403Otherb 2036 2123 2212 2321Subtotal 114705 120206 125370 131195

Child (lt13 yrs at diagnosis)Perinatal 6137 6154 6178 6143Otherc 570 575 571 560Subtotal 6707 6730 6748 6703

Subtotal for 33 states 428107 448605 468879 491727Data for US dependent areas 15809 16399 17150 17955

Totald 443916 465005 486028 509681Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 19

Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission categorymdash33 states with confidential name-based HIV infection reporting

Transmission category

White not Hispanic

Black not Hispanic Hispanic

AsianPacific Islander

American IndianAlaska

Native Totala

No No No No No No

Male adult or adolescentMale-to-male sexual contact 108259 77 70242 49 36043 57 1669 68 938 62 218676 62Injection drug use 12328 9 31339 22 14472 23 264 11 216 14 59077 17Male-to-male sexual contact

and injection drug use 11283 8 9587 7 3720 6 93 4 205 13 25085 7High-risk heterosexual contactb 6667 5 31140 22 8788 14 395 16 143 9 47562 13Otherc 1458 1 1492 1 404 1 30 1 17 1 3424 1Subtotal 139994 100 143799 100 63427 100 2450 100 1519 100 353825 100

Female adult or adolescentInjection drug use 8262 33 19136 23 5528 28 106 15 175 30 33470 26High-risk heterosexual contactb 16338 65 63204 75 14132 71 573 82 392 68 95403 73Otherc 450 2 1469 2 344 2 24 3 12 2 2321 2Subtotal 25050 100 83809 100 20004 100 703 100 578 100 131195 100

Child (lt13 yrs at diagnosis)Perinatal 801 84 4064 93 1183 92 28 82 20 95 6143 92Otherd 154 16 283 7 107 8 6 18 1 5 560 8Subtotal 955 100 4347 100 1290 100 34 100 21 100 6703 100

Totale 166000 231957 84720 3187 2119 491727Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of 33 states that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Includes 3745 persons of unknown race or multiple racesb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes 5 persons of unknown sex Because column totals were calculated independently of the values for the subpopulations the values

in each column may not sum to the column total

20 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Map 1 Estimated rates (per 100000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

Note Rates adjusted for reporting delays Rates of HIV infection include only persons living with HIV infection that has not progressed to AIDSSince 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 Islandsa Includes persons whose area of residence is unknown

Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

Note Rates adjusted for reporting delays Rates of HIV infection include only persons living with HIV infection that has not progressed to AIDSSince 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 Islandsa Includes persons whose area of residence is unknown

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 21

Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002ndash2006mdashUnited States and dependent areas

2002 2003 2004 2005 2006Data for 50 states and the District of Columbia

Age at end of year (yrs)lt13 2308 2006 1684 1394 111513ndash14 685 747 784 762 71115ndash19 1465 1694 1974 2243 248720ndash24 3910 4292 4629 5033 536725ndash29 12725 12743 13045 13505 1435930ndash34 35558 33870 32057 29949 2882435ndash39 70107 68106 65076 62235 5964940ndash44 80377 86294 91335 94021 9517445ndash49 64702 71276 77417 84153 9077550ndash54 41270 46855 53333 59256 6647655ndash59 20113 24145 28356 33522 3901460ndash64 9681 11293 13305 15380 18072gt65 7520 8946 10604 12430 14669

RaceethnicityWhite not Hispanic 129426 135278 141508 147426 154495Black not Hispanic 150488 161326 171654 181056 191590Hispanic 63424 67895 72024 76334 80815AsianPacific Islander 3060 3426 3759 4121 4526American IndianAlaska Native 1254 1356 1458 1562 1651

Transmission categoryMale adult or adolescentMale-to-male sexual contact 158092 168233 178551 188622 199693Injection drug use 56708 58436 59940 61229 62998Male-to-male sexual contact and injection drug use 24726 25457 26144 26785 27523High-risk heterosexual contacta 27329 30300 33181 35916 39004Otherb 3588 3665 3769 3888 4026Subtotal 270444 286091 301585 316440 333244

Female adult or adolescentInjection drug use 27863 28874 29828 30646 31575High-risk heterosexual contacta 46445 51489 56229 60693 65631Otherb 1903 2033 2178 2315 2465Subtotal 76210 82395 88236 93653 99671

Child (lt13 yrs at diagnosis)Perinatal 3633 3654 3651 3664 3660Otherc 129 124 123 122 115Subtotal 3762 3778 3774 3786 3775

Region of residenceNortheast 105599 110929 115562 120208 125620Midwest 36011 38571 41178 44171 47010South 137081 147284 157975 166962 177591West 71729 75483 78883 82540 86473

Subtotal for 50 states and the District of Columbia 350419 372267 393598 413882 436693

Data for US dependent areas 9880 10365 10713 11106 11359

Totald 360617 383024 404849 425646 448871Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

22 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission categorymdash50 states and the District of Columbia

Transmission category

White not Hispanic

Black not Hispanic Hispanic

AsianPacific Islander

American IndianAlaska

Native Totala

No No No No No No

Male adult or adolescentMale-to-male sexual contact 101299 75 57520 45 36087 57 2715 72 704 57 199693 60Injection drug use 13168 10 33911 27 14795 23 325 9 201 16 62998 19Male-to-male sexual contact and

injection drug use 12393 9 10121 8 4352 7 198 5 220 18 27523 8High-risk heterosexual contactb 6081 5 24205 19 7816 12 444 12 105 8 39004 12Otherc 1743 1 1602 1 574 1 69 2 16 1 4026 1Subtotal 134683 100 127359 100 63623 100 3752 100 1246 100 333244 100

Female adult or adolescentInjection drug use 7407 38 18531 30 5025 30 115 15 153 39 31575 32High-risk heterosexual contactb 11350 59 41741 68 11092 67 588 78 227 58 65631 66Otherc 508 3 1456 2 413 2 51 7 13 3 2465 2Subtotal 19264 100 61728 100 16531 100 753 100 393 100 99671 100

Child (lt13 yrs at diagnosis)Perinatal 500 92 2468 99 629 95 20 94 12 100 3660 97Otherd 46 8 34 1 33 5 1 6 0 0 115 3Subtotal 546 100 2503 100 662 100 21 100 12 100 3775 100

Totale 154495 191590 80815 4526 1651 436693

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Includes 3616 persons of unknown race or multiple racesb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes 3 person of unknown sex Because column totals were calculated independently of the values for the subpopulations the values in each column

may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 23

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by

area of residence and age categorymdashUnited States and dependent areas

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

Alabama 5469 17 5486 3744 11 3755Alaska 272 1 273 330 1 331Arizona 5744 49 5793 4922 7 4929Arkansas 2291 7 2298 2139 6 2145California mdash mdash mdash 61451 105 61555Colorado 5855 13 5869 4083 2 4085Connecticut mdash mdash mdash 7406 15 7421Delaware mdash mdash mdash 1753 7 1760District of Columbia mdash mdash mdash 10059 30 10089Floridab 35461 263 35723 46469 194 46663Georgia mdash mdash mdash 17336 47 17383Hawaii mdash mdash mdash 1234 3 1237Idaho 356 0 356 313 0 313Illinois mdash mdash mdash 16139 46 16185Indiana 3849 21 3870 3996 14 4010Iowa 588 2 590 869 3 872Kansas 1230 7 1237 1272 2 1274Kentucky mdash mdash mdash 2589 13 2602Louisiana 7361 101 7462 8052 21 8074Maine mdash mdash mdash 512 2 514Maryland mdash mdash mdash 14540 41 14581Massachusetts mdash mdash mdash 8806 20 8826Michigan 6118 55 6173 6615 12 6627Minnesota 3227 21 3248 2314 9 2323Mississippi 4200 32 4232 3155 13 3168Missouri 4999 33 5033 5479 7 5486Montana mdash mdash mdash 205 0 205Nebraska 688 12 700 771 2 773Nevada 3402 13 3415 2969 3 2972New Hampshire mdash mdash mdash 556 3 559New Jersey 16059 153 16212 17168 57 17226New Mexico 910 0 909 1252 3 1255New York 42220 801 43021 70697 148 70845North Carolina 11700 60 11760 8451 12 8463North Dakota 87 2 89 73 1 74Ohio 8266 57 8323 7054 30 7084Oklahoma 2191 17 2208 2191 3 2194Oregon mdash mdash mdash 2840 4 2844Pennsylvania mdash mdash mdash 18633 71 18703Rhode Island mdash mdash mdash 1296 7 1303South Carolina 6349 45 6394 7035 23 7058South Dakota 195 4 199 139 1 140Tennessee 6579 51 6631 6403 11 6414Texas 24741 262 25003 34010 53 34063Utah 893 10 903 1164 0 1164Vermont mdash mdash mdash 238 2 240Virginia 9937 41 9978 8423 24 8447Washington mdash mdash mdash 5471 5 5476West Virginia 660 5 665 749 5 754Wisconsin 2322 15 2337 2153 12 2165Wyoming 86 2 88 102 1 103

Subtotal 224303 2174 226477 435621 1115 436736

24 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age categorymdashUnited States and dependent areas (cont)

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

US dependent areasAmerican Samoa 2 0 2 1 0 1Guam 63 0 63 36 0 36Northern Mariana Islands 7 0 7 3 0 3Puerto Rico 6269 31 6300 10971 26 10997US Virgin Islands 228 2 230 312 2 314Otherc mdash mdash mdash 1 0 1

Totald 230872 2207 233079 447724 1147 448871

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reporting a See Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at

least 2003b Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterc Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasd Total number of persons living with HIV infection (not AIDS) includes persons reported from areas with confidential name-based HIV

infection reporting who were residents of other states or whose area of residence is unknown Total number of persons living with AIDS includes persons whose area of residence is unknown Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 25

Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristicsmdashUnited States and dependent areas

No of persons

Survival in months

gt12 gt24 gt36Data for 50 states and the District of Columbia

Age at diagnosis (yrs)lt13 101 096 094 09413ndash14 60 098 098 09515ndash19 305 098 096 09520ndash24 1351 096 093 09225ndash29 3034 095 092 09130ndash34 5499 094 091 08935ndash39 7888 093 090 08740ndash44 7085 092 088 08545ndash49 5090 089 085 08250ndash54 3067 086 081 07855ndash59 1505 083 078 07460ndash64 806 080 073 069gt65 614 073 068 065

RaceethnicityWhite not Hispanic 10706 092 089 087Black not Hispanic 18406 090 086 082Hispanic 6398 092 090 088AsianPacific Islander 404 094 092 090American IndianAlaska Native 167 084 081 075

Transmission categoryMale adult or adolescentMale-to-male sexual contact 12830 093 090 088Injection drug use 4048 089 084 081Male-to-male sexual contact and injection drug use 1701 093 089 086High-risk heterosexual contacta 3170 091 088 085Otherb 5019 086 083 080Subtotal 26768 091 088 085

Female adult or adolescentInjection drug use 2101 089 083 078High-risk heterosexual contacta 4686 093 089 086Otherb 2749 090 085 083Subtotal 9536 091 087 083

Child (lt13 yrs at diagnosis)Perinatal 98 096 095 095Otherc 3 100 067 067Subtotal 101 096 094 094

Subtotal for 50 states and the District of Columbia 36405 091 087 085

Data for US dependent areas 891 083 078 075

Total 37352d 091 087 084Note Excludes persons whose date of death was before or in the same month as date of diagnosis Excludes persons whose month of diagnosis or month of death is unknowna Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes 325 persons of unknown race or multiple races

26 Survival after AIDS Diagnosis

Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by year of diagnosismdashUnited States and dependent areas

Months after AIDS diagnosis

Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by age groupmdashUnited States and dependent areas

Months after AIDS diagnosis

Survival after AIDS Diagnosis 27

Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by raceethnicitymdashUnited States and dependent areas

Months after AIDS diagnosis

28 Survival after AIDS Diagnosis

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006

and cumulativemdashUnited States and dependent areas

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Alabama 510 112 462 100 8626 76 8702Alaska 24 36 38 57 648 7 655Arizona 626 105 539 87 10396 46 10442Arkansas 237 85 252 90 3891 36 3927California 4069 113 3960 109 142254 664 142918Colorado 351 75 322 68 8742 31 8773Connecticut 658 188 422 120 14716 183 14899Delaware 177 210 116 136 3547 26 3573District of Columbia 672 1155 853 1467 17372 189 17561Florida 4921 277 4932 273 104084 1530 105614Georgia 2325 255 1605 171 31734 231 31965Hawaii 105 82 93 72 2927 17 2944Idaho 24 17 26 18 604 2 606Illinois 1886 148 1382 108 33620 282 33902Indiana 407 65 346 55 8239 56 8295Iowa 93 31 86 29 1727 13 1740Kansas 105 38 120 43 2781 14 2795Kentucky 249 60 207 49 4600 32 4632Louisiana 936 208 824 192 17612 128 17740Maine 21 16 68 51 1110 8 1118Maryland 1558 279 1626 290 30252 319 30571Massachusetts 666 104 533 83 19181 214 19395Michigan 821 81 672 67 14941 113 15054Minnesota 226 44 212 41 4817 28 4845Mississippi 368 127 365 125 6642 56 6698Missouri 385 66 469 80 11016 61 11077Montana 21 22 7 07 373 3 376Nebraska 53 30 118 67 1479 11 1490Nevada 293 121 294 118 5733 29 5762New Hampshire 33 25 55 42 1074 10 1084New Jersey 1262 145 1065 122 48750 778 49528New Mexico 134 70 93 48 2603 7 2610New York 6201 321 5495 285 174908 2354 177262North Carolina 916 106 1229 139 15954 118 16072North Dakota 10 16 6 09 144 1 145Ohio 753 66 767 67 14957 138 15095Oklahoma 281 79 205 57 4836 26 4862Oregon 217 60 281 76 5995 20 6015Pennsylvania 1486 120 1893 152 33417 365 33782Rhode Island 87 81 111 104 2580 28 2608South Carolina 682 161 705 163 13301 105 13406South Dakota 18 23 18 23 255 5 260Tennessee 818 137 680 113 12457 59 12516Texas 3045 133 2998 128 69735 392 70127Utah 63 25 57 22 2295 20 2315Vermont 5 08 18 29 461 6 467Virginia 638 84 605 79 16802 177 16979Washington 485 77 389 61 11792 34 11826West Virginia 74 41 67 37 1500 11 1511Wisconsin 122 22 217 39 4513 33 4546Wyoming 6 12 8 16 228 2 230

Subtotal 40123 135 37911 127 952221 9094 961315

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 29

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulativemdashUnited States and dependent areas (cont)

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

US dependent areasAmerican Samoa 0 0 0 0 1 0 1Guam 0 0 0 0 68 1 69Northern Mariana Islands 0 0 0 0 3 0 3Puerto Rico 1029 263 850 216 29511 400 29911US Virgin Islands 17 156 32 295 629 18 647Otherb 0 0 0 0 3 0 3

Totalc 41357 138 39002 129 983343 9522 992865d

a From the beginning of the epidemic through 2006b Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasc Includes persons whose state or area of residence is unknownd Includes 916 persons whose state or area of residence is unknown

30 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

MSA (population gt 500000)

Akron Ohio 66 94 32 46 762 1 763

AlbanyndashSchenectadyndashTroy NY 97 114 105 123 2253 24 2277

Albuquerque N Mex 70 88 50 61 1404 2 1406

AllentownndashBethlehemndashEaston PandashNJ 72 91 119 149 1352 17 1369

AtlantandashSandy SpringsndashMarietta Ga 1586 319 1006 196 21896 128 22024

AugustandashRichmond County GandashSC 106 205 32 61 1851 24 1875

AustinndashRound Rock Tex 227 156 186 123 4830 26 4856

Bakersfield Calif 76 100 122 156 1528 8 1536

BaltimorendashTowson Md 1064 401 1001 377 20352 218 20570

Baton Rouge La 222 304 231 301 3732 20 3752

BirminghamndashHoover Ala 151 139 110 100 2614 25 2639

Boise CityndashNampa Idaho 14 26 14 25 281 0 281

Boston MassndashNHa 441 99 355 80 13476 147 13623

Boston Division 269 146 185 101 8451 91 8542

Cambridge Division 108 74 102 70 3126 35 3161

Essex Division 52 71 51 69 1577 20 1597

BridgeportndashStamfordndashNorwalk Conn 181 201 135 150 3733 57 3790

BuffalondashNiagara Falls NY 117 102 96 84 2476 20 2496

Cape CoralndashFort Myers Fla 44 81 91 159 1692 24 1716

CharlestonndashNorth Charleston SC 92 155 91 151 2034 18 2052

CharlottendashGastoniandashConcord NCndashSC 214 141 285 180 3242 22 3264

Chicago IllndashIndndashWis 1716 182 1159 122 30118 261 30379

Chicago Division 1604 203 1073 135 28300 248 28548

Gary Division 61 88 50 71 1038 8 1046

Lake Division 51 59 36 41 780 5 785

CincinnatindashMiddletown OhiondashKyndashInd 111 53 199 95 2735 17 2752

ClevelandndashElyriandashMentor Ohio 228 107 170 80 4226 48 4274

Colorado Springs Colo 19 32 21 35 576 5 581

Columbia SC 177 256 197 280 3274 24 3298

Columbus Ohio 166 97 165 96 3112 15 3127

Dallas Tex 874 150 929 155 20238 63 20301

Dallas Division 681 175 714 178 16038 37 16075

Fort Worth Division 193 100 215 108 4200 26 4226

Dayton Ohio 58 69 54 64 1217 15 1232

DenverndashAurora Colo 274 116 236 98 6899 22 6921

Des Moines Iowa 30 57 23 43 530 4 534

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 31

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Detroit Mich 570 127 445 100 10373 73 10446

Detroit Division 443 223 330 167 8268 57 8325

Warren Division 127 51 115 46 2105 16 2121

El Paso Tex 56 78 40 54 1476 10 1486

Fresno Calif 52 59 64 72 1430 11 1441

Grand RapidsndashWyoming Mich 46 60 51 66 816 6 822

GreensborondashHigh Point NC 52 77 66 96 1265 14 1279

Greenville SC 70 119 67 111 1292 4 1296

HarrisburgndashCarlisle Pa 23 44 67 128 1224 8 1232

HartfordndashWest HartfordndashEast Hartford Conn 256 216 135 114 5126 46 5172

Honolulu Hawaii 54 60 69 76 2121 14 2135

HoustonndashBaytownndashSugar Land Tex 1017 190 1092 197 25821 172 25993

Indianapolis Ind 191 116 150 90 3824 25 3849

Jackson Miss 134 257 117 221 2419 30 2449

Jacksonville Fla 309 248 315 246 6020 75 6095

Kansas City MondashKans 183 94 160 81 4669 15 4684

Knoxville Tenn 47 72 35 52 882 5 887

Lakeland Fla 103 190 112 199 1811 21 1832

Las VegasndashParadise Nev 245 143 258 145 4616 28 4644

Little RockndashNorth Little Rock Ark 87 135 75 115 1383 14 1397

Los Angeles Calif 1529 118 1684 130 57953 293 58246

Los Angeles Division 1339 135 1435 144 51098 250 51348

Santa Anna Division 190 63 249 83 6855 43 6898

Louisville KyndashInd 123 102 97 79 2286 22 2308

Madison Wis 10 19 29 53 520 4 524

McAllenndashEdinburgndashPharr Tex 57 84 45 64 630 11 641

Memphis TennndashMissndashArk 402 320 346 271 5128 19 5147

Miami Fla 2420 446 2289 419 55807 997 56804

Fort Lauderdale Division 810 455 769 430 16412 262 16674

Miami Division 1243 523 1165 485 29703 512 30215

West Palm Beach Division 367 290 355 279 9692 223 9915

MilwaukeendashWaukeshandashWest Allis Wis 68 45 109 72 2507 18 2525

MinneapolisndashSt PaulndashBloomington MinnndashWis 186 59 184 58 4259 22 4281

Modesto Calif 36 71 22 43 671 6 677

NashvillendashDavidsonndashMurfreesboro Tenn 224 158 172 118 3848 20 3868

New HavenndashMilford Conn 169 200 107 127 4573 73 4646

New OrleansndashMetairiendashKenner La 393 299 271 264 8835 67 8902

32 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

New York NYndashNJndashPa 6215 330 5500 292 195177 2906 198083

Edison Division 191 83 130 56 6709 139 6848

Nassau Division 262 93 246 88 8141 110 8251

New York Division 5266 456 4716 408 160408 2323 162731

Newark Division 496 231 408 190 19919 334 20253

Oklahoma City Okla 125 108 88 75 2255 5 2260

OmahandashCouncil Bluffs NebndashIowa 37 46 80 97 1035 3 1038

Orlando Fla 544 282 517 260 8653 92 8745

OxnardndashThousand OaksndashVentura Calif 49 62 21 26 1008 3 1011

Palm BayndashMelbournendashTitusville Fla 68 129 61 114 1512 11 1523

Philadelphia PandashNJndashDelndashMd 1261 217 1348 231 28221 313 28534

Camden Division 108 87 111 89 3118 42 3160

Philadelphia Division 1022 263 1144 294 22112 250 22362

Wilmington Division 131 191 93 134 2991 21 3012

PhoenixndashMesandashScottsdale Ariz 460 119 376 93 7459 31 7490

Pittsburgh Pa 143 60 135 57 3182 19 3201

PortlandndashSouth Portland Maine 9 18 34 66 562 1 563

PortlandndashVancouverndashBeaverton OrendashWash 170 81 215 101 4825 10 4835

PoughkeepsiendashNewburghndashMiddletown NY 136 204 113 168 3162 24 3186

ProvidencendashNew BedfordndashFall River RIndashMass 132 82 155 96 3900 44 3944

RaleighndashCary NC 138 145 201 202 1987 13 2000

Richmond Va 119 101 122 102 3371 35 3406

RiversidendashSan BernardinondashOntario Calif 361 92 306 76 8568 60 8628

Rochester NY 165 159 124 120 3134 13 3147

SacramentondashArden-ArcadendashRoseville Calif 154 75 169 82 4000 26 4026

St Louis MondashIll 192 69 366 131 5965 40 6005

Salt Lake City Utah 46 44 40 37 1743 10 1753

San Antonio Tex 215 114 247 127 4987 30 5017

San DiegondashCarlsbadndashSan Marcos Calif 491 167 384 131 12934 61 12995

San Francisco Calif 867 209 690 165 40152 96 40248

Oakland Division 312 126 246 99 9546 48 9594

San Francisco Division 555 329 444 261 30606 48 30654

San JosendashSunnyvalendashSanta Clara Calif 88 50 145 81 3747 15 3762

San JuanndashCaguasndashGuaynabo PR 745 289 578 223 21402 277 21679

SarasotandashBradentonndashVenice Fla 82 122 104 152 1978 27 2005

ScrantonndashWilkes-Barre Pa 27 49 47 85 572 6 578

Seattle Wash 353 110 280 86 9172 27 9199

Seattle Division 316 129 255 102 8161 18 8179

Tacoma Division 37 49 25 33 1011 9 1020

Springfield Mass 88 128 45 66 2075 26 2101

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 33

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Stockton Calif 52 78 52 77 1076 15 1091

Syracuse NY 52 80 49 75 1317 8 1325

TampandashSt PetersburgndashClearwater Fla 559 211 605 224 11174 112 11286

Toledo Ohio 25 38 66 101 812 14 826

Tucson Ariz 103 111 100 106 2010 10 2020

Tulsa Okla 83 94 65 72 1494 10 1504

Virginia BeachndashNorfolkndashNewport News VandashNC 183 111 132 80 4711 63 4774

Washington DCndashVandashMdndashWV 1322 252 1684 318 31130 315 31445

Bethesda Division 135 118 173 150 2774 23 2797

Washington Division 1187 289 1511 365 28356 292 28648

Wichita Kans 35 60 38 64 851 2 853

Worcester Mass 76 97 79 101 1783 20 1803

YoungstownndashWarrenndashBoardman OhiondashPa 27 46 26 44 519 0 519

Subtotal for MSAs (population gt500000) 33602 173 31274 159 829633 8171 837804

Metropolitan areas (population of 50000 to 499999) 4477 80 4466 79 94829 847 95676

Nonmetropolitan areas 2666 54 2732 55 52063 445 52508

Totalb 41144 137 38749 128 981708 9494 991202

Note Because of the lack of census information for all US dependent areas includes data for only the 50 states the District of Columbia and Puerto RicoMSA metropolitan statistical areaMSA definitions for this report can be found at httpwwwcensusgovpopulationwwwestimatesmetrodefhtmla Reported case counts for the metropolitan divisions do not sum to the MSA total MSA total includes data from 1 metropolitan division with

population of lt500000b Includes persons whose county of residence is unknown

34 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Alabama (January 1988) 502 6041 48 6089

Alaska (February 1999) 38 285 2 287

Arizona (January 1987) 617 5877 80 5957

Arkansas (July 1989) 206 2349 20 2369

California (April 2006) 6581 7056 92 7148

Colorado (November 1985) 319 6084 31 6115

Connecticut (January 2005)b 826 2500 101 2601

Delaware (February 2006) 788 801 18 819

Florida (July 1997)c 4163 36386 397 36783

Georgia (December 2003) 2245 8197 194 8391

Idaho (June 1986) 35 340 4 344

Illinois (January 2006) 6241 6661 162 6823

Indiana (July 1988) 399 4027 43 4070

Iowa (July 1998) 69 586 5 591

Kansas (July 1999) 142 1225 15 1240

Kentucky (October 2004) 333 1303 13 1316

Louisiana (February 1993) 728 8149 166 8315

Maine (January 2006) 386 393 3 396

Michigan (April 1992) 635 6702 134 6836

Minnesota (October 1985) 309 3356 40 3396

Mississippi (August 1988) 352 4549 59 4608

Missouri (October 1987) 502 5086 55 5141

Nebraska (September 1995) 91 672 14 686

Nevada (February 1992) 339 3532 24 3556

New Hampshire (January 2005) 59 466 9 475

New Jersey (January 1992) 1477 17513 325 17838

New Mexico (January 1998) 114 949 4 953

New York (June 2000) 5326 42345 1820 44165

North Carolina (February 1990) 1615 13879 143 14022

North Dakota (January 1988) 4 82 1 83

Ohio (June 1990) 867 8222 101 8323

Oklahoma (June 1988) 229 2401 30 2431

Oregon (April 2006) 49 95 19 114

Pennsylvania (October 2002)d 4269 9537 179 9716

Rhode Island (July 2006) 14 21 0 21

South Carolina (February 1986) 493 6970 93 7063

South Dakota (January 1988) 18 215 6 221

Tennessee (January 1992) 732 7115 90 7205

Texas (January 1999)e 3370 24282 417 24699

Utah (April 1989) 106 893 14 907

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 35

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Virginia (July 1989) 864 10257 95 10352

Washington (March 2006) 4048 4157 40 4197

West Virginia (January 1989) 66 673 8 681

Wisconsin (November 1985) 261 2500 31 2531

Wyoming (June 1989) 7 93 1 94

Subtotal 50834 274822 5146 279968

US dependent areas

American Samoa (August 2001) 0 1 0 1

Guam (March 2000) 2 66 0 66

Northern Mariana Islands (October 2001) 2 7 0 7

Puerto Rico (January 2003) 1471 5610 91 5701

US Virgin Islands (December 1998) 22 247 6 253

Persons reported from areas with confidential name-based HIV infection reporting but who were residents of other areas 132 685 21 706

Totalf 52878 282640 5314 287954

Note Includes data from 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through 2006b Beginning in 1992 Connecticut had name-based HIV reporting for cases in children only From January 2002 through December 2004

Connecticut had name- or code-based HIV reporting for cases in adolescents and adults As of January 2005 Connecticut has name-based reporting of all cases of HIV infection

c Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterd On October 18 2002 Pennsylvania initiated confidential name-based HIV infection reporting in all areas except Philadelphia Code-based

reporting was implemented in Philadelphia in March 2004 and the switch to name-based reporting was made in October 2005e From February 1994 through December 1998 Texas reported HIV infection in children onlyf Includes 1252 persons reported from areas with confidential name-based HIV infection reporting but whose area of residence is unknown

36 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulativemdashUnited States and dependent areas

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No Adult or adolescentMale-to-male sexual contact 13775 49 429897 54 mdash mdash mdash mdash 13775 35 429897 44Injection drug use 3413 12 163070 21 1826 17 67693 35 5239 13 230763 23Male-to-male sexual contact and

injection drug use 1603 6 65524 8 mdash mdash mdash mdash 1603 4 65524 7Hemophiliacoagulation disorder 43 0 5176 1 11 0 348 0 54 0 5524 1High-risk heterosexual contactc 2997 11 49610 6 4839 46 85186 44 7836 20 134796 14

Sex with injection drug user 330 1 11683 1 706 7 26073 14 1036 3 37756 4Sex with bisexual male mdash mdash mdash mdash 234 2 5162 3 234 1 5162 1Sex with person with hemophilia 1 0 84 0 11 0 502 0 12 0 586 0Sex with HIV-infected transfusion

recipient 22 0 553 0 21 0 793 0 43 0 1346 0Sex with HIV-infected person risk

factor not specified 2644 9 37290 5 3867 37 52656 27 6511 17 89946 9Receipt of blood transfusion blood

d components or tissue 63 0 5213 1 68 1 4176 2 131 0 9389 1Otherrisk factor not reported or

identifiede 6484 23 73136 9 3793 36 34311 18 10278 26 107450 11Subtotal 28378 100 791626 100 10537 100 191714 100 38916 100 983343 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 0 0 222 5 0 0 7 0 0 0 229 2Mother with documented HIV infection or

1 of the following risk factors 24 75 4315 89 50 93 4423 95 74 86 8738 92Injection drug use 4 13 1676 35 4 7 1665 36 8 9 3341 35Sex with injection drug user 4 13 789 16 4 7 750 16 8 9 1539 16Sex with bisexual male 1 3 101 2 2 4 110 2 3 3 211 2Sex with person with hemophilia 0 0 20 0 0 0 16 0 0 0 36 0Sex with HIV-infected transfusion

recipient 0 0 11 0 0 0 15 0 0 0 26 0Sex with HIV-infected person risk

factor not specified 6 19 742 15 17 31 790 17 23 27 1532 16Receipt of blood transfusion blood

components or tissue 0 0 70 1 0 0 82 2 0 0 152 2Has HIV infection risk factor not

specified 9 28 906 19 23 43 995 21 32 37 1901 20Receipt of blood transfusion blood

fcomponents or tissue 1 3 243 5 0 0 144 3 1 1 387 4Otherrisk factor not reported or

identifiedg 7 22 75 2 4 7 93 2 11 13 168 2Subtotal 32 100 4855 100 54 100 4667 100 86 100 9522 100

Total 28410 100 796481 100 10591 100 196381 100 39002 100 992865 100a From the beginning of the epidemic through 2006b From the beginning of the epidemic through 2006 Includes 3 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infectiond AIDS developed in 47 adultsadolescents after they received blood that had tested negative for HIV antibodies AIDS developed in 14 additional adults

after they received tissue organs or artificial insemination from HIV-infected donors Four of the 14 received tissue or organs from a donor who was negative for HIV antibody at the time of donation

e Includes 37 adultsadolescents who were exposed to HIV-infected blood body fluids or concentrated virus in health care laboratory or household settings as supported by seroconversion epidemiologic andor laboratory evidence One person was infected after intentional inoculation with HIV-infected blood Includes an additional 740 persons who acquired HIV infection perinatally but who were more than 12 years of age when AIDS was diagnosed These 740 persons are not counted in the values for the pediatric transmission category

f AIDS developed in 3 children after they received blood that had tested negative for HIV antibodiesg Includes 5 children who were exposed to HIV-infected blood as supported by seroconversion epidemiologic andor laboratory evidence 1 child was

infected after intentional inoculation with HIV-infected blood and 5 children were exposed to HIV-infected blood in a household setting Of the 168 children 26 had sexual contact with an adult with or at high risk for HIV infection

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 37

Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No

Adult or adolescentMale-to-male sexual contact 22912 59 103679 52 mdash mdash mdash mdash 22912 44 103679 37

Injection drug use 3503 9 24255 12 2124 16 13925 17 5627 11 38181 14

Male-to-male sexual contact and injection drug use 1946 5 10704 5 mdash mdash mdash mdash 1946 4 10704 4

Hemophiliacoagulation disorder 43 0 495 0 6 0 73 0 49 0 568 0

High-risk heterosexual contactc 2874 7 16830 8 5939 45 38315 47 8813 17 55145 20

Sex with injection drug user 308 1 2601 1 757 6 6791 8 1065 2 9392 3

Sex with bisexual male mdash mdash mdash mdash 328 2 2265 3 328 1 2265 1

Sex with person with hemophilia 4 0 31 0 16 0 201 0 20 0 232 0

Sex with HIV-infected transfusion recipient 13 0 131 0 28 0 223 0 41 0 354 0

Sex with HIV-infected person risk factor not specified 2549 7 14067 7 4810 36 28835 35 7359 14 42902 15

Receipt of blood transfusion blood components or tissue 61 0 489 0 50 0 536 1 111 0 1025 0

Otherrisk factor not reported or identified 7748 20 44021 22 5106 39 29312 36 12854 25 73338 26

Subtotal 39087 100 200473 100 13225 100 82161 100 52312 100 282640 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 8 3 106 4 0 0 1 0 8 1 107 2

Mother with documented HIV infection or 1 of the following risk factors 197 74 2195 85 254 85 2417 89 451 80 4612 87

Injection drug use 34 13 532 21 53 18 561 21 87 15 1093 21

Sex with injection drug user 12 5 208 8 21 7 213 8 33 6 421 8

Sex with bisexual male 5 2 37 1 4 1 32 1 9 2 69 1

Sex with person with hemophilia 0 0 3 0 1 0 7 0 1 0 10 0

Sex with HIV-infected transfusion recipient 0 0 4 0 0 0 4 0 0 0 8 0

Sex with HIV-infected person risk factor not specified 54 20 534 21 76 25 629 23 130 23 1163 22

Receipt of blood transfusion blood components or tissue 0 0 17 1 2 1 20 1 2 0 37 1

Has HIV infection risk factor not specified 92 35 860 33 97 32 951 35 189 33 1811 34

Receipt of blood transfusion blood components or tissue 6 2 28 1 3 1 24 1 9 2 52 1

Otherrisk factor not reported or identified 55 21 260 10 43 14 283 10 98 17 543 10

Subtotal 266 100 2589 100 300 100 2725 100 566 100 5314 100

Total 39353 100 203062 100 13525 100 84886 100 52878 100 287954 100

Note See Table 16 for the list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006b From the beginning of the epidemic through December 2006 Includes 6 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infection

38 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity

2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 6251 65 253927 73Injection drug use 733 8 31737 9Male-to-male sexual contact and injection drug use 732 8 31434 9Hemophiliacoagulation disorder 26 0 3989 1High-risk heterosexual contactb 416 4 7850 2

Sex with injection drug user 74 1 2310 1

Sex with person with hemophilia 0 0 36 0

Sex with HIV-infected transfusion recipient 2 0 176 0

Sex with HIV-infected person risk factor not specified 340 4 5328 2Receipt of blood transfusion blood components or tissue 20 0 3194 1Otherrisk factor not reported or identified 1400 15 16469 5

Total 9578 100 348600 100

Black not HispanicMale-to-male sexual contact 4309 36 103297 37Injection drug use 1635 14 83369 30Male-to-male sexual contact and injection drug use 526 4 22134 8Hemophiliacoagulation disorder 10 0 604 0High-risk heterosexual contactb 1875 16 29952 11

Sex with injection drug user 167 1 6823 2Sex with person with hemophilia 1 0 36 0Sex with HIV-infected transfusion recipient 15 0 237 0Sex with HIV-infected person risk factor not specified 1692 14 22856 8

Receipt of blood transfusion blood components or tissue 24 0 1218 0Otherrisk factor not reported or identified 3579 30 40268 14

Total 11958 100 280842 100

HispanicMale-to-male sexual contact 2816 47 64893 44Injection drug use 965 16 46337 31Male-to-male sexual contact and injection drug use 287 5 10884 7Hemophiliacoagulation disorder 6 0 466 0High-risk heterosexual contactb 638 11 10950 7

Sex with injection drug user 84 1 2409 2Sex with person with hemophilia 0 0 11 0Sex with HIV-infected transfusion recipient 5 0 125 0Sex with HIV-infected person risk factor not specified 549 9 8405 6

Receipt of blood transfusion blood components or tissue 17 0 657 0Otherrisk factor not reported or identified 1326 22 14832 10

Total 6055 100 149019 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 39

a

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulative

No No

AsianPacific IslanderMale-to-male sexual contact 225 54 4475 68Injection drug use 20 5 317 5Male-to-male sexual contact and injection drug use 17 4 284 4Hemophiliacoagulation disorder 1 0 70 1High-risk heterosexual contactb 34 8 376 6

Sex with injection drug user 1 0 54 1Sex with person with hemophilia 0 0 1 0Sex with HIV-infected transfusion recipient 0 0 8 0Sex with HIV-infected person risk factor not specified 33 8 313 5

Receipt of blood transfusion blood components or tissue 2 0 112 2Otherrisk factor not reported or identified 114 28 949 14

Total 413 100 6583 100

American IndianAlaska NativeMale-to-male sexual contact 61 49 1403 55Injection drug use 15 12 395 15Male-to-male sexual contact and injection drug use 23 19 457 18Hemophiliacoagulation disorder 0 0 27 1High-risk heterosexual contactb 9 7 118 5

Sex with injection drug user 1 1 33 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 8 6 82 3

Receipt of blood transfusion blood components or tissue 0 0 8 0Otherrisk factor not reported or identified 16 13 155 6

Total 124 100 2563 100

Total casesMale-to-male sexual contact 13775 49 429897 54Injection drug use 3413 12 163070 21Male-to-male sexual contact and injection drug use 1603 6 65524 8Hemophiliacoagulation disorder 43 0 5176 1High-risk heterosexual contactb 2997 11 49610 6

Sex with injection drug user 330 1 11683 1Sex with person with hemophilia 1 0 84 0Sex with HIV-infected transfusion recipient 22 0 553 0Sex with HIV-infected person risk factor not specified 2644 9 37290 5

Receipt of blood transfusion blood components or tissue 63 0 5213 1Otherrisk factor not reported or identified 6484 23 73136 9

Total 28378c 100 791626d 100a From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 4019 males of unknown race or multiple races

40 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 11963 73 55725 69Injection drug use 858 5 5512 7Male-to-male sexual contact and injection drug use 1092 7 5578 7Hemophiliacoagulation disorder 29 0 355 0High-risk heterosexual contactb 522 3 2658 3

Sex with injection drug user 65 0 544 1Sex with person with hemophilia 0 0 8 0Sex with HIV-infected transfusion recipient 3 0 33 0Sex with HIV-infected person risk factor not specified 454 3 2073 3

Receipt of blood transfusion blood components or tissue 14 0 197 0Otherrisk factor not reported or identified 1956 12 11147 14

Total 16434 100 81172 100

Black not HispanicMale-to-male sexual contact 6203 44 30148 37Injection drug use 1594 11 11997 15Male-to-male sexual contact and injection drug use 483 3 3489 4Hemophiliacoagulation disorder 10 0 109 0High-risk heterosexual contactb 1714 12 10905 13

Sex with injection drug user 169 1 1554 2Sex with person with hemophilia 4 0 17 0Sex with HIV-infected transfusion recipient 6 0 77 0Sex with HIV-infected person risk factor not specified 1535 11 9257 11

Receipt of blood transfusion blood components or tissue 32 0 223 0Otherrisk factor not reported or identified 4151 29 24632 30

Total 14187 100 81503 100

HispanicMale-to-male sexual contact 4094 55 15623 47Injection drug use 993 13 6407 19Male-to-male sexual contact and injection drug use 316 4 1402 4Hemophiliacoagulation disorder 3 0 26 0High-risk heterosexual contactb 582 8 2963 9

Sex with injection drug user 65 1 455 1Sex with person with hemophilia 0 0 6 0Sex with HIV-infected transfusion recipient 4 0 18 0Sex with HIV-infected person risk factor not specified 513 7 2484 7

Receipt of blood transfusion blood components or tissue 11 0 55 0Otherrisk factor not reported or identified 1475 20 6977 21

Total 7474 100 33453 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 41

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderMale-to-male sexual contact 402 70 1006 63Injection drug use 17 3 55 3Male-to-male sexual contact and injection drug use 15 3 38 2Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 25 4 96 6

Sex with injection drug user 3 1 10 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 22 4 83 5

Receipt of blood transfusion blood components or tissue 4 1 7 0Otherrisk factor not reported or identified 109 19 397 25

Total 572 100 1600 100

American IndianAlaska NativeMale-to-male sexual contact 104 61 516 57Injection drug use 13 8 101 11Male-to-male sexual contact and injection drug use 19 11 110 12Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 10 6 53 6

Sex with injection drug user 2 1 14 2Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 8 5 39 4

Receipt of blood transfusion blood components or tissue 0 0 2 0Otherrisk factor not reported or identified 24 14 125 14

Total 170 100 907 100

Total casesMale-to-male sexual contact 22912 59 103679 52Injection drug use 3503 9 24255 12Male-to-male sexual contact and injection drug use 1946 5 10704 5Hemophiliacoagulation disorder 43 0 495 0High-risk heterosexual contactb 2874 7 16830 8

Sex with injection drug user 308 1 2601 1Sex with person with hemophilia 4 0 31 0Sex with HIV-infected transfusion recipient 13 0 131 0Sex with HIV-infected person risk factor not specified 2549 7 14067 7

Receipt of blood transfusion blood components or tissue 61 0 489 0Otherrisk factor not reported or identified 7748 20 44021 22

Total 39087c 100 200473d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 1838 males of unknown race or multiple races

42 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race

ethnicity 2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 482 28 14981 40Hemophiliacoagulation disorder 4 0 123 0High-risk heterosexual contactb 725 42 15799 42

Sex with injection drug user 153 9 5650 15Sex with bisexual male 63 4 1859 5Sex with person with hemophilia 5 0 329 1Sex with HIV-infected transfusion recipient 5 0 338 1Sex with HIV-infected person risk factor not specified 499 29 7623 20

Receipt of blood transfusion blood components or tissue 15 1 1870 5Otherrisk factor not reported or identified 499 29 4801 13

Total 1725 100 37574 100

Black not HispanicInjection drug use 982 15 38914 34Hemophiliacoagulation disorder 3 0 145 0High-risk heterosexual contactb 3103 46 49876 44

Sex with injection drug user 373 6 13530 12Sex with bisexual male 136 2 2352 2Sex with person with hemophilia 4 0 121 0Sex with HIV-infected transfusion recipient 8 0 277 0Sex with HIV-infected person risk factor not specified 2582 38 33596 29

Receipt of blood transfusion blood components or tissue 39 1 1546 1Otherrisk factor not reported or identified 2612 39 23894 21

Total 6739 100 114375 100

HispanicInjection drug use 322 18 12892 35Hemophiliacoagulation disorder 4 0 67 0High-risk heterosexual contactb 894 49 17995 49

Sex with injection drug user 166 9 6522 18Sex with bisexual male 32 2 818 2Sex with person with hemophilia 1 0 45 0Sex with HIV-infected transfusion recipient 7 0 141 0Sex with HIV-infected person risk factor not specified 688 38 10469 29

Receipt of blood transfusion blood components or tissue 12 1 619 2Otherrisk factor not reported or identified 592 32 5023 14

Total 1824 100 36596 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 43

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 8 8 125 12Hemophiliacoagulation disorder 0 0 7 1High-risk heterosexual contactb 49 47 574 53

Sex with injection drug user 4 4 114 11Sex with bisexual male 2 2 80 7Sex with person with hemophilia 0 0 4 0Sex with HIV-infected transfusion recipient 1 1 25 2Sex with HIV-infected person risk factor not specified 42 40 351 33

Receipt of blood transfusion blood components or tissue 1 1 93 9Otherrisk factor not reported or identified 46 44 279 26

Total 104 100 1078 100

American IndianAlaska NativeInjection drug use 13 32 280 42Hemophiliacoagulation disorder 0 0 3 0High-risk heterosexual contactb 15 37 277 41

Sex with injection drug user 4 10 107 16Sex with bisexual male 1 2 27 4Sex with person with hemophilia 0 0 2 0Sex with HIV-infected transfusion recipient 0 0 6 1Sex with HIV-infected person risk factor not specified 10 24 135 20

Receipt of blood transfusion blood components or tissue 1 2 17 3Otherrisk factor not reported or identified 12 29 95 14

Total 41 100 672 100

Total casesInjection drug use 1826 17 67693 35Hemophiliacoagulation disorder 11 0 348 0High-risk heterosexual contactb 4839 46 85186 44

Sex with injection drug user 706 7 26073 14Sex with bisexual male 234 2 5162 3Sex with person with hemophilia 11 0 502 0Sex with HIV-infected transfusion recipient 21 0 793 0Sex with HIV-infected person risk factor not specified 3867 37 52656 27

Receipt of blood transfusion blood components or tissue 68 1 4176 2Otherrisk factor not reported or identified 3793 36 34311 18

Total 10537c 100 191714d 100a From the beginning of the epidemic through 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 104 females of unknown race or multiple racesd Includes 1419 females of unknown race or multiple races

44 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 690 26 4260 26Hemophiliacoagulation disorder 3 0 24 0

bHigh-risk heterosexual contact 1132 42 7593 46Sex with injection drug user 205 8 1876 11Sex with bisexual male 98 4 659 4Sex with person with hemophilia 10 0 115 1Sex with HIV-infected transfusion recipient 7 0 64 0Sex with HIV-infected person risk factor not specified 812 30 4879 29

Receipt of blood transfusion blood components or tissue 12 0 146 1Otherrisk factor not reported or identified 850 32 4567 28

Total 2687 100 16590 100

Black not HispanicInjection drug use 1034 13 7105 14Hemophiliacoagulation disorder 1 0 35 0

bHigh-risk heterosexual contact 3451 44 23732 46Sex with injection drug user 313 4 3473 7Sex with bisexual male 155 2 1294 3Sex with person with hemophilia 5 0 71 0Sex with HIV-infected transfusion recipient 14 0 120 0Sex with HIV-infected person risk factor not specified 2964 38 18774 36

Receipt of blood transfusion blood components or tissue 26 0 324 1Otherrisk factor not reported or identified 3370 43 20244 39

Total 7882 100 51440 100

HispanicInjection drug use 339 15 2280 18Hemophiliacoagulation disorder 2 0 11 0

bHigh-risk heterosexual contact 1198 52 6264 50Sex with injection drug user 218 9 1324 11Sex with bisexual male 62 3 266 2Sex with person with hemophilia 1 0 11 0Sex with HIV-infected transfusion recipient 7 0 39 0Sex with HIV-infected person risk factor not specified 910 39 4624 37

Receipt of blood transfusion blood components or tissue 12 1 58 0Otherrisk factor not reported or identified 767 33 3843 31

Total 2318 100 12456 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 45

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 17: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas

Year of death

Cumulativea2002 2003 2004 2005 2006

Data for 50 states and the District of ColumbiaAge at death (yrs)lt13 25 22 15 7 13 4889

13ndash14 10 6 15 12 5 276

15ndash19 39 36 36 38 44 1104

20ndash24 151 157 175 147 162 8716

25ndash29 553 512 482 458 405 43671

30ndash34 1480 1272 1128 1069 785 95351

35ndash39 2967 2763 2425 2096 1682 116746

40ndash44 3595 3516 3393 3317 2636 104133

45ndash49 3294 3234 3251 3275 2886 72831

50ndash54 2318 2373 2502 2645 2343 44255

55ndash59 1209 1322 1425 1543 1480 25123

60ndash64 616 705 741 797 771 14315

gt65 691 773 807 865 805 14393

RaceethnicityWhite not Hispanic 5214 5097 4836 4758 3860 239529

Black not Hispanic 9037 8675 8581 8679 7426 218392

Hispanic 2429 2632 2641 2513 2425 80690

AsianPacific Islander 97 84 111 87 114 3426

American IndianAlaska Native 83 73 80 65 66 1693

Transmission categoryMale adult or adolescentMale-to-male sexual contact 5960 5937 5735 5641 4930 266272

Injection drug use 3738 3547 3315 3314 2641 107173

Male-to-male sexual contact and injection drug use 1278 1299 1237 1289 1064 40993

High-risk heterosexual contactb 1465 1501 1625 1571 1470 26236

Otherc 160 149 125 117 80 9867

Subtotal 12601 12431 12038 11932 10184 450541

Female adult or adolescentInjection drug use 1923 1825 1855 1768 1456 43143

High-risk heterosexual contactb 2281 2292 2373 2458 2258 42620

Otherc 84 87 72 68 70 4131

Subtotal 4289 4204 4300 4295 3784 89895

Child (lt13 yrs at diagnosis)Perinatal 53 49 56 39 42 4848

Otherd 4 5 1 2 7 521

Subtotal 57 54 57 41 48 5369

Deaths 17

Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas (cont)

Year of death

Cumulativea2002 2003 2004 2005 2006

Region of residenceNortheast 5313 5012 4779 4750 4074 180623

Midwest 1726 1666 1482 1378 1325 54468

South 7337 7427 7535 7907 6475 197209

West 2571 2585 2600 2234 2141 113506

Subtotal for 50 states and the District of Columbia 16948 16690 16395 16268 14016 545805

Data for US dependent areas 667 575 572 562 580 19858

Totale 17628 17283 16982 16865 14627 565927f

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column totalf Includes 2082 persons of unknown race or multiple races 261 persons of unknown state of residence and 2 persons who were residents

of other areas

18 Deaths

Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003ndash2006mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

2003 2004 2005 2006Data for 33 states

Age at end of year (yrs)lt13 4154 3700 3294 286713ndash14 1130 1238 1212 113915ndash19 3298 3627 4024 453920ndash24 12389 12826 13411 1430125ndash29 26167 26924 28164 2960030ndash34 49602 47577 45109 4418935ndash39 80703 77871 75842 7363440ndash44 92040 97109 100102 10176445ndash49 71345 77490 83816 9028350ndash54 45133 51033 56640 6319555ndash59 22793 26610 31186 3600860ndash64 10820 12642 14422 16658gt65 8531 9959 11657 13551

RaceethnicityWhite not Hispanic 145081 151694 158375 166000Black not Hispanic 202951 212425 221439 231957Hispanic 72612 76503 80491 84720AsianPacific Islander 2234 2529 2858 3187American IndianAlaska Native 1788 1889 2008 2119

Transmission categoryMale adult or adolescentMale-to-male sexual contact 181771 193245 205423 218676Injection drug use 57651 58149 58369 59077Male-to-male sexual contact and injection drug use 23965 24434 24725 25085High-risk heterosexual contacta 40084 42559 44915 47562Otherb 3218 3278 3325 3424Subtotal 306689 321665 336756 353825

Female adult or adolescentInjection drug use 32346 32735 32973 33470High-risk heterosexual contacta 80324 85348 90185 95403Otherb 2036 2123 2212 2321Subtotal 114705 120206 125370 131195

Child (lt13 yrs at diagnosis)Perinatal 6137 6154 6178 6143Otherc 570 575 571 560Subtotal 6707 6730 6748 6703

Subtotal for 33 states 428107 448605 468879 491727Data for US dependent areas 15809 16399 17150 17955

Totald 443916 465005 486028 509681Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 19

Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission categorymdash33 states with confidential name-based HIV infection reporting

Transmission category

White not Hispanic

Black not Hispanic Hispanic

AsianPacific Islander

American IndianAlaska

Native Totala

No No No No No No

Male adult or adolescentMale-to-male sexual contact 108259 77 70242 49 36043 57 1669 68 938 62 218676 62Injection drug use 12328 9 31339 22 14472 23 264 11 216 14 59077 17Male-to-male sexual contact

and injection drug use 11283 8 9587 7 3720 6 93 4 205 13 25085 7High-risk heterosexual contactb 6667 5 31140 22 8788 14 395 16 143 9 47562 13Otherc 1458 1 1492 1 404 1 30 1 17 1 3424 1Subtotal 139994 100 143799 100 63427 100 2450 100 1519 100 353825 100

Female adult or adolescentInjection drug use 8262 33 19136 23 5528 28 106 15 175 30 33470 26High-risk heterosexual contactb 16338 65 63204 75 14132 71 573 82 392 68 95403 73Otherc 450 2 1469 2 344 2 24 3 12 2 2321 2Subtotal 25050 100 83809 100 20004 100 703 100 578 100 131195 100

Child (lt13 yrs at diagnosis)Perinatal 801 84 4064 93 1183 92 28 82 20 95 6143 92Otherd 154 16 283 7 107 8 6 18 1 5 560 8Subtotal 955 100 4347 100 1290 100 34 100 21 100 6703 100

Totale 166000 231957 84720 3187 2119 491727Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of 33 states that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Includes 3745 persons of unknown race or multiple racesb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes 5 persons of unknown sex Because column totals were calculated independently of the values for the subpopulations the values

in each column may not sum to the column total

20 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Map 1 Estimated rates (per 100000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

Note Rates adjusted for reporting delays Rates of HIV infection include only persons living with HIV infection that has not progressed to AIDSSince 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 Islandsa Includes persons whose area of residence is unknown

Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

Note Rates adjusted for reporting delays Rates of HIV infection include only persons living with HIV infection that has not progressed to AIDSSince 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 Islandsa Includes persons whose area of residence is unknown

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 21

Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002ndash2006mdashUnited States and dependent areas

2002 2003 2004 2005 2006Data for 50 states and the District of Columbia

Age at end of year (yrs)lt13 2308 2006 1684 1394 111513ndash14 685 747 784 762 71115ndash19 1465 1694 1974 2243 248720ndash24 3910 4292 4629 5033 536725ndash29 12725 12743 13045 13505 1435930ndash34 35558 33870 32057 29949 2882435ndash39 70107 68106 65076 62235 5964940ndash44 80377 86294 91335 94021 9517445ndash49 64702 71276 77417 84153 9077550ndash54 41270 46855 53333 59256 6647655ndash59 20113 24145 28356 33522 3901460ndash64 9681 11293 13305 15380 18072gt65 7520 8946 10604 12430 14669

RaceethnicityWhite not Hispanic 129426 135278 141508 147426 154495Black not Hispanic 150488 161326 171654 181056 191590Hispanic 63424 67895 72024 76334 80815AsianPacific Islander 3060 3426 3759 4121 4526American IndianAlaska Native 1254 1356 1458 1562 1651

Transmission categoryMale adult or adolescentMale-to-male sexual contact 158092 168233 178551 188622 199693Injection drug use 56708 58436 59940 61229 62998Male-to-male sexual contact and injection drug use 24726 25457 26144 26785 27523High-risk heterosexual contacta 27329 30300 33181 35916 39004Otherb 3588 3665 3769 3888 4026Subtotal 270444 286091 301585 316440 333244

Female adult or adolescentInjection drug use 27863 28874 29828 30646 31575High-risk heterosexual contacta 46445 51489 56229 60693 65631Otherb 1903 2033 2178 2315 2465Subtotal 76210 82395 88236 93653 99671

Child (lt13 yrs at diagnosis)Perinatal 3633 3654 3651 3664 3660Otherc 129 124 123 122 115Subtotal 3762 3778 3774 3786 3775

Region of residenceNortheast 105599 110929 115562 120208 125620Midwest 36011 38571 41178 44171 47010South 137081 147284 157975 166962 177591West 71729 75483 78883 82540 86473

Subtotal for 50 states and the District of Columbia 350419 372267 393598 413882 436693

Data for US dependent areas 9880 10365 10713 11106 11359

Totald 360617 383024 404849 425646 448871Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

22 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission categorymdash50 states and the District of Columbia

Transmission category

White not Hispanic

Black not Hispanic Hispanic

AsianPacific Islander

American IndianAlaska

Native Totala

No No No No No No

Male adult or adolescentMale-to-male sexual contact 101299 75 57520 45 36087 57 2715 72 704 57 199693 60Injection drug use 13168 10 33911 27 14795 23 325 9 201 16 62998 19Male-to-male sexual contact and

injection drug use 12393 9 10121 8 4352 7 198 5 220 18 27523 8High-risk heterosexual contactb 6081 5 24205 19 7816 12 444 12 105 8 39004 12Otherc 1743 1 1602 1 574 1 69 2 16 1 4026 1Subtotal 134683 100 127359 100 63623 100 3752 100 1246 100 333244 100

Female adult or adolescentInjection drug use 7407 38 18531 30 5025 30 115 15 153 39 31575 32High-risk heterosexual contactb 11350 59 41741 68 11092 67 588 78 227 58 65631 66Otherc 508 3 1456 2 413 2 51 7 13 3 2465 2Subtotal 19264 100 61728 100 16531 100 753 100 393 100 99671 100

Child (lt13 yrs at diagnosis)Perinatal 500 92 2468 99 629 95 20 94 12 100 3660 97Otherd 46 8 34 1 33 5 1 6 0 0 115 3Subtotal 546 100 2503 100 662 100 21 100 12 100 3775 100

Totale 154495 191590 80815 4526 1651 436693

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Includes 3616 persons of unknown race or multiple racesb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes 3 person of unknown sex Because column totals were calculated independently of the values for the subpopulations the values in each column

may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 23

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by

area of residence and age categorymdashUnited States and dependent areas

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

Alabama 5469 17 5486 3744 11 3755Alaska 272 1 273 330 1 331Arizona 5744 49 5793 4922 7 4929Arkansas 2291 7 2298 2139 6 2145California mdash mdash mdash 61451 105 61555Colorado 5855 13 5869 4083 2 4085Connecticut mdash mdash mdash 7406 15 7421Delaware mdash mdash mdash 1753 7 1760District of Columbia mdash mdash mdash 10059 30 10089Floridab 35461 263 35723 46469 194 46663Georgia mdash mdash mdash 17336 47 17383Hawaii mdash mdash mdash 1234 3 1237Idaho 356 0 356 313 0 313Illinois mdash mdash mdash 16139 46 16185Indiana 3849 21 3870 3996 14 4010Iowa 588 2 590 869 3 872Kansas 1230 7 1237 1272 2 1274Kentucky mdash mdash mdash 2589 13 2602Louisiana 7361 101 7462 8052 21 8074Maine mdash mdash mdash 512 2 514Maryland mdash mdash mdash 14540 41 14581Massachusetts mdash mdash mdash 8806 20 8826Michigan 6118 55 6173 6615 12 6627Minnesota 3227 21 3248 2314 9 2323Mississippi 4200 32 4232 3155 13 3168Missouri 4999 33 5033 5479 7 5486Montana mdash mdash mdash 205 0 205Nebraska 688 12 700 771 2 773Nevada 3402 13 3415 2969 3 2972New Hampshire mdash mdash mdash 556 3 559New Jersey 16059 153 16212 17168 57 17226New Mexico 910 0 909 1252 3 1255New York 42220 801 43021 70697 148 70845North Carolina 11700 60 11760 8451 12 8463North Dakota 87 2 89 73 1 74Ohio 8266 57 8323 7054 30 7084Oklahoma 2191 17 2208 2191 3 2194Oregon mdash mdash mdash 2840 4 2844Pennsylvania mdash mdash mdash 18633 71 18703Rhode Island mdash mdash mdash 1296 7 1303South Carolina 6349 45 6394 7035 23 7058South Dakota 195 4 199 139 1 140Tennessee 6579 51 6631 6403 11 6414Texas 24741 262 25003 34010 53 34063Utah 893 10 903 1164 0 1164Vermont mdash mdash mdash 238 2 240Virginia 9937 41 9978 8423 24 8447Washington mdash mdash mdash 5471 5 5476West Virginia 660 5 665 749 5 754Wisconsin 2322 15 2337 2153 12 2165Wyoming 86 2 88 102 1 103

Subtotal 224303 2174 226477 435621 1115 436736

24 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age categorymdashUnited States and dependent areas (cont)

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

US dependent areasAmerican Samoa 2 0 2 1 0 1Guam 63 0 63 36 0 36Northern Mariana Islands 7 0 7 3 0 3Puerto Rico 6269 31 6300 10971 26 10997US Virgin Islands 228 2 230 312 2 314Otherc mdash mdash mdash 1 0 1

Totald 230872 2207 233079 447724 1147 448871

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reporting a See Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at

least 2003b Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterc Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasd Total number of persons living with HIV infection (not AIDS) includes persons reported from areas with confidential name-based HIV

infection reporting who were residents of other states or whose area of residence is unknown Total number of persons living with AIDS includes persons whose area of residence is unknown Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 25

Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristicsmdashUnited States and dependent areas

No of persons

Survival in months

gt12 gt24 gt36Data for 50 states and the District of Columbia

Age at diagnosis (yrs)lt13 101 096 094 09413ndash14 60 098 098 09515ndash19 305 098 096 09520ndash24 1351 096 093 09225ndash29 3034 095 092 09130ndash34 5499 094 091 08935ndash39 7888 093 090 08740ndash44 7085 092 088 08545ndash49 5090 089 085 08250ndash54 3067 086 081 07855ndash59 1505 083 078 07460ndash64 806 080 073 069gt65 614 073 068 065

RaceethnicityWhite not Hispanic 10706 092 089 087Black not Hispanic 18406 090 086 082Hispanic 6398 092 090 088AsianPacific Islander 404 094 092 090American IndianAlaska Native 167 084 081 075

Transmission categoryMale adult or adolescentMale-to-male sexual contact 12830 093 090 088Injection drug use 4048 089 084 081Male-to-male sexual contact and injection drug use 1701 093 089 086High-risk heterosexual contacta 3170 091 088 085Otherb 5019 086 083 080Subtotal 26768 091 088 085

Female adult or adolescentInjection drug use 2101 089 083 078High-risk heterosexual contacta 4686 093 089 086Otherb 2749 090 085 083Subtotal 9536 091 087 083

Child (lt13 yrs at diagnosis)Perinatal 98 096 095 095Otherc 3 100 067 067Subtotal 101 096 094 094

Subtotal for 50 states and the District of Columbia 36405 091 087 085

Data for US dependent areas 891 083 078 075

Total 37352d 091 087 084Note Excludes persons whose date of death was before or in the same month as date of diagnosis Excludes persons whose month of diagnosis or month of death is unknowna Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes 325 persons of unknown race or multiple races

26 Survival after AIDS Diagnosis

Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by year of diagnosismdashUnited States and dependent areas

Months after AIDS diagnosis

Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by age groupmdashUnited States and dependent areas

Months after AIDS diagnosis

Survival after AIDS Diagnosis 27

Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by raceethnicitymdashUnited States and dependent areas

Months after AIDS diagnosis

28 Survival after AIDS Diagnosis

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006

and cumulativemdashUnited States and dependent areas

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Alabama 510 112 462 100 8626 76 8702Alaska 24 36 38 57 648 7 655Arizona 626 105 539 87 10396 46 10442Arkansas 237 85 252 90 3891 36 3927California 4069 113 3960 109 142254 664 142918Colorado 351 75 322 68 8742 31 8773Connecticut 658 188 422 120 14716 183 14899Delaware 177 210 116 136 3547 26 3573District of Columbia 672 1155 853 1467 17372 189 17561Florida 4921 277 4932 273 104084 1530 105614Georgia 2325 255 1605 171 31734 231 31965Hawaii 105 82 93 72 2927 17 2944Idaho 24 17 26 18 604 2 606Illinois 1886 148 1382 108 33620 282 33902Indiana 407 65 346 55 8239 56 8295Iowa 93 31 86 29 1727 13 1740Kansas 105 38 120 43 2781 14 2795Kentucky 249 60 207 49 4600 32 4632Louisiana 936 208 824 192 17612 128 17740Maine 21 16 68 51 1110 8 1118Maryland 1558 279 1626 290 30252 319 30571Massachusetts 666 104 533 83 19181 214 19395Michigan 821 81 672 67 14941 113 15054Minnesota 226 44 212 41 4817 28 4845Mississippi 368 127 365 125 6642 56 6698Missouri 385 66 469 80 11016 61 11077Montana 21 22 7 07 373 3 376Nebraska 53 30 118 67 1479 11 1490Nevada 293 121 294 118 5733 29 5762New Hampshire 33 25 55 42 1074 10 1084New Jersey 1262 145 1065 122 48750 778 49528New Mexico 134 70 93 48 2603 7 2610New York 6201 321 5495 285 174908 2354 177262North Carolina 916 106 1229 139 15954 118 16072North Dakota 10 16 6 09 144 1 145Ohio 753 66 767 67 14957 138 15095Oklahoma 281 79 205 57 4836 26 4862Oregon 217 60 281 76 5995 20 6015Pennsylvania 1486 120 1893 152 33417 365 33782Rhode Island 87 81 111 104 2580 28 2608South Carolina 682 161 705 163 13301 105 13406South Dakota 18 23 18 23 255 5 260Tennessee 818 137 680 113 12457 59 12516Texas 3045 133 2998 128 69735 392 70127Utah 63 25 57 22 2295 20 2315Vermont 5 08 18 29 461 6 467Virginia 638 84 605 79 16802 177 16979Washington 485 77 389 61 11792 34 11826West Virginia 74 41 67 37 1500 11 1511Wisconsin 122 22 217 39 4513 33 4546Wyoming 6 12 8 16 228 2 230

Subtotal 40123 135 37911 127 952221 9094 961315

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 29

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulativemdashUnited States and dependent areas (cont)

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

US dependent areasAmerican Samoa 0 0 0 0 1 0 1Guam 0 0 0 0 68 1 69Northern Mariana Islands 0 0 0 0 3 0 3Puerto Rico 1029 263 850 216 29511 400 29911US Virgin Islands 17 156 32 295 629 18 647Otherb 0 0 0 0 3 0 3

Totalc 41357 138 39002 129 983343 9522 992865d

a From the beginning of the epidemic through 2006b Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasc Includes persons whose state or area of residence is unknownd Includes 916 persons whose state or area of residence is unknown

30 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

MSA (population gt 500000)

Akron Ohio 66 94 32 46 762 1 763

AlbanyndashSchenectadyndashTroy NY 97 114 105 123 2253 24 2277

Albuquerque N Mex 70 88 50 61 1404 2 1406

AllentownndashBethlehemndashEaston PandashNJ 72 91 119 149 1352 17 1369

AtlantandashSandy SpringsndashMarietta Ga 1586 319 1006 196 21896 128 22024

AugustandashRichmond County GandashSC 106 205 32 61 1851 24 1875

AustinndashRound Rock Tex 227 156 186 123 4830 26 4856

Bakersfield Calif 76 100 122 156 1528 8 1536

BaltimorendashTowson Md 1064 401 1001 377 20352 218 20570

Baton Rouge La 222 304 231 301 3732 20 3752

BirminghamndashHoover Ala 151 139 110 100 2614 25 2639

Boise CityndashNampa Idaho 14 26 14 25 281 0 281

Boston MassndashNHa 441 99 355 80 13476 147 13623

Boston Division 269 146 185 101 8451 91 8542

Cambridge Division 108 74 102 70 3126 35 3161

Essex Division 52 71 51 69 1577 20 1597

BridgeportndashStamfordndashNorwalk Conn 181 201 135 150 3733 57 3790

BuffalondashNiagara Falls NY 117 102 96 84 2476 20 2496

Cape CoralndashFort Myers Fla 44 81 91 159 1692 24 1716

CharlestonndashNorth Charleston SC 92 155 91 151 2034 18 2052

CharlottendashGastoniandashConcord NCndashSC 214 141 285 180 3242 22 3264

Chicago IllndashIndndashWis 1716 182 1159 122 30118 261 30379

Chicago Division 1604 203 1073 135 28300 248 28548

Gary Division 61 88 50 71 1038 8 1046

Lake Division 51 59 36 41 780 5 785

CincinnatindashMiddletown OhiondashKyndashInd 111 53 199 95 2735 17 2752

ClevelandndashElyriandashMentor Ohio 228 107 170 80 4226 48 4274

Colorado Springs Colo 19 32 21 35 576 5 581

Columbia SC 177 256 197 280 3274 24 3298

Columbus Ohio 166 97 165 96 3112 15 3127

Dallas Tex 874 150 929 155 20238 63 20301

Dallas Division 681 175 714 178 16038 37 16075

Fort Worth Division 193 100 215 108 4200 26 4226

Dayton Ohio 58 69 54 64 1217 15 1232

DenverndashAurora Colo 274 116 236 98 6899 22 6921

Des Moines Iowa 30 57 23 43 530 4 534

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 31

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Detroit Mich 570 127 445 100 10373 73 10446

Detroit Division 443 223 330 167 8268 57 8325

Warren Division 127 51 115 46 2105 16 2121

El Paso Tex 56 78 40 54 1476 10 1486

Fresno Calif 52 59 64 72 1430 11 1441

Grand RapidsndashWyoming Mich 46 60 51 66 816 6 822

GreensborondashHigh Point NC 52 77 66 96 1265 14 1279

Greenville SC 70 119 67 111 1292 4 1296

HarrisburgndashCarlisle Pa 23 44 67 128 1224 8 1232

HartfordndashWest HartfordndashEast Hartford Conn 256 216 135 114 5126 46 5172

Honolulu Hawaii 54 60 69 76 2121 14 2135

HoustonndashBaytownndashSugar Land Tex 1017 190 1092 197 25821 172 25993

Indianapolis Ind 191 116 150 90 3824 25 3849

Jackson Miss 134 257 117 221 2419 30 2449

Jacksonville Fla 309 248 315 246 6020 75 6095

Kansas City MondashKans 183 94 160 81 4669 15 4684

Knoxville Tenn 47 72 35 52 882 5 887

Lakeland Fla 103 190 112 199 1811 21 1832

Las VegasndashParadise Nev 245 143 258 145 4616 28 4644

Little RockndashNorth Little Rock Ark 87 135 75 115 1383 14 1397

Los Angeles Calif 1529 118 1684 130 57953 293 58246

Los Angeles Division 1339 135 1435 144 51098 250 51348

Santa Anna Division 190 63 249 83 6855 43 6898

Louisville KyndashInd 123 102 97 79 2286 22 2308

Madison Wis 10 19 29 53 520 4 524

McAllenndashEdinburgndashPharr Tex 57 84 45 64 630 11 641

Memphis TennndashMissndashArk 402 320 346 271 5128 19 5147

Miami Fla 2420 446 2289 419 55807 997 56804

Fort Lauderdale Division 810 455 769 430 16412 262 16674

Miami Division 1243 523 1165 485 29703 512 30215

West Palm Beach Division 367 290 355 279 9692 223 9915

MilwaukeendashWaukeshandashWest Allis Wis 68 45 109 72 2507 18 2525

MinneapolisndashSt PaulndashBloomington MinnndashWis 186 59 184 58 4259 22 4281

Modesto Calif 36 71 22 43 671 6 677

NashvillendashDavidsonndashMurfreesboro Tenn 224 158 172 118 3848 20 3868

New HavenndashMilford Conn 169 200 107 127 4573 73 4646

New OrleansndashMetairiendashKenner La 393 299 271 264 8835 67 8902

32 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

New York NYndashNJndashPa 6215 330 5500 292 195177 2906 198083

Edison Division 191 83 130 56 6709 139 6848

Nassau Division 262 93 246 88 8141 110 8251

New York Division 5266 456 4716 408 160408 2323 162731

Newark Division 496 231 408 190 19919 334 20253

Oklahoma City Okla 125 108 88 75 2255 5 2260

OmahandashCouncil Bluffs NebndashIowa 37 46 80 97 1035 3 1038

Orlando Fla 544 282 517 260 8653 92 8745

OxnardndashThousand OaksndashVentura Calif 49 62 21 26 1008 3 1011

Palm BayndashMelbournendashTitusville Fla 68 129 61 114 1512 11 1523

Philadelphia PandashNJndashDelndashMd 1261 217 1348 231 28221 313 28534

Camden Division 108 87 111 89 3118 42 3160

Philadelphia Division 1022 263 1144 294 22112 250 22362

Wilmington Division 131 191 93 134 2991 21 3012

PhoenixndashMesandashScottsdale Ariz 460 119 376 93 7459 31 7490

Pittsburgh Pa 143 60 135 57 3182 19 3201

PortlandndashSouth Portland Maine 9 18 34 66 562 1 563

PortlandndashVancouverndashBeaverton OrendashWash 170 81 215 101 4825 10 4835

PoughkeepsiendashNewburghndashMiddletown NY 136 204 113 168 3162 24 3186

ProvidencendashNew BedfordndashFall River RIndashMass 132 82 155 96 3900 44 3944

RaleighndashCary NC 138 145 201 202 1987 13 2000

Richmond Va 119 101 122 102 3371 35 3406

RiversidendashSan BernardinondashOntario Calif 361 92 306 76 8568 60 8628

Rochester NY 165 159 124 120 3134 13 3147

SacramentondashArden-ArcadendashRoseville Calif 154 75 169 82 4000 26 4026

St Louis MondashIll 192 69 366 131 5965 40 6005

Salt Lake City Utah 46 44 40 37 1743 10 1753

San Antonio Tex 215 114 247 127 4987 30 5017

San DiegondashCarlsbadndashSan Marcos Calif 491 167 384 131 12934 61 12995

San Francisco Calif 867 209 690 165 40152 96 40248

Oakland Division 312 126 246 99 9546 48 9594

San Francisco Division 555 329 444 261 30606 48 30654

San JosendashSunnyvalendashSanta Clara Calif 88 50 145 81 3747 15 3762

San JuanndashCaguasndashGuaynabo PR 745 289 578 223 21402 277 21679

SarasotandashBradentonndashVenice Fla 82 122 104 152 1978 27 2005

ScrantonndashWilkes-Barre Pa 27 49 47 85 572 6 578

Seattle Wash 353 110 280 86 9172 27 9199

Seattle Division 316 129 255 102 8161 18 8179

Tacoma Division 37 49 25 33 1011 9 1020

Springfield Mass 88 128 45 66 2075 26 2101

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 33

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Stockton Calif 52 78 52 77 1076 15 1091

Syracuse NY 52 80 49 75 1317 8 1325

TampandashSt PetersburgndashClearwater Fla 559 211 605 224 11174 112 11286

Toledo Ohio 25 38 66 101 812 14 826

Tucson Ariz 103 111 100 106 2010 10 2020

Tulsa Okla 83 94 65 72 1494 10 1504

Virginia BeachndashNorfolkndashNewport News VandashNC 183 111 132 80 4711 63 4774

Washington DCndashVandashMdndashWV 1322 252 1684 318 31130 315 31445

Bethesda Division 135 118 173 150 2774 23 2797

Washington Division 1187 289 1511 365 28356 292 28648

Wichita Kans 35 60 38 64 851 2 853

Worcester Mass 76 97 79 101 1783 20 1803

YoungstownndashWarrenndashBoardman OhiondashPa 27 46 26 44 519 0 519

Subtotal for MSAs (population gt500000) 33602 173 31274 159 829633 8171 837804

Metropolitan areas (population of 50000 to 499999) 4477 80 4466 79 94829 847 95676

Nonmetropolitan areas 2666 54 2732 55 52063 445 52508

Totalb 41144 137 38749 128 981708 9494 991202

Note Because of the lack of census information for all US dependent areas includes data for only the 50 states the District of Columbia and Puerto RicoMSA metropolitan statistical areaMSA definitions for this report can be found at httpwwwcensusgovpopulationwwwestimatesmetrodefhtmla Reported case counts for the metropolitan divisions do not sum to the MSA total MSA total includes data from 1 metropolitan division with

population of lt500000b Includes persons whose county of residence is unknown

34 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Alabama (January 1988) 502 6041 48 6089

Alaska (February 1999) 38 285 2 287

Arizona (January 1987) 617 5877 80 5957

Arkansas (July 1989) 206 2349 20 2369

California (April 2006) 6581 7056 92 7148

Colorado (November 1985) 319 6084 31 6115

Connecticut (January 2005)b 826 2500 101 2601

Delaware (February 2006) 788 801 18 819

Florida (July 1997)c 4163 36386 397 36783

Georgia (December 2003) 2245 8197 194 8391

Idaho (June 1986) 35 340 4 344

Illinois (January 2006) 6241 6661 162 6823

Indiana (July 1988) 399 4027 43 4070

Iowa (July 1998) 69 586 5 591

Kansas (July 1999) 142 1225 15 1240

Kentucky (October 2004) 333 1303 13 1316

Louisiana (February 1993) 728 8149 166 8315

Maine (January 2006) 386 393 3 396

Michigan (April 1992) 635 6702 134 6836

Minnesota (October 1985) 309 3356 40 3396

Mississippi (August 1988) 352 4549 59 4608

Missouri (October 1987) 502 5086 55 5141

Nebraska (September 1995) 91 672 14 686

Nevada (February 1992) 339 3532 24 3556

New Hampshire (January 2005) 59 466 9 475

New Jersey (January 1992) 1477 17513 325 17838

New Mexico (January 1998) 114 949 4 953

New York (June 2000) 5326 42345 1820 44165

North Carolina (February 1990) 1615 13879 143 14022

North Dakota (January 1988) 4 82 1 83

Ohio (June 1990) 867 8222 101 8323

Oklahoma (June 1988) 229 2401 30 2431

Oregon (April 2006) 49 95 19 114

Pennsylvania (October 2002)d 4269 9537 179 9716

Rhode Island (July 2006) 14 21 0 21

South Carolina (February 1986) 493 6970 93 7063

South Dakota (January 1988) 18 215 6 221

Tennessee (January 1992) 732 7115 90 7205

Texas (January 1999)e 3370 24282 417 24699

Utah (April 1989) 106 893 14 907

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 35

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Virginia (July 1989) 864 10257 95 10352

Washington (March 2006) 4048 4157 40 4197

West Virginia (January 1989) 66 673 8 681

Wisconsin (November 1985) 261 2500 31 2531

Wyoming (June 1989) 7 93 1 94

Subtotal 50834 274822 5146 279968

US dependent areas

American Samoa (August 2001) 0 1 0 1

Guam (March 2000) 2 66 0 66

Northern Mariana Islands (October 2001) 2 7 0 7

Puerto Rico (January 2003) 1471 5610 91 5701

US Virgin Islands (December 1998) 22 247 6 253

Persons reported from areas with confidential name-based HIV infection reporting but who were residents of other areas 132 685 21 706

Totalf 52878 282640 5314 287954

Note Includes data from 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through 2006b Beginning in 1992 Connecticut had name-based HIV reporting for cases in children only From January 2002 through December 2004

Connecticut had name- or code-based HIV reporting for cases in adolescents and adults As of January 2005 Connecticut has name-based reporting of all cases of HIV infection

c Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterd On October 18 2002 Pennsylvania initiated confidential name-based HIV infection reporting in all areas except Philadelphia Code-based

reporting was implemented in Philadelphia in March 2004 and the switch to name-based reporting was made in October 2005e From February 1994 through December 1998 Texas reported HIV infection in children onlyf Includes 1252 persons reported from areas with confidential name-based HIV infection reporting but whose area of residence is unknown

36 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulativemdashUnited States and dependent areas

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No Adult or adolescentMale-to-male sexual contact 13775 49 429897 54 mdash mdash mdash mdash 13775 35 429897 44Injection drug use 3413 12 163070 21 1826 17 67693 35 5239 13 230763 23Male-to-male sexual contact and

injection drug use 1603 6 65524 8 mdash mdash mdash mdash 1603 4 65524 7Hemophiliacoagulation disorder 43 0 5176 1 11 0 348 0 54 0 5524 1High-risk heterosexual contactc 2997 11 49610 6 4839 46 85186 44 7836 20 134796 14

Sex with injection drug user 330 1 11683 1 706 7 26073 14 1036 3 37756 4Sex with bisexual male mdash mdash mdash mdash 234 2 5162 3 234 1 5162 1Sex with person with hemophilia 1 0 84 0 11 0 502 0 12 0 586 0Sex with HIV-infected transfusion

recipient 22 0 553 0 21 0 793 0 43 0 1346 0Sex with HIV-infected person risk

factor not specified 2644 9 37290 5 3867 37 52656 27 6511 17 89946 9Receipt of blood transfusion blood

d components or tissue 63 0 5213 1 68 1 4176 2 131 0 9389 1Otherrisk factor not reported or

identifiede 6484 23 73136 9 3793 36 34311 18 10278 26 107450 11Subtotal 28378 100 791626 100 10537 100 191714 100 38916 100 983343 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 0 0 222 5 0 0 7 0 0 0 229 2Mother with documented HIV infection or

1 of the following risk factors 24 75 4315 89 50 93 4423 95 74 86 8738 92Injection drug use 4 13 1676 35 4 7 1665 36 8 9 3341 35Sex with injection drug user 4 13 789 16 4 7 750 16 8 9 1539 16Sex with bisexual male 1 3 101 2 2 4 110 2 3 3 211 2Sex with person with hemophilia 0 0 20 0 0 0 16 0 0 0 36 0Sex with HIV-infected transfusion

recipient 0 0 11 0 0 0 15 0 0 0 26 0Sex with HIV-infected person risk

factor not specified 6 19 742 15 17 31 790 17 23 27 1532 16Receipt of blood transfusion blood

components or tissue 0 0 70 1 0 0 82 2 0 0 152 2Has HIV infection risk factor not

specified 9 28 906 19 23 43 995 21 32 37 1901 20Receipt of blood transfusion blood

fcomponents or tissue 1 3 243 5 0 0 144 3 1 1 387 4Otherrisk factor not reported or

identifiedg 7 22 75 2 4 7 93 2 11 13 168 2Subtotal 32 100 4855 100 54 100 4667 100 86 100 9522 100

Total 28410 100 796481 100 10591 100 196381 100 39002 100 992865 100a From the beginning of the epidemic through 2006b From the beginning of the epidemic through 2006 Includes 3 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infectiond AIDS developed in 47 adultsadolescents after they received blood that had tested negative for HIV antibodies AIDS developed in 14 additional adults

after they received tissue organs or artificial insemination from HIV-infected donors Four of the 14 received tissue or organs from a donor who was negative for HIV antibody at the time of donation

e Includes 37 adultsadolescents who were exposed to HIV-infected blood body fluids or concentrated virus in health care laboratory or household settings as supported by seroconversion epidemiologic andor laboratory evidence One person was infected after intentional inoculation with HIV-infected blood Includes an additional 740 persons who acquired HIV infection perinatally but who were more than 12 years of age when AIDS was diagnosed These 740 persons are not counted in the values for the pediatric transmission category

f AIDS developed in 3 children after they received blood that had tested negative for HIV antibodiesg Includes 5 children who were exposed to HIV-infected blood as supported by seroconversion epidemiologic andor laboratory evidence 1 child was

infected after intentional inoculation with HIV-infected blood and 5 children were exposed to HIV-infected blood in a household setting Of the 168 children 26 had sexual contact with an adult with or at high risk for HIV infection

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 37

Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No

Adult or adolescentMale-to-male sexual contact 22912 59 103679 52 mdash mdash mdash mdash 22912 44 103679 37

Injection drug use 3503 9 24255 12 2124 16 13925 17 5627 11 38181 14

Male-to-male sexual contact and injection drug use 1946 5 10704 5 mdash mdash mdash mdash 1946 4 10704 4

Hemophiliacoagulation disorder 43 0 495 0 6 0 73 0 49 0 568 0

High-risk heterosexual contactc 2874 7 16830 8 5939 45 38315 47 8813 17 55145 20

Sex with injection drug user 308 1 2601 1 757 6 6791 8 1065 2 9392 3

Sex with bisexual male mdash mdash mdash mdash 328 2 2265 3 328 1 2265 1

Sex with person with hemophilia 4 0 31 0 16 0 201 0 20 0 232 0

Sex with HIV-infected transfusion recipient 13 0 131 0 28 0 223 0 41 0 354 0

Sex with HIV-infected person risk factor not specified 2549 7 14067 7 4810 36 28835 35 7359 14 42902 15

Receipt of blood transfusion blood components or tissue 61 0 489 0 50 0 536 1 111 0 1025 0

Otherrisk factor not reported or identified 7748 20 44021 22 5106 39 29312 36 12854 25 73338 26

Subtotal 39087 100 200473 100 13225 100 82161 100 52312 100 282640 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 8 3 106 4 0 0 1 0 8 1 107 2

Mother with documented HIV infection or 1 of the following risk factors 197 74 2195 85 254 85 2417 89 451 80 4612 87

Injection drug use 34 13 532 21 53 18 561 21 87 15 1093 21

Sex with injection drug user 12 5 208 8 21 7 213 8 33 6 421 8

Sex with bisexual male 5 2 37 1 4 1 32 1 9 2 69 1

Sex with person with hemophilia 0 0 3 0 1 0 7 0 1 0 10 0

Sex with HIV-infected transfusion recipient 0 0 4 0 0 0 4 0 0 0 8 0

Sex with HIV-infected person risk factor not specified 54 20 534 21 76 25 629 23 130 23 1163 22

Receipt of blood transfusion blood components or tissue 0 0 17 1 2 1 20 1 2 0 37 1

Has HIV infection risk factor not specified 92 35 860 33 97 32 951 35 189 33 1811 34

Receipt of blood transfusion blood components or tissue 6 2 28 1 3 1 24 1 9 2 52 1

Otherrisk factor not reported or identified 55 21 260 10 43 14 283 10 98 17 543 10

Subtotal 266 100 2589 100 300 100 2725 100 566 100 5314 100

Total 39353 100 203062 100 13525 100 84886 100 52878 100 287954 100

Note See Table 16 for the list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006b From the beginning of the epidemic through December 2006 Includes 6 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infection

38 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity

2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 6251 65 253927 73Injection drug use 733 8 31737 9Male-to-male sexual contact and injection drug use 732 8 31434 9Hemophiliacoagulation disorder 26 0 3989 1High-risk heterosexual contactb 416 4 7850 2

Sex with injection drug user 74 1 2310 1

Sex with person with hemophilia 0 0 36 0

Sex with HIV-infected transfusion recipient 2 0 176 0

Sex with HIV-infected person risk factor not specified 340 4 5328 2Receipt of blood transfusion blood components or tissue 20 0 3194 1Otherrisk factor not reported or identified 1400 15 16469 5

Total 9578 100 348600 100

Black not HispanicMale-to-male sexual contact 4309 36 103297 37Injection drug use 1635 14 83369 30Male-to-male sexual contact and injection drug use 526 4 22134 8Hemophiliacoagulation disorder 10 0 604 0High-risk heterosexual contactb 1875 16 29952 11

Sex with injection drug user 167 1 6823 2Sex with person with hemophilia 1 0 36 0Sex with HIV-infected transfusion recipient 15 0 237 0Sex with HIV-infected person risk factor not specified 1692 14 22856 8

Receipt of blood transfusion blood components or tissue 24 0 1218 0Otherrisk factor not reported or identified 3579 30 40268 14

Total 11958 100 280842 100

HispanicMale-to-male sexual contact 2816 47 64893 44Injection drug use 965 16 46337 31Male-to-male sexual contact and injection drug use 287 5 10884 7Hemophiliacoagulation disorder 6 0 466 0High-risk heterosexual contactb 638 11 10950 7

Sex with injection drug user 84 1 2409 2Sex with person with hemophilia 0 0 11 0Sex with HIV-infected transfusion recipient 5 0 125 0Sex with HIV-infected person risk factor not specified 549 9 8405 6

Receipt of blood transfusion blood components or tissue 17 0 657 0Otherrisk factor not reported or identified 1326 22 14832 10

Total 6055 100 149019 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 39

a

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulative

No No

AsianPacific IslanderMale-to-male sexual contact 225 54 4475 68Injection drug use 20 5 317 5Male-to-male sexual contact and injection drug use 17 4 284 4Hemophiliacoagulation disorder 1 0 70 1High-risk heterosexual contactb 34 8 376 6

Sex with injection drug user 1 0 54 1Sex with person with hemophilia 0 0 1 0Sex with HIV-infected transfusion recipient 0 0 8 0Sex with HIV-infected person risk factor not specified 33 8 313 5

Receipt of blood transfusion blood components or tissue 2 0 112 2Otherrisk factor not reported or identified 114 28 949 14

Total 413 100 6583 100

American IndianAlaska NativeMale-to-male sexual contact 61 49 1403 55Injection drug use 15 12 395 15Male-to-male sexual contact and injection drug use 23 19 457 18Hemophiliacoagulation disorder 0 0 27 1High-risk heterosexual contactb 9 7 118 5

Sex with injection drug user 1 1 33 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 8 6 82 3

Receipt of blood transfusion blood components or tissue 0 0 8 0Otherrisk factor not reported or identified 16 13 155 6

Total 124 100 2563 100

Total casesMale-to-male sexual contact 13775 49 429897 54Injection drug use 3413 12 163070 21Male-to-male sexual contact and injection drug use 1603 6 65524 8Hemophiliacoagulation disorder 43 0 5176 1High-risk heterosexual contactb 2997 11 49610 6

Sex with injection drug user 330 1 11683 1Sex with person with hemophilia 1 0 84 0Sex with HIV-infected transfusion recipient 22 0 553 0Sex with HIV-infected person risk factor not specified 2644 9 37290 5

Receipt of blood transfusion blood components or tissue 63 0 5213 1Otherrisk factor not reported or identified 6484 23 73136 9

Total 28378c 100 791626d 100a From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 4019 males of unknown race or multiple races

40 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 11963 73 55725 69Injection drug use 858 5 5512 7Male-to-male sexual contact and injection drug use 1092 7 5578 7Hemophiliacoagulation disorder 29 0 355 0High-risk heterosexual contactb 522 3 2658 3

Sex with injection drug user 65 0 544 1Sex with person with hemophilia 0 0 8 0Sex with HIV-infected transfusion recipient 3 0 33 0Sex with HIV-infected person risk factor not specified 454 3 2073 3

Receipt of blood transfusion blood components or tissue 14 0 197 0Otherrisk factor not reported or identified 1956 12 11147 14

Total 16434 100 81172 100

Black not HispanicMale-to-male sexual contact 6203 44 30148 37Injection drug use 1594 11 11997 15Male-to-male sexual contact and injection drug use 483 3 3489 4Hemophiliacoagulation disorder 10 0 109 0High-risk heterosexual contactb 1714 12 10905 13

Sex with injection drug user 169 1 1554 2Sex with person with hemophilia 4 0 17 0Sex with HIV-infected transfusion recipient 6 0 77 0Sex with HIV-infected person risk factor not specified 1535 11 9257 11

Receipt of blood transfusion blood components or tissue 32 0 223 0Otherrisk factor not reported or identified 4151 29 24632 30

Total 14187 100 81503 100

HispanicMale-to-male sexual contact 4094 55 15623 47Injection drug use 993 13 6407 19Male-to-male sexual contact and injection drug use 316 4 1402 4Hemophiliacoagulation disorder 3 0 26 0High-risk heterosexual contactb 582 8 2963 9

Sex with injection drug user 65 1 455 1Sex with person with hemophilia 0 0 6 0Sex with HIV-infected transfusion recipient 4 0 18 0Sex with HIV-infected person risk factor not specified 513 7 2484 7

Receipt of blood transfusion blood components or tissue 11 0 55 0Otherrisk factor not reported or identified 1475 20 6977 21

Total 7474 100 33453 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 41

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderMale-to-male sexual contact 402 70 1006 63Injection drug use 17 3 55 3Male-to-male sexual contact and injection drug use 15 3 38 2Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 25 4 96 6

Sex with injection drug user 3 1 10 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 22 4 83 5

Receipt of blood transfusion blood components or tissue 4 1 7 0Otherrisk factor not reported or identified 109 19 397 25

Total 572 100 1600 100

American IndianAlaska NativeMale-to-male sexual contact 104 61 516 57Injection drug use 13 8 101 11Male-to-male sexual contact and injection drug use 19 11 110 12Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 10 6 53 6

Sex with injection drug user 2 1 14 2Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 8 5 39 4

Receipt of blood transfusion blood components or tissue 0 0 2 0Otherrisk factor not reported or identified 24 14 125 14

Total 170 100 907 100

Total casesMale-to-male sexual contact 22912 59 103679 52Injection drug use 3503 9 24255 12Male-to-male sexual contact and injection drug use 1946 5 10704 5Hemophiliacoagulation disorder 43 0 495 0High-risk heterosexual contactb 2874 7 16830 8

Sex with injection drug user 308 1 2601 1Sex with person with hemophilia 4 0 31 0Sex with HIV-infected transfusion recipient 13 0 131 0Sex with HIV-infected person risk factor not specified 2549 7 14067 7

Receipt of blood transfusion blood components or tissue 61 0 489 0Otherrisk factor not reported or identified 7748 20 44021 22

Total 39087c 100 200473d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 1838 males of unknown race or multiple races

42 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race

ethnicity 2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 482 28 14981 40Hemophiliacoagulation disorder 4 0 123 0High-risk heterosexual contactb 725 42 15799 42

Sex with injection drug user 153 9 5650 15Sex with bisexual male 63 4 1859 5Sex with person with hemophilia 5 0 329 1Sex with HIV-infected transfusion recipient 5 0 338 1Sex with HIV-infected person risk factor not specified 499 29 7623 20

Receipt of blood transfusion blood components or tissue 15 1 1870 5Otherrisk factor not reported or identified 499 29 4801 13

Total 1725 100 37574 100

Black not HispanicInjection drug use 982 15 38914 34Hemophiliacoagulation disorder 3 0 145 0High-risk heterosexual contactb 3103 46 49876 44

Sex with injection drug user 373 6 13530 12Sex with bisexual male 136 2 2352 2Sex with person with hemophilia 4 0 121 0Sex with HIV-infected transfusion recipient 8 0 277 0Sex with HIV-infected person risk factor not specified 2582 38 33596 29

Receipt of blood transfusion blood components or tissue 39 1 1546 1Otherrisk factor not reported or identified 2612 39 23894 21

Total 6739 100 114375 100

HispanicInjection drug use 322 18 12892 35Hemophiliacoagulation disorder 4 0 67 0High-risk heterosexual contactb 894 49 17995 49

Sex with injection drug user 166 9 6522 18Sex with bisexual male 32 2 818 2Sex with person with hemophilia 1 0 45 0Sex with HIV-infected transfusion recipient 7 0 141 0Sex with HIV-infected person risk factor not specified 688 38 10469 29

Receipt of blood transfusion blood components or tissue 12 1 619 2Otherrisk factor not reported or identified 592 32 5023 14

Total 1824 100 36596 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 43

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 8 8 125 12Hemophiliacoagulation disorder 0 0 7 1High-risk heterosexual contactb 49 47 574 53

Sex with injection drug user 4 4 114 11Sex with bisexual male 2 2 80 7Sex with person with hemophilia 0 0 4 0Sex with HIV-infected transfusion recipient 1 1 25 2Sex with HIV-infected person risk factor not specified 42 40 351 33

Receipt of blood transfusion blood components or tissue 1 1 93 9Otherrisk factor not reported or identified 46 44 279 26

Total 104 100 1078 100

American IndianAlaska NativeInjection drug use 13 32 280 42Hemophiliacoagulation disorder 0 0 3 0High-risk heterosexual contactb 15 37 277 41

Sex with injection drug user 4 10 107 16Sex with bisexual male 1 2 27 4Sex with person with hemophilia 0 0 2 0Sex with HIV-infected transfusion recipient 0 0 6 1Sex with HIV-infected person risk factor not specified 10 24 135 20

Receipt of blood transfusion blood components or tissue 1 2 17 3Otherrisk factor not reported or identified 12 29 95 14

Total 41 100 672 100

Total casesInjection drug use 1826 17 67693 35Hemophiliacoagulation disorder 11 0 348 0High-risk heterosexual contactb 4839 46 85186 44

Sex with injection drug user 706 7 26073 14Sex with bisexual male 234 2 5162 3Sex with person with hemophilia 11 0 502 0Sex with HIV-infected transfusion recipient 21 0 793 0Sex with HIV-infected person risk factor not specified 3867 37 52656 27

Receipt of blood transfusion blood components or tissue 68 1 4176 2Otherrisk factor not reported or identified 3793 36 34311 18

Total 10537c 100 191714d 100a From the beginning of the epidemic through 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 104 females of unknown race or multiple racesd Includes 1419 females of unknown race or multiple races

44 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 690 26 4260 26Hemophiliacoagulation disorder 3 0 24 0

bHigh-risk heterosexual contact 1132 42 7593 46Sex with injection drug user 205 8 1876 11Sex with bisexual male 98 4 659 4Sex with person with hemophilia 10 0 115 1Sex with HIV-infected transfusion recipient 7 0 64 0Sex with HIV-infected person risk factor not specified 812 30 4879 29

Receipt of blood transfusion blood components or tissue 12 0 146 1Otherrisk factor not reported or identified 850 32 4567 28

Total 2687 100 16590 100

Black not HispanicInjection drug use 1034 13 7105 14Hemophiliacoagulation disorder 1 0 35 0

bHigh-risk heterosexual contact 3451 44 23732 46Sex with injection drug user 313 4 3473 7Sex with bisexual male 155 2 1294 3Sex with person with hemophilia 5 0 71 0Sex with HIV-infected transfusion recipient 14 0 120 0Sex with HIV-infected person risk factor not specified 2964 38 18774 36

Receipt of blood transfusion blood components or tissue 26 0 324 1Otherrisk factor not reported or identified 3370 43 20244 39

Total 7882 100 51440 100

HispanicInjection drug use 339 15 2280 18Hemophiliacoagulation disorder 2 0 11 0

bHigh-risk heterosexual contact 1198 52 6264 50Sex with injection drug user 218 9 1324 11Sex with bisexual male 62 3 266 2Sex with person with hemophilia 1 0 11 0Sex with HIV-infected transfusion recipient 7 0 39 0Sex with HIV-infected person risk factor not specified 910 39 4624 37

Receipt of blood transfusion blood components or tissue 12 1 58 0Otherrisk factor not reported or identified 767 33 3843 31

Total 2318 100 12456 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 45

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 18: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002ndash2006 and cumulativemdashUnited States and dependent areas (cont)

Year of death

Cumulativea2002 2003 2004 2005 2006

Region of residenceNortheast 5313 5012 4779 4750 4074 180623

Midwest 1726 1666 1482 1378 1325 54468

South 7337 7427 7535 7907 6475 197209

West 2571 2585 2600 2234 2141 113506

Subtotal for 50 states and the District of Columbia 16948 16690 16395 16268 14016 545805

Data for US dependent areas 667 575 572 562 580 19858

Totale 17628 17283 16982 16865 14627 565927f

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column totalf Includes 2082 persons of unknown race or multiple races 261 persons of unknown state of residence and 2 persons who were residents

of other areas

18 Deaths

Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003ndash2006mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

2003 2004 2005 2006Data for 33 states

Age at end of year (yrs)lt13 4154 3700 3294 286713ndash14 1130 1238 1212 113915ndash19 3298 3627 4024 453920ndash24 12389 12826 13411 1430125ndash29 26167 26924 28164 2960030ndash34 49602 47577 45109 4418935ndash39 80703 77871 75842 7363440ndash44 92040 97109 100102 10176445ndash49 71345 77490 83816 9028350ndash54 45133 51033 56640 6319555ndash59 22793 26610 31186 3600860ndash64 10820 12642 14422 16658gt65 8531 9959 11657 13551

RaceethnicityWhite not Hispanic 145081 151694 158375 166000Black not Hispanic 202951 212425 221439 231957Hispanic 72612 76503 80491 84720AsianPacific Islander 2234 2529 2858 3187American IndianAlaska Native 1788 1889 2008 2119

Transmission categoryMale adult or adolescentMale-to-male sexual contact 181771 193245 205423 218676Injection drug use 57651 58149 58369 59077Male-to-male sexual contact and injection drug use 23965 24434 24725 25085High-risk heterosexual contacta 40084 42559 44915 47562Otherb 3218 3278 3325 3424Subtotal 306689 321665 336756 353825

Female adult or adolescentInjection drug use 32346 32735 32973 33470High-risk heterosexual contacta 80324 85348 90185 95403Otherb 2036 2123 2212 2321Subtotal 114705 120206 125370 131195

Child (lt13 yrs at diagnosis)Perinatal 6137 6154 6178 6143Otherc 570 575 571 560Subtotal 6707 6730 6748 6703

Subtotal for 33 states 428107 448605 468879 491727Data for US dependent areas 15809 16399 17150 17955

Totald 443916 465005 486028 509681Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 19

Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission categorymdash33 states with confidential name-based HIV infection reporting

Transmission category

White not Hispanic

Black not Hispanic Hispanic

AsianPacific Islander

American IndianAlaska

Native Totala

No No No No No No

Male adult or adolescentMale-to-male sexual contact 108259 77 70242 49 36043 57 1669 68 938 62 218676 62Injection drug use 12328 9 31339 22 14472 23 264 11 216 14 59077 17Male-to-male sexual contact

and injection drug use 11283 8 9587 7 3720 6 93 4 205 13 25085 7High-risk heterosexual contactb 6667 5 31140 22 8788 14 395 16 143 9 47562 13Otherc 1458 1 1492 1 404 1 30 1 17 1 3424 1Subtotal 139994 100 143799 100 63427 100 2450 100 1519 100 353825 100

Female adult or adolescentInjection drug use 8262 33 19136 23 5528 28 106 15 175 30 33470 26High-risk heterosexual contactb 16338 65 63204 75 14132 71 573 82 392 68 95403 73Otherc 450 2 1469 2 344 2 24 3 12 2 2321 2Subtotal 25050 100 83809 100 20004 100 703 100 578 100 131195 100

Child (lt13 yrs at diagnosis)Perinatal 801 84 4064 93 1183 92 28 82 20 95 6143 92Otherd 154 16 283 7 107 8 6 18 1 5 560 8Subtotal 955 100 4347 100 1290 100 34 100 21 100 6703 100

Totale 166000 231957 84720 3187 2119 491727Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of 33 states that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Includes 3745 persons of unknown race or multiple racesb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes 5 persons of unknown sex Because column totals were calculated independently of the values for the subpopulations the values

in each column may not sum to the column total

20 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Map 1 Estimated rates (per 100000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

Note Rates adjusted for reporting delays Rates of HIV infection include only persons living with HIV infection that has not progressed to AIDSSince 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 Islandsa Includes persons whose area of residence is unknown

Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

Note Rates adjusted for reporting delays Rates of HIV infection include only persons living with HIV infection that has not progressed to AIDSSince 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 Islandsa Includes persons whose area of residence is unknown

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 21

Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002ndash2006mdashUnited States and dependent areas

2002 2003 2004 2005 2006Data for 50 states and the District of Columbia

Age at end of year (yrs)lt13 2308 2006 1684 1394 111513ndash14 685 747 784 762 71115ndash19 1465 1694 1974 2243 248720ndash24 3910 4292 4629 5033 536725ndash29 12725 12743 13045 13505 1435930ndash34 35558 33870 32057 29949 2882435ndash39 70107 68106 65076 62235 5964940ndash44 80377 86294 91335 94021 9517445ndash49 64702 71276 77417 84153 9077550ndash54 41270 46855 53333 59256 6647655ndash59 20113 24145 28356 33522 3901460ndash64 9681 11293 13305 15380 18072gt65 7520 8946 10604 12430 14669

RaceethnicityWhite not Hispanic 129426 135278 141508 147426 154495Black not Hispanic 150488 161326 171654 181056 191590Hispanic 63424 67895 72024 76334 80815AsianPacific Islander 3060 3426 3759 4121 4526American IndianAlaska Native 1254 1356 1458 1562 1651

Transmission categoryMale adult or adolescentMale-to-male sexual contact 158092 168233 178551 188622 199693Injection drug use 56708 58436 59940 61229 62998Male-to-male sexual contact and injection drug use 24726 25457 26144 26785 27523High-risk heterosexual contacta 27329 30300 33181 35916 39004Otherb 3588 3665 3769 3888 4026Subtotal 270444 286091 301585 316440 333244

Female adult or adolescentInjection drug use 27863 28874 29828 30646 31575High-risk heterosexual contacta 46445 51489 56229 60693 65631Otherb 1903 2033 2178 2315 2465Subtotal 76210 82395 88236 93653 99671

Child (lt13 yrs at diagnosis)Perinatal 3633 3654 3651 3664 3660Otherc 129 124 123 122 115Subtotal 3762 3778 3774 3786 3775

Region of residenceNortheast 105599 110929 115562 120208 125620Midwest 36011 38571 41178 44171 47010South 137081 147284 157975 166962 177591West 71729 75483 78883 82540 86473

Subtotal for 50 states and the District of Columbia 350419 372267 393598 413882 436693

Data for US dependent areas 9880 10365 10713 11106 11359

Totald 360617 383024 404849 425646 448871Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

22 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission categorymdash50 states and the District of Columbia

Transmission category

White not Hispanic

Black not Hispanic Hispanic

AsianPacific Islander

American IndianAlaska

Native Totala

No No No No No No

Male adult or adolescentMale-to-male sexual contact 101299 75 57520 45 36087 57 2715 72 704 57 199693 60Injection drug use 13168 10 33911 27 14795 23 325 9 201 16 62998 19Male-to-male sexual contact and

injection drug use 12393 9 10121 8 4352 7 198 5 220 18 27523 8High-risk heterosexual contactb 6081 5 24205 19 7816 12 444 12 105 8 39004 12Otherc 1743 1 1602 1 574 1 69 2 16 1 4026 1Subtotal 134683 100 127359 100 63623 100 3752 100 1246 100 333244 100

Female adult or adolescentInjection drug use 7407 38 18531 30 5025 30 115 15 153 39 31575 32High-risk heterosexual contactb 11350 59 41741 68 11092 67 588 78 227 58 65631 66Otherc 508 3 1456 2 413 2 51 7 13 3 2465 2Subtotal 19264 100 61728 100 16531 100 753 100 393 100 99671 100

Child (lt13 yrs at diagnosis)Perinatal 500 92 2468 99 629 95 20 94 12 100 3660 97Otherd 46 8 34 1 33 5 1 6 0 0 115 3Subtotal 546 100 2503 100 662 100 21 100 12 100 3775 100

Totale 154495 191590 80815 4526 1651 436693

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Includes 3616 persons of unknown race or multiple racesb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes 3 person of unknown sex Because column totals were calculated independently of the values for the subpopulations the values in each column

may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 23

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by

area of residence and age categorymdashUnited States and dependent areas

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

Alabama 5469 17 5486 3744 11 3755Alaska 272 1 273 330 1 331Arizona 5744 49 5793 4922 7 4929Arkansas 2291 7 2298 2139 6 2145California mdash mdash mdash 61451 105 61555Colorado 5855 13 5869 4083 2 4085Connecticut mdash mdash mdash 7406 15 7421Delaware mdash mdash mdash 1753 7 1760District of Columbia mdash mdash mdash 10059 30 10089Floridab 35461 263 35723 46469 194 46663Georgia mdash mdash mdash 17336 47 17383Hawaii mdash mdash mdash 1234 3 1237Idaho 356 0 356 313 0 313Illinois mdash mdash mdash 16139 46 16185Indiana 3849 21 3870 3996 14 4010Iowa 588 2 590 869 3 872Kansas 1230 7 1237 1272 2 1274Kentucky mdash mdash mdash 2589 13 2602Louisiana 7361 101 7462 8052 21 8074Maine mdash mdash mdash 512 2 514Maryland mdash mdash mdash 14540 41 14581Massachusetts mdash mdash mdash 8806 20 8826Michigan 6118 55 6173 6615 12 6627Minnesota 3227 21 3248 2314 9 2323Mississippi 4200 32 4232 3155 13 3168Missouri 4999 33 5033 5479 7 5486Montana mdash mdash mdash 205 0 205Nebraska 688 12 700 771 2 773Nevada 3402 13 3415 2969 3 2972New Hampshire mdash mdash mdash 556 3 559New Jersey 16059 153 16212 17168 57 17226New Mexico 910 0 909 1252 3 1255New York 42220 801 43021 70697 148 70845North Carolina 11700 60 11760 8451 12 8463North Dakota 87 2 89 73 1 74Ohio 8266 57 8323 7054 30 7084Oklahoma 2191 17 2208 2191 3 2194Oregon mdash mdash mdash 2840 4 2844Pennsylvania mdash mdash mdash 18633 71 18703Rhode Island mdash mdash mdash 1296 7 1303South Carolina 6349 45 6394 7035 23 7058South Dakota 195 4 199 139 1 140Tennessee 6579 51 6631 6403 11 6414Texas 24741 262 25003 34010 53 34063Utah 893 10 903 1164 0 1164Vermont mdash mdash mdash 238 2 240Virginia 9937 41 9978 8423 24 8447Washington mdash mdash mdash 5471 5 5476West Virginia 660 5 665 749 5 754Wisconsin 2322 15 2337 2153 12 2165Wyoming 86 2 88 102 1 103

Subtotal 224303 2174 226477 435621 1115 436736

24 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age categorymdashUnited States and dependent areas (cont)

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

US dependent areasAmerican Samoa 2 0 2 1 0 1Guam 63 0 63 36 0 36Northern Mariana Islands 7 0 7 3 0 3Puerto Rico 6269 31 6300 10971 26 10997US Virgin Islands 228 2 230 312 2 314Otherc mdash mdash mdash 1 0 1

Totald 230872 2207 233079 447724 1147 448871

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reporting a See Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at

least 2003b Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterc Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasd Total number of persons living with HIV infection (not AIDS) includes persons reported from areas with confidential name-based HIV

infection reporting who were residents of other states or whose area of residence is unknown Total number of persons living with AIDS includes persons whose area of residence is unknown Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 25

Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristicsmdashUnited States and dependent areas

No of persons

Survival in months

gt12 gt24 gt36Data for 50 states and the District of Columbia

Age at diagnosis (yrs)lt13 101 096 094 09413ndash14 60 098 098 09515ndash19 305 098 096 09520ndash24 1351 096 093 09225ndash29 3034 095 092 09130ndash34 5499 094 091 08935ndash39 7888 093 090 08740ndash44 7085 092 088 08545ndash49 5090 089 085 08250ndash54 3067 086 081 07855ndash59 1505 083 078 07460ndash64 806 080 073 069gt65 614 073 068 065

RaceethnicityWhite not Hispanic 10706 092 089 087Black not Hispanic 18406 090 086 082Hispanic 6398 092 090 088AsianPacific Islander 404 094 092 090American IndianAlaska Native 167 084 081 075

Transmission categoryMale adult or adolescentMale-to-male sexual contact 12830 093 090 088Injection drug use 4048 089 084 081Male-to-male sexual contact and injection drug use 1701 093 089 086High-risk heterosexual contacta 3170 091 088 085Otherb 5019 086 083 080Subtotal 26768 091 088 085

Female adult or adolescentInjection drug use 2101 089 083 078High-risk heterosexual contacta 4686 093 089 086Otherb 2749 090 085 083Subtotal 9536 091 087 083

Child (lt13 yrs at diagnosis)Perinatal 98 096 095 095Otherc 3 100 067 067Subtotal 101 096 094 094

Subtotal for 50 states and the District of Columbia 36405 091 087 085

Data for US dependent areas 891 083 078 075

Total 37352d 091 087 084Note Excludes persons whose date of death was before or in the same month as date of diagnosis Excludes persons whose month of diagnosis or month of death is unknowna Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes 325 persons of unknown race or multiple races

26 Survival after AIDS Diagnosis

Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by year of diagnosismdashUnited States and dependent areas

Months after AIDS diagnosis

Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by age groupmdashUnited States and dependent areas

Months after AIDS diagnosis

Survival after AIDS Diagnosis 27

Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by raceethnicitymdashUnited States and dependent areas

Months after AIDS diagnosis

28 Survival after AIDS Diagnosis

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006

and cumulativemdashUnited States and dependent areas

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Alabama 510 112 462 100 8626 76 8702Alaska 24 36 38 57 648 7 655Arizona 626 105 539 87 10396 46 10442Arkansas 237 85 252 90 3891 36 3927California 4069 113 3960 109 142254 664 142918Colorado 351 75 322 68 8742 31 8773Connecticut 658 188 422 120 14716 183 14899Delaware 177 210 116 136 3547 26 3573District of Columbia 672 1155 853 1467 17372 189 17561Florida 4921 277 4932 273 104084 1530 105614Georgia 2325 255 1605 171 31734 231 31965Hawaii 105 82 93 72 2927 17 2944Idaho 24 17 26 18 604 2 606Illinois 1886 148 1382 108 33620 282 33902Indiana 407 65 346 55 8239 56 8295Iowa 93 31 86 29 1727 13 1740Kansas 105 38 120 43 2781 14 2795Kentucky 249 60 207 49 4600 32 4632Louisiana 936 208 824 192 17612 128 17740Maine 21 16 68 51 1110 8 1118Maryland 1558 279 1626 290 30252 319 30571Massachusetts 666 104 533 83 19181 214 19395Michigan 821 81 672 67 14941 113 15054Minnesota 226 44 212 41 4817 28 4845Mississippi 368 127 365 125 6642 56 6698Missouri 385 66 469 80 11016 61 11077Montana 21 22 7 07 373 3 376Nebraska 53 30 118 67 1479 11 1490Nevada 293 121 294 118 5733 29 5762New Hampshire 33 25 55 42 1074 10 1084New Jersey 1262 145 1065 122 48750 778 49528New Mexico 134 70 93 48 2603 7 2610New York 6201 321 5495 285 174908 2354 177262North Carolina 916 106 1229 139 15954 118 16072North Dakota 10 16 6 09 144 1 145Ohio 753 66 767 67 14957 138 15095Oklahoma 281 79 205 57 4836 26 4862Oregon 217 60 281 76 5995 20 6015Pennsylvania 1486 120 1893 152 33417 365 33782Rhode Island 87 81 111 104 2580 28 2608South Carolina 682 161 705 163 13301 105 13406South Dakota 18 23 18 23 255 5 260Tennessee 818 137 680 113 12457 59 12516Texas 3045 133 2998 128 69735 392 70127Utah 63 25 57 22 2295 20 2315Vermont 5 08 18 29 461 6 467Virginia 638 84 605 79 16802 177 16979Washington 485 77 389 61 11792 34 11826West Virginia 74 41 67 37 1500 11 1511Wisconsin 122 22 217 39 4513 33 4546Wyoming 6 12 8 16 228 2 230

Subtotal 40123 135 37911 127 952221 9094 961315

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 29

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulativemdashUnited States and dependent areas (cont)

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

US dependent areasAmerican Samoa 0 0 0 0 1 0 1Guam 0 0 0 0 68 1 69Northern Mariana Islands 0 0 0 0 3 0 3Puerto Rico 1029 263 850 216 29511 400 29911US Virgin Islands 17 156 32 295 629 18 647Otherb 0 0 0 0 3 0 3

Totalc 41357 138 39002 129 983343 9522 992865d

a From the beginning of the epidemic through 2006b Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasc Includes persons whose state or area of residence is unknownd Includes 916 persons whose state or area of residence is unknown

30 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

MSA (population gt 500000)

Akron Ohio 66 94 32 46 762 1 763

AlbanyndashSchenectadyndashTroy NY 97 114 105 123 2253 24 2277

Albuquerque N Mex 70 88 50 61 1404 2 1406

AllentownndashBethlehemndashEaston PandashNJ 72 91 119 149 1352 17 1369

AtlantandashSandy SpringsndashMarietta Ga 1586 319 1006 196 21896 128 22024

AugustandashRichmond County GandashSC 106 205 32 61 1851 24 1875

AustinndashRound Rock Tex 227 156 186 123 4830 26 4856

Bakersfield Calif 76 100 122 156 1528 8 1536

BaltimorendashTowson Md 1064 401 1001 377 20352 218 20570

Baton Rouge La 222 304 231 301 3732 20 3752

BirminghamndashHoover Ala 151 139 110 100 2614 25 2639

Boise CityndashNampa Idaho 14 26 14 25 281 0 281

Boston MassndashNHa 441 99 355 80 13476 147 13623

Boston Division 269 146 185 101 8451 91 8542

Cambridge Division 108 74 102 70 3126 35 3161

Essex Division 52 71 51 69 1577 20 1597

BridgeportndashStamfordndashNorwalk Conn 181 201 135 150 3733 57 3790

BuffalondashNiagara Falls NY 117 102 96 84 2476 20 2496

Cape CoralndashFort Myers Fla 44 81 91 159 1692 24 1716

CharlestonndashNorth Charleston SC 92 155 91 151 2034 18 2052

CharlottendashGastoniandashConcord NCndashSC 214 141 285 180 3242 22 3264

Chicago IllndashIndndashWis 1716 182 1159 122 30118 261 30379

Chicago Division 1604 203 1073 135 28300 248 28548

Gary Division 61 88 50 71 1038 8 1046

Lake Division 51 59 36 41 780 5 785

CincinnatindashMiddletown OhiondashKyndashInd 111 53 199 95 2735 17 2752

ClevelandndashElyriandashMentor Ohio 228 107 170 80 4226 48 4274

Colorado Springs Colo 19 32 21 35 576 5 581

Columbia SC 177 256 197 280 3274 24 3298

Columbus Ohio 166 97 165 96 3112 15 3127

Dallas Tex 874 150 929 155 20238 63 20301

Dallas Division 681 175 714 178 16038 37 16075

Fort Worth Division 193 100 215 108 4200 26 4226

Dayton Ohio 58 69 54 64 1217 15 1232

DenverndashAurora Colo 274 116 236 98 6899 22 6921

Des Moines Iowa 30 57 23 43 530 4 534

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 31

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Detroit Mich 570 127 445 100 10373 73 10446

Detroit Division 443 223 330 167 8268 57 8325

Warren Division 127 51 115 46 2105 16 2121

El Paso Tex 56 78 40 54 1476 10 1486

Fresno Calif 52 59 64 72 1430 11 1441

Grand RapidsndashWyoming Mich 46 60 51 66 816 6 822

GreensborondashHigh Point NC 52 77 66 96 1265 14 1279

Greenville SC 70 119 67 111 1292 4 1296

HarrisburgndashCarlisle Pa 23 44 67 128 1224 8 1232

HartfordndashWest HartfordndashEast Hartford Conn 256 216 135 114 5126 46 5172

Honolulu Hawaii 54 60 69 76 2121 14 2135

HoustonndashBaytownndashSugar Land Tex 1017 190 1092 197 25821 172 25993

Indianapolis Ind 191 116 150 90 3824 25 3849

Jackson Miss 134 257 117 221 2419 30 2449

Jacksonville Fla 309 248 315 246 6020 75 6095

Kansas City MondashKans 183 94 160 81 4669 15 4684

Knoxville Tenn 47 72 35 52 882 5 887

Lakeland Fla 103 190 112 199 1811 21 1832

Las VegasndashParadise Nev 245 143 258 145 4616 28 4644

Little RockndashNorth Little Rock Ark 87 135 75 115 1383 14 1397

Los Angeles Calif 1529 118 1684 130 57953 293 58246

Los Angeles Division 1339 135 1435 144 51098 250 51348

Santa Anna Division 190 63 249 83 6855 43 6898

Louisville KyndashInd 123 102 97 79 2286 22 2308

Madison Wis 10 19 29 53 520 4 524

McAllenndashEdinburgndashPharr Tex 57 84 45 64 630 11 641

Memphis TennndashMissndashArk 402 320 346 271 5128 19 5147

Miami Fla 2420 446 2289 419 55807 997 56804

Fort Lauderdale Division 810 455 769 430 16412 262 16674

Miami Division 1243 523 1165 485 29703 512 30215

West Palm Beach Division 367 290 355 279 9692 223 9915

MilwaukeendashWaukeshandashWest Allis Wis 68 45 109 72 2507 18 2525

MinneapolisndashSt PaulndashBloomington MinnndashWis 186 59 184 58 4259 22 4281

Modesto Calif 36 71 22 43 671 6 677

NashvillendashDavidsonndashMurfreesboro Tenn 224 158 172 118 3848 20 3868

New HavenndashMilford Conn 169 200 107 127 4573 73 4646

New OrleansndashMetairiendashKenner La 393 299 271 264 8835 67 8902

32 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

New York NYndashNJndashPa 6215 330 5500 292 195177 2906 198083

Edison Division 191 83 130 56 6709 139 6848

Nassau Division 262 93 246 88 8141 110 8251

New York Division 5266 456 4716 408 160408 2323 162731

Newark Division 496 231 408 190 19919 334 20253

Oklahoma City Okla 125 108 88 75 2255 5 2260

OmahandashCouncil Bluffs NebndashIowa 37 46 80 97 1035 3 1038

Orlando Fla 544 282 517 260 8653 92 8745

OxnardndashThousand OaksndashVentura Calif 49 62 21 26 1008 3 1011

Palm BayndashMelbournendashTitusville Fla 68 129 61 114 1512 11 1523

Philadelphia PandashNJndashDelndashMd 1261 217 1348 231 28221 313 28534

Camden Division 108 87 111 89 3118 42 3160

Philadelphia Division 1022 263 1144 294 22112 250 22362

Wilmington Division 131 191 93 134 2991 21 3012

PhoenixndashMesandashScottsdale Ariz 460 119 376 93 7459 31 7490

Pittsburgh Pa 143 60 135 57 3182 19 3201

PortlandndashSouth Portland Maine 9 18 34 66 562 1 563

PortlandndashVancouverndashBeaverton OrendashWash 170 81 215 101 4825 10 4835

PoughkeepsiendashNewburghndashMiddletown NY 136 204 113 168 3162 24 3186

ProvidencendashNew BedfordndashFall River RIndashMass 132 82 155 96 3900 44 3944

RaleighndashCary NC 138 145 201 202 1987 13 2000

Richmond Va 119 101 122 102 3371 35 3406

RiversidendashSan BernardinondashOntario Calif 361 92 306 76 8568 60 8628

Rochester NY 165 159 124 120 3134 13 3147

SacramentondashArden-ArcadendashRoseville Calif 154 75 169 82 4000 26 4026

St Louis MondashIll 192 69 366 131 5965 40 6005

Salt Lake City Utah 46 44 40 37 1743 10 1753

San Antonio Tex 215 114 247 127 4987 30 5017

San DiegondashCarlsbadndashSan Marcos Calif 491 167 384 131 12934 61 12995

San Francisco Calif 867 209 690 165 40152 96 40248

Oakland Division 312 126 246 99 9546 48 9594

San Francisco Division 555 329 444 261 30606 48 30654

San JosendashSunnyvalendashSanta Clara Calif 88 50 145 81 3747 15 3762

San JuanndashCaguasndashGuaynabo PR 745 289 578 223 21402 277 21679

SarasotandashBradentonndashVenice Fla 82 122 104 152 1978 27 2005

ScrantonndashWilkes-Barre Pa 27 49 47 85 572 6 578

Seattle Wash 353 110 280 86 9172 27 9199

Seattle Division 316 129 255 102 8161 18 8179

Tacoma Division 37 49 25 33 1011 9 1020

Springfield Mass 88 128 45 66 2075 26 2101

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 33

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Stockton Calif 52 78 52 77 1076 15 1091

Syracuse NY 52 80 49 75 1317 8 1325

TampandashSt PetersburgndashClearwater Fla 559 211 605 224 11174 112 11286

Toledo Ohio 25 38 66 101 812 14 826

Tucson Ariz 103 111 100 106 2010 10 2020

Tulsa Okla 83 94 65 72 1494 10 1504

Virginia BeachndashNorfolkndashNewport News VandashNC 183 111 132 80 4711 63 4774

Washington DCndashVandashMdndashWV 1322 252 1684 318 31130 315 31445

Bethesda Division 135 118 173 150 2774 23 2797

Washington Division 1187 289 1511 365 28356 292 28648

Wichita Kans 35 60 38 64 851 2 853

Worcester Mass 76 97 79 101 1783 20 1803

YoungstownndashWarrenndashBoardman OhiondashPa 27 46 26 44 519 0 519

Subtotal for MSAs (population gt500000) 33602 173 31274 159 829633 8171 837804

Metropolitan areas (population of 50000 to 499999) 4477 80 4466 79 94829 847 95676

Nonmetropolitan areas 2666 54 2732 55 52063 445 52508

Totalb 41144 137 38749 128 981708 9494 991202

Note Because of the lack of census information for all US dependent areas includes data for only the 50 states the District of Columbia and Puerto RicoMSA metropolitan statistical areaMSA definitions for this report can be found at httpwwwcensusgovpopulationwwwestimatesmetrodefhtmla Reported case counts for the metropolitan divisions do not sum to the MSA total MSA total includes data from 1 metropolitan division with

population of lt500000b Includes persons whose county of residence is unknown

34 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Alabama (January 1988) 502 6041 48 6089

Alaska (February 1999) 38 285 2 287

Arizona (January 1987) 617 5877 80 5957

Arkansas (July 1989) 206 2349 20 2369

California (April 2006) 6581 7056 92 7148

Colorado (November 1985) 319 6084 31 6115

Connecticut (January 2005)b 826 2500 101 2601

Delaware (February 2006) 788 801 18 819

Florida (July 1997)c 4163 36386 397 36783

Georgia (December 2003) 2245 8197 194 8391

Idaho (June 1986) 35 340 4 344

Illinois (January 2006) 6241 6661 162 6823

Indiana (July 1988) 399 4027 43 4070

Iowa (July 1998) 69 586 5 591

Kansas (July 1999) 142 1225 15 1240

Kentucky (October 2004) 333 1303 13 1316

Louisiana (February 1993) 728 8149 166 8315

Maine (January 2006) 386 393 3 396

Michigan (April 1992) 635 6702 134 6836

Minnesota (October 1985) 309 3356 40 3396

Mississippi (August 1988) 352 4549 59 4608

Missouri (October 1987) 502 5086 55 5141

Nebraska (September 1995) 91 672 14 686

Nevada (February 1992) 339 3532 24 3556

New Hampshire (January 2005) 59 466 9 475

New Jersey (January 1992) 1477 17513 325 17838

New Mexico (January 1998) 114 949 4 953

New York (June 2000) 5326 42345 1820 44165

North Carolina (February 1990) 1615 13879 143 14022

North Dakota (January 1988) 4 82 1 83

Ohio (June 1990) 867 8222 101 8323

Oklahoma (June 1988) 229 2401 30 2431

Oregon (April 2006) 49 95 19 114

Pennsylvania (October 2002)d 4269 9537 179 9716

Rhode Island (July 2006) 14 21 0 21

South Carolina (February 1986) 493 6970 93 7063

South Dakota (January 1988) 18 215 6 221

Tennessee (January 1992) 732 7115 90 7205

Texas (January 1999)e 3370 24282 417 24699

Utah (April 1989) 106 893 14 907

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 35

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Virginia (July 1989) 864 10257 95 10352

Washington (March 2006) 4048 4157 40 4197

West Virginia (January 1989) 66 673 8 681

Wisconsin (November 1985) 261 2500 31 2531

Wyoming (June 1989) 7 93 1 94

Subtotal 50834 274822 5146 279968

US dependent areas

American Samoa (August 2001) 0 1 0 1

Guam (March 2000) 2 66 0 66

Northern Mariana Islands (October 2001) 2 7 0 7

Puerto Rico (January 2003) 1471 5610 91 5701

US Virgin Islands (December 1998) 22 247 6 253

Persons reported from areas with confidential name-based HIV infection reporting but who were residents of other areas 132 685 21 706

Totalf 52878 282640 5314 287954

Note Includes data from 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through 2006b Beginning in 1992 Connecticut had name-based HIV reporting for cases in children only From January 2002 through December 2004

Connecticut had name- or code-based HIV reporting for cases in adolescents and adults As of January 2005 Connecticut has name-based reporting of all cases of HIV infection

c Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterd On October 18 2002 Pennsylvania initiated confidential name-based HIV infection reporting in all areas except Philadelphia Code-based

reporting was implemented in Philadelphia in March 2004 and the switch to name-based reporting was made in October 2005e From February 1994 through December 1998 Texas reported HIV infection in children onlyf Includes 1252 persons reported from areas with confidential name-based HIV infection reporting but whose area of residence is unknown

36 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulativemdashUnited States and dependent areas

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No Adult or adolescentMale-to-male sexual contact 13775 49 429897 54 mdash mdash mdash mdash 13775 35 429897 44Injection drug use 3413 12 163070 21 1826 17 67693 35 5239 13 230763 23Male-to-male sexual contact and

injection drug use 1603 6 65524 8 mdash mdash mdash mdash 1603 4 65524 7Hemophiliacoagulation disorder 43 0 5176 1 11 0 348 0 54 0 5524 1High-risk heterosexual contactc 2997 11 49610 6 4839 46 85186 44 7836 20 134796 14

Sex with injection drug user 330 1 11683 1 706 7 26073 14 1036 3 37756 4Sex with bisexual male mdash mdash mdash mdash 234 2 5162 3 234 1 5162 1Sex with person with hemophilia 1 0 84 0 11 0 502 0 12 0 586 0Sex with HIV-infected transfusion

recipient 22 0 553 0 21 0 793 0 43 0 1346 0Sex with HIV-infected person risk

factor not specified 2644 9 37290 5 3867 37 52656 27 6511 17 89946 9Receipt of blood transfusion blood

d components or tissue 63 0 5213 1 68 1 4176 2 131 0 9389 1Otherrisk factor not reported or

identifiede 6484 23 73136 9 3793 36 34311 18 10278 26 107450 11Subtotal 28378 100 791626 100 10537 100 191714 100 38916 100 983343 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 0 0 222 5 0 0 7 0 0 0 229 2Mother with documented HIV infection or

1 of the following risk factors 24 75 4315 89 50 93 4423 95 74 86 8738 92Injection drug use 4 13 1676 35 4 7 1665 36 8 9 3341 35Sex with injection drug user 4 13 789 16 4 7 750 16 8 9 1539 16Sex with bisexual male 1 3 101 2 2 4 110 2 3 3 211 2Sex with person with hemophilia 0 0 20 0 0 0 16 0 0 0 36 0Sex with HIV-infected transfusion

recipient 0 0 11 0 0 0 15 0 0 0 26 0Sex with HIV-infected person risk

factor not specified 6 19 742 15 17 31 790 17 23 27 1532 16Receipt of blood transfusion blood

components or tissue 0 0 70 1 0 0 82 2 0 0 152 2Has HIV infection risk factor not

specified 9 28 906 19 23 43 995 21 32 37 1901 20Receipt of blood transfusion blood

fcomponents or tissue 1 3 243 5 0 0 144 3 1 1 387 4Otherrisk factor not reported or

identifiedg 7 22 75 2 4 7 93 2 11 13 168 2Subtotal 32 100 4855 100 54 100 4667 100 86 100 9522 100

Total 28410 100 796481 100 10591 100 196381 100 39002 100 992865 100a From the beginning of the epidemic through 2006b From the beginning of the epidemic through 2006 Includes 3 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infectiond AIDS developed in 47 adultsadolescents after they received blood that had tested negative for HIV antibodies AIDS developed in 14 additional adults

after they received tissue organs or artificial insemination from HIV-infected donors Four of the 14 received tissue or organs from a donor who was negative for HIV antibody at the time of donation

e Includes 37 adultsadolescents who were exposed to HIV-infected blood body fluids or concentrated virus in health care laboratory or household settings as supported by seroconversion epidemiologic andor laboratory evidence One person was infected after intentional inoculation with HIV-infected blood Includes an additional 740 persons who acquired HIV infection perinatally but who were more than 12 years of age when AIDS was diagnosed These 740 persons are not counted in the values for the pediatric transmission category

f AIDS developed in 3 children after they received blood that had tested negative for HIV antibodiesg Includes 5 children who were exposed to HIV-infected blood as supported by seroconversion epidemiologic andor laboratory evidence 1 child was

infected after intentional inoculation with HIV-infected blood and 5 children were exposed to HIV-infected blood in a household setting Of the 168 children 26 had sexual contact with an adult with or at high risk for HIV infection

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 37

Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No

Adult or adolescentMale-to-male sexual contact 22912 59 103679 52 mdash mdash mdash mdash 22912 44 103679 37

Injection drug use 3503 9 24255 12 2124 16 13925 17 5627 11 38181 14

Male-to-male sexual contact and injection drug use 1946 5 10704 5 mdash mdash mdash mdash 1946 4 10704 4

Hemophiliacoagulation disorder 43 0 495 0 6 0 73 0 49 0 568 0

High-risk heterosexual contactc 2874 7 16830 8 5939 45 38315 47 8813 17 55145 20

Sex with injection drug user 308 1 2601 1 757 6 6791 8 1065 2 9392 3

Sex with bisexual male mdash mdash mdash mdash 328 2 2265 3 328 1 2265 1

Sex with person with hemophilia 4 0 31 0 16 0 201 0 20 0 232 0

Sex with HIV-infected transfusion recipient 13 0 131 0 28 0 223 0 41 0 354 0

Sex with HIV-infected person risk factor not specified 2549 7 14067 7 4810 36 28835 35 7359 14 42902 15

Receipt of blood transfusion blood components or tissue 61 0 489 0 50 0 536 1 111 0 1025 0

Otherrisk factor not reported or identified 7748 20 44021 22 5106 39 29312 36 12854 25 73338 26

Subtotal 39087 100 200473 100 13225 100 82161 100 52312 100 282640 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 8 3 106 4 0 0 1 0 8 1 107 2

Mother with documented HIV infection or 1 of the following risk factors 197 74 2195 85 254 85 2417 89 451 80 4612 87

Injection drug use 34 13 532 21 53 18 561 21 87 15 1093 21

Sex with injection drug user 12 5 208 8 21 7 213 8 33 6 421 8

Sex with bisexual male 5 2 37 1 4 1 32 1 9 2 69 1

Sex with person with hemophilia 0 0 3 0 1 0 7 0 1 0 10 0

Sex with HIV-infected transfusion recipient 0 0 4 0 0 0 4 0 0 0 8 0

Sex with HIV-infected person risk factor not specified 54 20 534 21 76 25 629 23 130 23 1163 22

Receipt of blood transfusion blood components or tissue 0 0 17 1 2 1 20 1 2 0 37 1

Has HIV infection risk factor not specified 92 35 860 33 97 32 951 35 189 33 1811 34

Receipt of blood transfusion blood components or tissue 6 2 28 1 3 1 24 1 9 2 52 1

Otherrisk factor not reported or identified 55 21 260 10 43 14 283 10 98 17 543 10

Subtotal 266 100 2589 100 300 100 2725 100 566 100 5314 100

Total 39353 100 203062 100 13525 100 84886 100 52878 100 287954 100

Note See Table 16 for the list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006b From the beginning of the epidemic through December 2006 Includes 6 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infection

38 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity

2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 6251 65 253927 73Injection drug use 733 8 31737 9Male-to-male sexual contact and injection drug use 732 8 31434 9Hemophiliacoagulation disorder 26 0 3989 1High-risk heterosexual contactb 416 4 7850 2

Sex with injection drug user 74 1 2310 1

Sex with person with hemophilia 0 0 36 0

Sex with HIV-infected transfusion recipient 2 0 176 0

Sex with HIV-infected person risk factor not specified 340 4 5328 2Receipt of blood transfusion blood components or tissue 20 0 3194 1Otherrisk factor not reported or identified 1400 15 16469 5

Total 9578 100 348600 100

Black not HispanicMale-to-male sexual contact 4309 36 103297 37Injection drug use 1635 14 83369 30Male-to-male sexual contact and injection drug use 526 4 22134 8Hemophiliacoagulation disorder 10 0 604 0High-risk heterosexual contactb 1875 16 29952 11

Sex with injection drug user 167 1 6823 2Sex with person with hemophilia 1 0 36 0Sex with HIV-infected transfusion recipient 15 0 237 0Sex with HIV-infected person risk factor not specified 1692 14 22856 8

Receipt of blood transfusion blood components or tissue 24 0 1218 0Otherrisk factor not reported or identified 3579 30 40268 14

Total 11958 100 280842 100

HispanicMale-to-male sexual contact 2816 47 64893 44Injection drug use 965 16 46337 31Male-to-male sexual contact and injection drug use 287 5 10884 7Hemophiliacoagulation disorder 6 0 466 0High-risk heterosexual contactb 638 11 10950 7

Sex with injection drug user 84 1 2409 2Sex with person with hemophilia 0 0 11 0Sex with HIV-infected transfusion recipient 5 0 125 0Sex with HIV-infected person risk factor not specified 549 9 8405 6

Receipt of blood transfusion blood components or tissue 17 0 657 0Otherrisk factor not reported or identified 1326 22 14832 10

Total 6055 100 149019 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 39

a

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulative

No No

AsianPacific IslanderMale-to-male sexual contact 225 54 4475 68Injection drug use 20 5 317 5Male-to-male sexual contact and injection drug use 17 4 284 4Hemophiliacoagulation disorder 1 0 70 1High-risk heterosexual contactb 34 8 376 6

Sex with injection drug user 1 0 54 1Sex with person with hemophilia 0 0 1 0Sex with HIV-infected transfusion recipient 0 0 8 0Sex with HIV-infected person risk factor not specified 33 8 313 5

Receipt of blood transfusion blood components or tissue 2 0 112 2Otherrisk factor not reported or identified 114 28 949 14

Total 413 100 6583 100

American IndianAlaska NativeMale-to-male sexual contact 61 49 1403 55Injection drug use 15 12 395 15Male-to-male sexual contact and injection drug use 23 19 457 18Hemophiliacoagulation disorder 0 0 27 1High-risk heterosexual contactb 9 7 118 5

Sex with injection drug user 1 1 33 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 8 6 82 3

Receipt of blood transfusion blood components or tissue 0 0 8 0Otherrisk factor not reported or identified 16 13 155 6

Total 124 100 2563 100

Total casesMale-to-male sexual contact 13775 49 429897 54Injection drug use 3413 12 163070 21Male-to-male sexual contact and injection drug use 1603 6 65524 8Hemophiliacoagulation disorder 43 0 5176 1High-risk heterosexual contactb 2997 11 49610 6

Sex with injection drug user 330 1 11683 1Sex with person with hemophilia 1 0 84 0Sex with HIV-infected transfusion recipient 22 0 553 0Sex with HIV-infected person risk factor not specified 2644 9 37290 5

Receipt of blood transfusion blood components or tissue 63 0 5213 1Otherrisk factor not reported or identified 6484 23 73136 9

Total 28378c 100 791626d 100a From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 4019 males of unknown race or multiple races

40 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 11963 73 55725 69Injection drug use 858 5 5512 7Male-to-male sexual contact and injection drug use 1092 7 5578 7Hemophiliacoagulation disorder 29 0 355 0High-risk heterosexual contactb 522 3 2658 3

Sex with injection drug user 65 0 544 1Sex with person with hemophilia 0 0 8 0Sex with HIV-infected transfusion recipient 3 0 33 0Sex with HIV-infected person risk factor not specified 454 3 2073 3

Receipt of blood transfusion blood components or tissue 14 0 197 0Otherrisk factor not reported or identified 1956 12 11147 14

Total 16434 100 81172 100

Black not HispanicMale-to-male sexual contact 6203 44 30148 37Injection drug use 1594 11 11997 15Male-to-male sexual contact and injection drug use 483 3 3489 4Hemophiliacoagulation disorder 10 0 109 0High-risk heterosexual contactb 1714 12 10905 13

Sex with injection drug user 169 1 1554 2Sex with person with hemophilia 4 0 17 0Sex with HIV-infected transfusion recipient 6 0 77 0Sex with HIV-infected person risk factor not specified 1535 11 9257 11

Receipt of blood transfusion blood components or tissue 32 0 223 0Otherrisk factor not reported or identified 4151 29 24632 30

Total 14187 100 81503 100

HispanicMale-to-male sexual contact 4094 55 15623 47Injection drug use 993 13 6407 19Male-to-male sexual contact and injection drug use 316 4 1402 4Hemophiliacoagulation disorder 3 0 26 0High-risk heterosexual contactb 582 8 2963 9

Sex with injection drug user 65 1 455 1Sex with person with hemophilia 0 0 6 0Sex with HIV-infected transfusion recipient 4 0 18 0Sex with HIV-infected person risk factor not specified 513 7 2484 7

Receipt of blood transfusion blood components or tissue 11 0 55 0Otherrisk factor not reported or identified 1475 20 6977 21

Total 7474 100 33453 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 41

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderMale-to-male sexual contact 402 70 1006 63Injection drug use 17 3 55 3Male-to-male sexual contact and injection drug use 15 3 38 2Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 25 4 96 6

Sex with injection drug user 3 1 10 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 22 4 83 5

Receipt of blood transfusion blood components or tissue 4 1 7 0Otherrisk factor not reported or identified 109 19 397 25

Total 572 100 1600 100

American IndianAlaska NativeMale-to-male sexual contact 104 61 516 57Injection drug use 13 8 101 11Male-to-male sexual contact and injection drug use 19 11 110 12Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 10 6 53 6

Sex with injection drug user 2 1 14 2Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 8 5 39 4

Receipt of blood transfusion blood components or tissue 0 0 2 0Otherrisk factor not reported or identified 24 14 125 14

Total 170 100 907 100

Total casesMale-to-male sexual contact 22912 59 103679 52Injection drug use 3503 9 24255 12Male-to-male sexual contact and injection drug use 1946 5 10704 5Hemophiliacoagulation disorder 43 0 495 0High-risk heterosexual contactb 2874 7 16830 8

Sex with injection drug user 308 1 2601 1Sex with person with hemophilia 4 0 31 0Sex with HIV-infected transfusion recipient 13 0 131 0Sex with HIV-infected person risk factor not specified 2549 7 14067 7

Receipt of blood transfusion blood components or tissue 61 0 489 0Otherrisk factor not reported or identified 7748 20 44021 22

Total 39087c 100 200473d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 1838 males of unknown race or multiple races

42 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race

ethnicity 2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 482 28 14981 40Hemophiliacoagulation disorder 4 0 123 0High-risk heterosexual contactb 725 42 15799 42

Sex with injection drug user 153 9 5650 15Sex with bisexual male 63 4 1859 5Sex with person with hemophilia 5 0 329 1Sex with HIV-infected transfusion recipient 5 0 338 1Sex with HIV-infected person risk factor not specified 499 29 7623 20

Receipt of blood transfusion blood components or tissue 15 1 1870 5Otherrisk factor not reported or identified 499 29 4801 13

Total 1725 100 37574 100

Black not HispanicInjection drug use 982 15 38914 34Hemophiliacoagulation disorder 3 0 145 0High-risk heterosexual contactb 3103 46 49876 44

Sex with injection drug user 373 6 13530 12Sex with bisexual male 136 2 2352 2Sex with person with hemophilia 4 0 121 0Sex with HIV-infected transfusion recipient 8 0 277 0Sex with HIV-infected person risk factor not specified 2582 38 33596 29

Receipt of blood transfusion blood components or tissue 39 1 1546 1Otherrisk factor not reported or identified 2612 39 23894 21

Total 6739 100 114375 100

HispanicInjection drug use 322 18 12892 35Hemophiliacoagulation disorder 4 0 67 0High-risk heterosexual contactb 894 49 17995 49

Sex with injection drug user 166 9 6522 18Sex with bisexual male 32 2 818 2Sex with person with hemophilia 1 0 45 0Sex with HIV-infected transfusion recipient 7 0 141 0Sex with HIV-infected person risk factor not specified 688 38 10469 29

Receipt of blood transfusion blood components or tissue 12 1 619 2Otherrisk factor not reported or identified 592 32 5023 14

Total 1824 100 36596 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 43

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 8 8 125 12Hemophiliacoagulation disorder 0 0 7 1High-risk heterosexual contactb 49 47 574 53

Sex with injection drug user 4 4 114 11Sex with bisexual male 2 2 80 7Sex with person with hemophilia 0 0 4 0Sex with HIV-infected transfusion recipient 1 1 25 2Sex with HIV-infected person risk factor not specified 42 40 351 33

Receipt of blood transfusion blood components or tissue 1 1 93 9Otherrisk factor not reported or identified 46 44 279 26

Total 104 100 1078 100

American IndianAlaska NativeInjection drug use 13 32 280 42Hemophiliacoagulation disorder 0 0 3 0High-risk heterosexual contactb 15 37 277 41

Sex with injection drug user 4 10 107 16Sex with bisexual male 1 2 27 4Sex with person with hemophilia 0 0 2 0Sex with HIV-infected transfusion recipient 0 0 6 1Sex with HIV-infected person risk factor not specified 10 24 135 20

Receipt of blood transfusion blood components or tissue 1 2 17 3Otherrisk factor not reported or identified 12 29 95 14

Total 41 100 672 100

Total casesInjection drug use 1826 17 67693 35Hemophiliacoagulation disorder 11 0 348 0High-risk heterosexual contactb 4839 46 85186 44

Sex with injection drug user 706 7 26073 14Sex with bisexual male 234 2 5162 3Sex with person with hemophilia 11 0 502 0Sex with HIV-infected transfusion recipient 21 0 793 0Sex with HIV-infected person risk factor not specified 3867 37 52656 27

Receipt of blood transfusion blood components or tissue 68 1 4176 2Otherrisk factor not reported or identified 3793 36 34311 18

Total 10537c 100 191714d 100a From the beginning of the epidemic through 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 104 females of unknown race or multiple racesd Includes 1419 females of unknown race or multiple races

44 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 690 26 4260 26Hemophiliacoagulation disorder 3 0 24 0

bHigh-risk heterosexual contact 1132 42 7593 46Sex with injection drug user 205 8 1876 11Sex with bisexual male 98 4 659 4Sex with person with hemophilia 10 0 115 1Sex with HIV-infected transfusion recipient 7 0 64 0Sex with HIV-infected person risk factor not specified 812 30 4879 29

Receipt of blood transfusion blood components or tissue 12 0 146 1Otherrisk factor not reported or identified 850 32 4567 28

Total 2687 100 16590 100

Black not HispanicInjection drug use 1034 13 7105 14Hemophiliacoagulation disorder 1 0 35 0

bHigh-risk heterosexual contact 3451 44 23732 46Sex with injection drug user 313 4 3473 7Sex with bisexual male 155 2 1294 3Sex with person with hemophilia 5 0 71 0Sex with HIV-infected transfusion recipient 14 0 120 0Sex with HIV-infected person risk factor not specified 2964 38 18774 36

Receipt of blood transfusion blood components or tissue 26 0 324 1Otherrisk factor not reported or identified 3370 43 20244 39

Total 7882 100 51440 100

HispanicInjection drug use 339 15 2280 18Hemophiliacoagulation disorder 2 0 11 0

bHigh-risk heterosexual contact 1198 52 6264 50Sex with injection drug user 218 9 1324 11Sex with bisexual male 62 3 266 2Sex with person with hemophilia 1 0 11 0Sex with HIV-infected transfusion recipient 7 0 39 0Sex with HIV-infected person risk factor not specified 910 39 4624 37

Receipt of blood transfusion blood components or tissue 12 1 58 0Otherrisk factor not reported or identified 767 33 3843 31

Total 2318 100 12456 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 45

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 19: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003ndash2006mdash33 states and 5 US dependent areas with confidential name-based HIV infection reporting

2003 2004 2005 2006Data for 33 states

Age at end of year (yrs)lt13 4154 3700 3294 286713ndash14 1130 1238 1212 113915ndash19 3298 3627 4024 453920ndash24 12389 12826 13411 1430125ndash29 26167 26924 28164 2960030ndash34 49602 47577 45109 4418935ndash39 80703 77871 75842 7363440ndash44 92040 97109 100102 10176445ndash49 71345 77490 83816 9028350ndash54 45133 51033 56640 6319555ndash59 22793 26610 31186 3600860ndash64 10820 12642 14422 16658gt65 8531 9959 11657 13551

RaceethnicityWhite not Hispanic 145081 151694 158375 166000Black not Hispanic 202951 212425 221439 231957Hispanic 72612 76503 80491 84720AsianPacific Islander 2234 2529 2858 3187American IndianAlaska Native 1788 1889 2008 2119

Transmission categoryMale adult or adolescentMale-to-male sexual contact 181771 193245 205423 218676Injection drug use 57651 58149 58369 59077Male-to-male sexual contact and injection drug use 23965 24434 24725 25085High-risk heterosexual contacta 40084 42559 44915 47562Otherb 3218 3278 3325 3424Subtotal 306689 321665 336756 353825

Female adult or adolescentInjection drug use 32346 32735 32973 33470High-risk heterosexual contacta 80324 85348 90185 95403Otherb 2036 2123 2212 2321Subtotal 114705 120206 125370 131195

Child (lt13 yrs at diagnosis)Perinatal 6137 6154 6178 6143Otherc 570 575 571 560Subtotal 6707 6730 6748 6703

Subtotal for 33 states 428107 448605 468879 491727Data for US dependent areas 15809 16399 17150 17955

Totald 443916 465005 486028 509681Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 19

Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission categorymdash33 states with confidential name-based HIV infection reporting

Transmission category

White not Hispanic

Black not Hispanic Hispanic

AsianPacific Islander

American IndianAlaska

Native Totala

No No No No No No

Male adult or adolescentMale-to-male sexual contact 108259 77 70242 49 36043 57 1669 68 938 62 218676 62Injection drug use 12328 9 31339 22 14472 23 264 11 216 14 59077 17Male-to-male sexual contact

and injection drug use 11283 8 9587 7 3720 6 93 4 205 13 25085 7High-risk heterosexual contactb 6667 5 31140 22 8788 14 395 16 143 9 47562 13Otherc 1458 1 1492 1 404 1 30 1 17 1 3424 1Subtotal 139994 100 143799 100 63427 100 2450 100 1519 100 353825 100

Female adult or adolescentInjection drug use 8262 33 19136 23 5528 28 106 15 175 30 33470 26High-risk heterosexual contactb 16338 65 63204 75 14132 71 573 82 392 68 95403 73Otherc 450 2 1469 2 344 2 24 3 12 2 2321 2Subtotal 25050 100 83809 100 20004 100 703 100 578 100 131195 100

Child (lt13 yrs at diagnosis)Perinatal 801 84 4064 93 1183 92 28 82 20 95 6143 92Otherd 154 16 283 7 107 8 6 18 1 5 560 8Subtotal 955 100 4347 100 1290 100 34 100 21 100 6703 100

Totale 166000 231957 84720 3187 2119 491727Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of 33 states that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Includes 3745 persons of unknown race or multiple racesb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes 5 persons of unknown sex Because column totals were calculated independently of the values for the subpopulations the values

in each column may not sum to the column total

20 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Map 1 Estimated rates (per 100000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

Note Rates adjusted for reporting delays Rates of HIV infection include only persons living with HIV infection that has not progressed to AIDSSince 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 Islandsa Includes persons whose area of residence is unknown

Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

Note Rates adjusted for reporting delays Rates of HIV infection include only persons living with HIV infection that has not progressed to AIDSSince 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 Islandsa Includes persons whose area of residence is unknown

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 21

Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002ndash2006mdashUnited States and dependent areas

2002 2003 2004 2005 2006Data for 50 states and the District of Columbia

Age at end of year (yrs)lt13 2308 2006 1684 1394 111513ndash14 685 747 784 762 71115ndash19 1465 1694 1974 2243 248720ndash24 3910 4292 4629 5033 536725ndash29 12725 12743 13045 13505 1435930ndash34 35558 33870 32057 29949 2882435ndash39 70107 68106 65076 62235 5964940ndash44 80377 86294 91335 94021 9517445ndash49 64702 71276 77417 84153 9077550ndash54 41270 46855 53333 59256 6647655ndash59 20113 24145 28356 33522 3901460ndash64 9681 11293 13305 15380 18072gt65 7520 8946 10604 12430 14669

RaceethnicityWhite not Hispanic 129426 135278 141508 147426 154495Black not Hispanic 150488 161326 171654 181056 191590Hispanic 63424 67895 72024 76334 80815AsianPacific Islander 3060 3426 3759 4121 4526American IndianAlaska Native 1254 1356 1458 1562 1651

Transmission categoryMale adult or adolescentMale-to-male sexual contact 158092 168233 178551 188622 199693Injection drug use 56708 58436 59940 61229 62998Male-to-male sexual contact and injection drug use 24726 25457 26144 26785 27523High-risk heterosexual contacta 27329 30300 33181 35916 39004Otherb 3588 3665 3769 3888 4026Subtotal 270444 286091 301585 316440 333244

Female adult or adolescentInjection drug use 27863 28874 29828 30646 31575High-risk heterosexual contacta 46445 51489 56229 60693 65631Otherb 1903 2033 2178 2315 2465Subtotal 76210 82395 88236 93653 99671

Child (lt13 yrs at diagnosis)Perinatal 3633 3654 3651 3664 3660Otherc 129 124 123 122 115Subtotal 3762 3778 3774 3786 3775

Region of residenceNortheast 105599 110929 115562 120208 125620Midwest 36011 38571 41178 44171 47010South 137081 147284 157975 166962 177591West 71729 75483 78883 82540 86473

Subtotal for 50 states and the District of Columbia 350419 372267 393598 413882 436693

Data for US dependent areas 9880 10365 10713 11106 11359

Totald 360617 383024 404849 425646 448871Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

22 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission categorymdash50 states and the District of Columbia

Transmission category

White not Hispanic

Black not Hispanic Hispanic

AsianPacific Islander

American IndianAlaska

Native Totala

No No No No No No

Male adult or adolescentMale-to-male sexual contact 101299 75 57520 45 36087 57 2715 72 704 57 199693 60Injection drug use 13168 10 33911 27 14795 23 325 9 201 16 62998 19Male-to-male sexual contact and

injection drug use 12393 9 10121 8 4352 7 198 5 220 18 27523 8High-risk heterosexual contactb 6081 5 24205 19 7816 12 444 12 105 8 39004 12Otherc 1743 1 1602 1 574 1 69 2 16 1 4026 1Subtotal 134683 100 127359 100 63623 100 3752 100 1246 100 333244 100

Female adult or adolescentInjection drug use 7407 38 18531 30 5025 30 115 15 153 39 31575 32High-risk heterosexual contactb 11350 59 41741 68 11092 67 588 78 227 58 65631 66Otherc 508 3 1456 2 413 2 51 7 13 3 2465 2Subtotal 19264 100 61728 100 16531 100 753 100 393 100 99671 100

Child (lt13 yrs at diagnosis)Perinatal 500 92 2468 99 629 95 20 94 12 100 3660 97Otherd 46 8 34 1 33 5 1 6 0 0 115 3Subtotal 546 100 2503 100 662 100 21 100 12 100 3775 100

Totale 154495 191590 80815 4526 1651 436693

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Includes 3616 persons of unknown race or multiple racesb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes 3 person of unknown sex Because column totals were calculated independently of the values for the subpopulations the values in each column

may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 23

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by

area of residence and age categorymdashUnited States and dependent areas

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

Alabama 5469 17 5486 3744 11 3755Alaska 272 1 273 330 1 331Arizona 5744 49 5793 4922 7 4929Arkansas 2291 7 2298 2139 6 2145California mdash mdash mdash 61451 105 61555Colorado 5855 13 5869 4083 2 4085Connecticut mdash mdash mdash 7406 15 7421Delaware mdash mdash mdash 1753 7 1760District of Columbia mdash mdash mdash 10059 30 10089Floridab 35461 263 35723 46469 194 46663Georgia mdash mdash mdash 17336 47 17383Hawaii mdash mdash mdash 1234 3 1237Idaho 356 0 356 313 0 313Illinois mdash mdash mdash 16139 46 16185Indiana 3849 21 3870 3996 14 4010Iowa 588 2 590 869 3 872Kansas 1230 7 1237 1272 2 1274Kentucky mdash mdash mdash 2589 13 2602Louisiana 7361 101 7462 8052 21 8074Maine mdash mdash mdash 512 2 514Maryland mdash mdash mdash 14540 41 14581Massachusetts mdash mdash mdash 8806 20 8826Michigan 6118 55 6173 6615 12 6627Minnesota 3227 21 3248 2314 9 2323Mississippi 4200 32 4232 3155 13 3168Missouri 4999 33 5033 5479 7 5486Montana mdash mdash mdash 205 0 205Nebraska 688 12 700 771 2 773Nevada 3402 13 3415 2969 3 2972New Hampshire mdash mdash mdash 556 3 559New Jersey 16059 153 16212 17168 57 17226New Mexico 910 0 909 1252 3 1255New York 42220 801 43021 70697 148 70845North Carolina 11700 60 11760 8451 12 8463North Dakota 87 2 89 73 1 74Ohio 8266 57 8323 7054 30 7084Oklahoma 2191 17 2208 2191 3 2194Oregon mdash mdash mdash 2840 4 2844Pennsylvania mdash mdash mdash 18633 71 18703Rhode Island mdash mdash mdash 1296 7 1303South Carolina 6349 45 6394 7035 23 7058South Dakota 195 4 199 139 1 140Tennessee 6579 51 6631 6403 11 6414Texas 24741 262 25003 34010 53 34063Utah 893 10 903 1164 0 1164Vermont mdash mdash mdash 238 2 240Virginia 9937 41 9978 8423 24 8447Washington mdash mdash mdash 5471 5 5476West Virginia 660 5 665 749 5 754Wisconsin 2322 15 2337 2153 12 2165Wyoming 86 2 88 102 1 103

Subtotal 224303 2174 226477 435621 1115 436736

24 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age categorymdashUnited States and dependent areas (cont)

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

US dependent areasAmerican Samoa 2 0 2 1 0 1Guam 63 0 63 36 0 36Northern Mariana Islands 7 0 7 3 0 3Puerto Rico 6269 31 6300 10971 26 10997US Virgin Islands 228 2 230 312 2 314Otherc mdash mdash mdash 1 0 1

Totald 230872 2207 233079 447724 1147 448871

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reporting a See Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at

least 2003b Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterc Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasd Total number of persons living with HIV infection (not AIDS) includes persons reported from areas with confidential name-based HIV

infection reporting who were residents of other states or whose area of residence is unknown Total number of persons living with AIDS includes persons whose area of residence is unknown Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 25

Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristicsmdashUnited States and dependent areas

No of persons

Survival in months

gt12 gt24 gt36Data for 50 states and the District of Columbia

Age at diagnosis (yrs)lt13 101 096 094 09413ndash14 60 098 098 09515ndash19 305 098 096 09520ndash24 1351 096 093 09225ndash29 3034 095 092 09130ndash34 5499 094 091 08935ndash39 7888 093 090 08740ndash44 7085 092 088 08545ndash49 5090 089 085 08250ndash54 3067 086 081 07855ndash59 1505 083 078 07460ndash64 806 080 073 069gt65 614 073 068 065

RaceethnicityWhite not Hispanic 10706 092 089 087Black not Hispanic 18406 090 086 082Hispanic 6398 092 090 088AsianPacific Islander 404 094 092 090American IndianAlaska Native 167 084 081 075

Transmission categoryMale adult or adolescentMale-to-male sexual contact 12830 093 090 088Injection drug use 4048 089 084 081Male-to-male sexual contact and injection drug use 1701 093 089 086High-risk heterosexual contacta 3170 091 088 085Otherb 5019 086 083 080Subtotal 26768 091 088 085

Female adult or adolescentInjection drug use 2101 089 083 078High-risk heterosexual contacta 4686 093 089 086Otherb 2749 090 085 083Subtotal 9536 091 087 083

Child (lt13 yrs at diagnosis)Perinatal 98 096 095 095Otherc 3 100 067 067Subtotal 101 096 094 094

Subtotal for 50 states and the District of Columbia 36405 091 087 085

Data for US dependent areas 891 083 078 075

Total 37352d 091 087 084Note Excludes persons whose date of death was before or in the same month as date of diagnosis Excludes persons whose month of diagnosis or month of death is unknowna Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes 325 persons of unknown race or multiple races

26 Survival after AIDS Diagnosis

Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by year of diagnosismdashUnited States and dependent areas

Months after AIDS diagnosis

Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by age groupmdashUnited States and dependent areas

Months after AIDS diagnosis

Survival after AIDS Diagnosis 27

Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by raceethnicitymdashUnited States and dependent areas

Months after AIDS diagnosis

28 Survival after AIDS Diagnosis

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006

and cumulativemdashUnited States and dependent areas

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Alabama 510 112 462 100 8626 76 8702Alaska 24 36 38 57 648 7 655Arizona 626 105 539 87 10396 46 10442Arkansas 237 85 252 90 3891 36 3927California 4069 113 3960 109 142254 664 142918Colorado 351 75 322 68 8742 31 8773Connecticut 658 188 422 120 14716 183 14899Delaware 177 210 116 136 3547 26 3573District of Columbia 672 1155 853 1467 17372 189 17561Florida 4921 277 4932 273 104084 1530 105614Georgia 2325 255 1605 171 31734 231 31965Hawaii 105 82 93 72 2927 17 2944Idaho 24 17 26 18 604 2 606Illinois 1886 148 1382 108 33620 282 33902Indiana 407 65 346 55 8239 56 8295Iowa 93 31 86 29 1727 13 1740Kansas 105 38 120 43 2781 14 2795Kentucky 249 60 207 49 4600 32 4632Louisiana 936 208 824 192 17612 128 17740Maine 21 16 68 51 1110 8 1118Maryland 1558 279 1626 290 30252 319 30571Massachusetts 666 104 533 83 19181 214 19395Michigan 821 81 672 67 14941 113 15054Minnesota 226 44 212 41 4817 28 4845Mississippi 368 127 365 125 6642 56 6698Missouri 385 66 469 80 11016 61 11077Montana 21 22 7 07 373 3 376Nebraska 53 30 118 67 1479 11 1490Nevada 293 121 294 118 5733 29 5762New Hampshire 33 25 55 42 1074 10 1084New Jersey 1262 145 1065 122 48750 778 49528New Mexico 134 70 93 48 2603 7 2610New York 6201 321 5495 285 174908 2354 177262North Carolina 916 106 1229 139 15954 118 16072North Dakota 10 16 6 09 144 1 145Ohio 753 66 767 67 14957 138 15095Oklahoma 281 79 205 57 4836 26 4862Oregon 217 60 281 76 5995 20 6015Pennsylvania 1486 120 1893 152 33417 365 33782Rhode Island 87 81 111 104 2580 28 2608South Carolina 682 161 705 163 13301 105 13406South Dakota 18 23 18 23 255 5 260Tennessee 818 137 680 113 12457 59 12516Texas 3045 133 2998 128 69735 392 70127Utah 63 25 57 22 2295 20 2315Vermont 5 08 18 29 461 6 467Virginia 638 84 605 79 16802 177 16979Washington 485 77 389 61 11792 34 11826West Virginia 74 41 67 37 1500 11 1511Wisconsin 122 22 217 39 4513 33 4546Wyoming 6 12 8 16 228 2 230

Subtotal 40123 135 37911 127 952221 9094 961315

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 29

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulativemdashUnited States and dependent areas (cont)

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

US dependent areasAmerican Samoa 0 0 0 0 1 0 1Guam 0 0 0 0 68 1 69Northern Mariana Islands 0 0 0 0 3 0 3Puerto Rico 1029 263 850 216 29511 400 29911US Virgin Islands 17 156 32 295 629 18 647Otherb 0 0 0 0 3 0 3

Totalc 41357 138 39002 129 983343 9522 992865d

a From the beginning of the epidemic through 2006b Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasc Includes persons whose state or area of residence is unknownd Includes 916 persons whose state or area of residence is unknown

30 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

MSA (population gt 500000)

Akron Ohio 66 94 32 46 762 1 763

AlbanyndashSchenectadyndashTroy NY 97 114 105 123 2253 24 2277

Albuquerque N Mex 70 88 50 61 1404 2 1406

AllentownndashBethlehemndashEaston PandashNJ 72 91 119 149 1352 17 1369

AtlantandashSandy SpringsndashMarietta Ga 1586 319 1006 196 21896 128 22024

AugustandashRichmond County GandashSC 106 205 32 61 1851 24 1875

AustinndashRound Rock Tex 227 156 186 123 4830 26 4856

Bakersfield Calif 76 100 122 156 1528 8 1536

BaltimorendashTowson Md 1064 401 1001 377 20352 218 20570

Baton Rouge La 222 304 231 301 3732 20 3752

BirminghamndashHoover Ala 151 139 110 100 2614 25 2639

Boise CityndashNampa Idaho 14 26 14 25 281 0 281

Boston MassndashNHa 441 99 355 80 13476 147 13623

Boston Division 269 146 185 101 8451 91 8542

Cambridge Division 108 74 102 70 3126 35 3161

Essex Division 52 71 51 69 1577 20 1597

BridgeportndashStamfordndashNorwalk Conn 181 201 135 150 3733 57 3790

BuffalondashNiagara Falls NY 117 102 96 84 2476 20 2496

Cape CoralndashFort Myers Fla 44 81 91 159 1692 24 1716

CharlestonndashNorth Charleston SC 92 155 91 151 2034 18 2052

CharlottendashGastoniandashConcord NCndashSC 214 141 285 180 3242 22 3264

Chicago IllndashIndndashWis 1716 182 1159 122 30118 261 30379

Chicago Division 1604 203 1073 135 28300 248 28548

Gary Division 61 88 50 71 1038 8 1046

Lake Division 51 59 36 41 780 5 785

CincinnatindashMiddletown OhiondashKyndashInd 111 53 199 95 2735 17 2752

ClevelandndashElyriandashMentor Ohio 228 107 170 80 4226 48 4274

Colorado Springs Colo 19 32 21 35 576 5 581

Columbia SC 177 256 197 280 3274 24 3298

Columbus Ohio 166 97 165 96 3112 15 3127

Dallas Tex 874 150 929 155 20238 63 20301

Dallas Division 681 175 714 178 16038 37 16075

Fort Worth Division 193 100 215 108 4200 26 4226

Dayton Ohio 58 69 54 64 1217 15 1232

DenverndashAurora Colo 274 116 236 98 6899 22 6921

Des Moines Iowa 30 57 23 43 530 4 534

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 31

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Detroit Mich 570 127 445 100 10373 73 10446

Detroit Division 443 223 330 167 8268 57 8325

Warren Division 127 51 115 46 2105 16 2121

El Paso Tex 56 78 40 54 1476 10 1486

Fresno Calif 52 59 64 72 1430 11 1441

Grand RapidsndashWyoming Mich 46 60 51 66 816 6 822

GreensborondashHigh Point NC 52 77 66 96 1265 14 1279

Greenville SC 70 119 67 111 1292 4 1296

HarrisburgndashCarlisle Pa 23 44 67 128 1224 8 1232

HartfordndashWest HartfordndashEast Hartford Conn 256 216 135 114 5126 46 5172

Honolulu Hawaii 54 60 69 76 2121 14 2135

HoustonndashBaytownndashSugar Land Tex 1017 190 1092 197 25821 172 25993

Indianapolis Ind 191 116 150 90 3824 25 3849

Jackson Miss 134 257 117 221 2419 30 2449

Jacksonville Fla 309 248 315 246 6020 75 6095

Kansas City MondashKans 183 94 160 81 4669 15 4684

Knoxville Tenn 47 72 35 52 882 5 887

Lakeland Fla 103 190 112 199 1811 21 1832

Las VegasndashParadise Nev 245 143 258 145 4616 28 4644

Little RockndashNorth Little Rock Ark 87 135 75 115 1383 14 1397

Los Angeles Calif 1529 118 1684 130 57953 293 58246

Los Angeles Division 1339 135 1435 144 51098 250 51348

Santa Anna Division 190 63 249 83 6855 43 6898

Louisville KyndashInd 123 102 97 79 2286 22 2308

Madison Wis 10 19 29 53 520 4 524

McAllenndashEdinburgndashPharr Tex 57 84 45 64 630 11 641

Memphis TennndashMissndashArk 402 320 346 271 5128 19 5147

Miami Fla 2420 446 2289 419 55807 997 56804

Fort Lauderdale Division 810 455 769 430 16412 262 16674

Miami Division 1243 523 1165 485 29703 512 30215

West Palm Beach Division 367 290 355 279 9692 223 9915

MilwaukeendashWaukeshandashWest Allis Wis 68 45 109 72 2507 18 2525

MinneapolisndashSt PaulndashBloomington MinnndashWis 186 59 184 58 4259 22 4281

Modesto Calif 36 71 22 43 671 6 677

NashvillendashDavidsonndashMurfreesboro Tenn 224 158 172 118 3848 20 3868

New HavenndashMilford Conn 169 200 107 127 4573 73 4646

New OrleansndashMetairiendashKenner La 393 299 271 264 8835 67 8902

32 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

New York NYndashNJndashPa 6215 330 5500 292 195177 2906 198083

Edison Division 191 83 130 56 6709 139 6848

Nassau Division 262 93 246 88 8141 110 8251

New York Division 5266 456 4716 408 160408 2323 162731

Newark Division 496 231 408 190 19919 334 20253

Oklahoma City Okla 125 108 88 75 2255 5 2260

OmahandashCouncil Bluffs NebndashIowa 37 46 80 97 1035 3 1038

Orlando Fla 544 282 517 260 8653 92 8745

OxnardndashThousand OaksndashVentura Calif 49 62 21 26 1008 3 1011

Palm BayndashMelbournendashTitusville Fla 68 129 61 114 1512 11 1523

Philadelphia PandashNJndashDelndashMd 1261 217 1348 231 28221 313 28534

Camden Division 108 87 111 89 3118 42 3160

Philadelphia Division 1022 263 1144 294 22112 250 22362

Wilmington Division 131 191 93 134 2991 21 3012

PhoenixndashMesandashScottsdale Ariz 460 119 376 93 7459 31 7490

Pittsburgh Pa 143 60 135 57 3182 19 3201

PortlandndashSouth Portland Maine 9 18 34 66 562 1 563

PortlandndashVancouverndashBeaverton OrendashWash 170 81 215 101 4825 10 4835

PoughkeepsiendashNewburghndashMiddletown NY 136 204 113 168 3162 24 3186

ProvidencendashNew BedfordndashFall River RIndashMass 132 82 155 96 3900 44 3944

RaleighndashCary NC 138 145 201 202 1987 13 2000

Richmond Va 119 101 122 102 3371 35 3406

RiversidendashSan BernardinondashOntario Calif 361 92 306 76 8568 60 8628

Rochester NY 165 159 124 120 3134 13 3147

SacramentondashArden-ArcadendashRoseville Calif 154 75 169 82 4000 26 4026

St Louis MondashIll 192 69 366 131 5965 40 6005

Salt Lake City Utah 46 44 40 37 1743 10 1753

San Antonio Tex 215 114 247 127 4987 30 5017

San DiegondashCarlsbadndashSan Marcos Calif 491 167 384 131 12934 61 12995

San Francisco Calif 867 209 690 165 40152 96 40248

Oakland Division 312 126 246 99 9546 48 9594

San Francisco Division 555 329 444 261 30606 48 30654

San JosendashSunnyvalendashSanta Clara Calif 88 50 145 81 3747 15 3762

San JuanndashCaguasndashGuaynabo PR 745 289 578 223 21402 277 21679

SarasotandashBradentonndashVenice Fla 82 122 104 152 1978 27 2005

ScrantonndashWilkes-Barre Pa 27 49 47 85 572 6 578

Seattle Wash 353 110 280 86 9172 27 9199

Seattle Division 316 129 255 102 8161 18 8179

Tacoma Division 37 49 25 33 1011 9 1020

Springfield Mass 88 128 45 66 2075 26 2101

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 33

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Stockton Calif 52 78 52 77 1076 15 1091

Syracuse NY 52 80 49 75 1317 8 1325

TampandashSt PetersburgndashClearwater Fla 559 211 605 224 11174 112 11286

Toledo Ohio 25 38 66 101 812 14 826

Tucson Ariz 103 111 100 106 2010 10 2020

Tulsa Okla 83 94 65 72 1494 10 1504

Virginia BeachndashNorfolkndashNewport News VandashNC 183 111 132 80 4711 63 4774

Washington DCndashVandashMdndashWV 1322 252 1684 318 31130 315 31445

Bethesda Division 135 118 173 150 2774 23 2797

Washington Division 1187 289 1511 365 28356 292 28648

Wichita Kans 35 60 38 64 851 2 853

Worcester Mass 76 97 79 101 1783 20 1803

YoungstownndashWarrenndashBoardman OhiondashPa 27 46 26 44 519 0 519

Subtotal for MSAs (population gt500000) 33602 173 31274 159 829633 8171 837804

Metropolitan areas (population of 50000 to 499999) 4477 80 4466 79 94829 847 95676

Nonmetropolitan areas 2666 54 2732 55 52063 445 52508

Totalb 41144 137 38749 128 981708 9494 991202

Note Because of the lack of census information for all US dependent areas includes data for only the 50 states the District of Columbia and Puerto RicoMSA metropolitan statistical areaMSA definitions for this report can be found at httpwwwcensusgovpopulationwwwestimatesmetrodefhtmla Reported case counts for the metropolitan divisions do not sum to the MSA total MSA total includes data from 1 metropolitan division with

population of lt500000b Includes persons whose county of residence is unknown

34 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Alabama (January 1988) 502 6041 48 6089

Alaska (February 1999) 38 285 2 287

Arizona (January 1987) 617 5877 80 5957

Arkansas (July 1989) 206 2349 20 2369

California (April 2006) 6581 7056 92 7148

Colorado (November 1985) 319 6084 31 6115

Connecticut (January 2005)b 826 2500 101 2601

Delaware (February 2006) 788 801 18 819

Florida (July 1997)c 4163 36386 397 36783

Georgia (December 2003) 2245 8197 194 8391

Idaho (June 1986) 35 340 4 344

Illinois (January 2006) 6241 6661 162 6823

Indiana (July 1988) 399 4027 43 4070

Iowa (July 1998) 69 586 5 591

Kansas (July 1999) 142 1225 15 1240

Kentucky (October 2004) 333 1303 13 1316

Louisiana (February 1993) 728 8149 166 8315

Maine (January 2006) 386 393 3 396

Michigan (April 1992) 635 6702 134 6836

Minnesota (October 1985) 309 3356 40 3396

Mississippi (August 1988) 352 4549 59 4608

Missouri (October 1987) 502 5086 55 5141

Nebraska (September 1995) 91 672 14 686

Nevada (February 1992) 339 3532 24 3556

New Hampshire (January 2005) 59 466 9 475

New Jersey (January 1992) 1477 17513 325 17838

New Mexico (January 1998) 114 949 4 953

New York (June 2000) 5326 42345 1820 44165

North Carolina (February 1990) 1615 13879 143 14022

North Dakota (January 1988) 4 82 1 83

Ohio (June 1990) 867 8222 101 8323

Oklahoma (June 1988) 229 2401 30 2431

Oregon (April 2006) 49 95 19 114

Pennsylvania (October 2002)d 4269 9537 179 9716

Rhode Island (July 2006) 14 21 0 21

South Carolina (February 1986) 493 6970 93 7063

South Dakota (January 1988) 18 215 6 221

Tennessee (January 1992) 732 7115 90 7205

Texas (January 1999)e 3370 24282 417 24699

Utah (April 1989) 106 893 14 907

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 35

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Virginia (July 1989) 864 10257 95 10352

Washington (March 2006) 4048 4157 40 4197

West Virginia (January 1989) 66 673 8 681

Wisconsin (November 1985) 261 2500 31 2531

Wyoming (June 1989) 7 93 1 94

Subtotal 50834 274822 5146 279968

US dependent areas

American Samoa (August 2001) 0 1 0 1

Guam (March 2000) 2 66 0 66

Northern Mariana Islands (October 2001) 2 7 0 7

Puerto Rico (January 2003) 1471 5610 91 5701

US Virgin Islands (December 1998) 22 247 6 253

Persons reported from areas with confidential name-based HIV infection reporting but who were residents of other areas 132 685 21 706

Totalf 52878 282640 5314 287954

Note Includes data from 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through 2006b Beginning in 1992 Connecticut had name-based HIV reporting for cases in children only From January 2002 through December 2004

Connecticut had name- or code-based HIV reporting for cases in adolescents and adults As of January 2005 Connecticut has name-based reporting of all cases of HIV infection

c Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterd On October 18 2002 Pennsylvania initiated confidential name-based HIV infection reporting in all areas except Philadelphia Code-based

reporting was implemented in Philadelphia in March 2004 and the switch to name-based reporting was made in October 2005e From February 1994 through December 1998 Texas reported HIV infection in children onlyf Includes 1252 persons reported from areas with confidential name-based HIV infection reporting but whose area of residence is unknown

36 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulativemdashUnited States and dependent areas

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No Adult or adolescentMale-to-male sexual contact 13775 49 429897 54 mdash mdash mdash mdash 13775 35 429897 44Injection drug use 3413 12 163070 21 1826 17 67693 35 5239 13 230763 23Male-to-male sexual contact and

injection drug use 1603 6 65524 8 mdash mdash mdash mdash 1603 4 65524 7Hemophiliacoagulation disorder 43 0 5176 1 11 0 348 0 54 0 5524 1High-risk heterosexual contactc 2997 11 49610 6 4839 46 85186 44 7836 20 134796 14

Sex with injection drug user 330 1 11683 1 706 7 26073 14 1036 3 37756 4Sex with bisexual male mdash mdash mdash mdash 234 2 5162 3 234 1 5162 1Sex with person with hemophilia 1 0 84 0 11 0 502 0 12 0 586 0Sex with HIV-infected transfusion

recipient 22 0 553 0 21 0 793 0 43 0 1346 0Sex with HIV-infected person risk

factor not specified 2644 9 37290 5 3867 37 52656 27 6511 17 89946 9Receipt of blood transfusion blood

d components or tissue 63 0 5213 1 68 1 4176 2 131 0 9389 1Otherrisk factor not reported or

identifiede 6484 23 73136 9 3793 36 34311 18 10278 26 107450 11Subtotal 28378 100 791626 100 10537 100 191714 100 38916 100 983343 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 0 0 222 5 0 0 7 0 0 0 229 2Mother with documented HIV infection or

1 of the following risk factors 24 75 4315 89 50 93 4423 95 74 86 8738 92Injection drug use 4 13 1676 35 4 7 1665 36 8 9 3341 35Sex with injection drug user 4 13 789 16 4 7 750 16 8 9 1539 16Sex with bisexual male 1 3 101 2 2 4 110 2 3 3 211 2Sex with person with hemophilia 0 0 20 0 0 0 16 0 0 0 36 0Sex with HIV-infected transfusion

recipient 0 0 11 0 0 0 15 0 0 0 26 0Sex with HIV-infected person risk

factor not specified 6 19 742 15 17 31 790 17 23 27 1532 16Receipt of blood transfusion blood

components or tissue 0 0 70 1 0 0 82 2 0 0 152 2Has HIV infection risk factor not

specified 9 28 906 19 23 43 995 21 32 37 1901 20Receipt of blood transfusion blood

fcomponents or tissue 1 3 243 5 0 0 144 3 1 1 387 4Otherrisk factor not reported or

identifiedg 7 22 75 2 4 7 93 2 11 13 168 2Subtotal 32 100 4855 100 54 100 4667 100 86 100 9522 100

Total 28410 100 796481 100 10591 100 196381 100 39002 100 992865 100a From the beginning of the epidemic through 2006b From the beginning of the epidemic through 2006 Includes 3 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infectiond AIDS developed in 47 adultsadolescents after they received blood that had tested negative for HIV antibodies AIDS developed in 14 additional adults

after they received tissue organs or artificial insemination from HIV-infected donors Four of the 14 received tissue or organs from a donor who was negative for HIV antibody at the time of donation

e Includes 37 adultsadolescents who were exposed to HIV-infected blood body fluids or concentrated virus in health care laboratory or household settings as supported by seroconversion epidemiologic andor laboratory evidence One person was infected after intentional inoculation with HIV-infected blood Includes an additional 740 persons who acquired HIV infection perinatally but who were more than 12 years of age when AIDS was diagnosed These 740 persons are not counted in the values for the pediatric transmission category

f AIDS developed in 3 children after they received blood that had tested negative for HIV antibodiesg Includes 5 children who were exposed to HIV-infected blood as supported by seroconversion epidemiologic andor laboratory evidence 1 child was

infected after intentional inoculation with HIV-infected blood and 5 children were exposed to HIV-infected blood in a household setting Of the 168 children 26 had sexual contact with an adult with or at high risk for HIV infection

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 37

Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No

Adult or adolescentMale-to-male sexual contact 22912 59 103679 52 mdash mdash mdash mdash 22912 44 103679 37

Injection drug use 3503 9 24255 12 2124 16 13925 17 5627 11 38181 14

Male-to-male sexual contact and injection drug use 1946 5 10704 5 mdash mdash mdash mdash 1946 4 10704 4

Hemophiliacoagulation disorder 43 0 495 0 6 0 73 0 49 0 568 0

High-risk heterosexual contactc 2874 7 16830 8 5939 45 38315 47 8813 17 55145 20

Sex with injection drug user 308 1 2601 1 757 6 6791 8 1065 2 9392 3

Sex with bisexual male mdash mdash mdash mdash 328 2 2265 3 328 1 2265 1

Sex with person with hemophilia 4 0 31 0 16 0 201 0 20 0 232 0

Sex with HIV-infected transfusion recipient 13 0 131 0 28 0 223 0 41 0 354 0

Sex with HIV-infected person risk factor not specified 2549 7 14067 7 4810 36 28835 35 7359 14 42902 15

Receipt of blood transfusion blood components or tissue 61 0 489 0 50 0 536 1 111 0 1025 0

Otherrisk factor not reported or identified 7748 20 44021 22 5106 39 29312 36 12854 25 73338 26

Subtotal 39087 100 200473 100 13225 100 82161 100 52312 100 282640 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 8 3 106 4 0 0 1 0 8 1 107 2

Mother with documented HIV infection or 1 of the following risk factors 197 74 2195 85 254 85 2417 89 451 80 4612 87

Injection drug use 34 13 532 21 53 18 561 21 87 15 1093 21

Sex with injection drug user 12 5 208 8 21 7 213 8 33 6 421 8

Sex with bisexual male 5 2 37 1 4 1 32 1 9 2 69 1

Sex with person with hemophilia 0 0 3 0 1 0 7 0 1 0 10 0

Sex with HIV-infected transfusion recipient 0 0 4 0 0 0 4 0 0 0 8 0

Sex with HIV-infected person risk factor not specified 54 20 534 21 76 25 629 23 130 23 1163 22

Receipt of blood transfusion blood components or tissue 0 0 17 1 2 1 20 1 2 0 37 1

Has HIV infection risk factor not specified 92 35 860 33 97 32 951 35 189 33 1811 34

Receipt of blood transfusion blood components or tissue 6 2 28 1 3 1 24 1 9 2 52 1

Otherrisk factor not reported or identified 55 21 260 10 43 14 283 10 98 17 543 10

Subtotal 266 100 2589 100 300 100 2725 100 566 100 5314 100

Total 39353 100 203062 100 13525 100 84886 100 52878 100 287954 100

Note See Table 16 for the list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006b From the beginning of the epidemic through December 2006 Includes 6 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infection

38 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity

2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 6251 65 253927 73Injection drug use 733 8 31737 9Male-to-male sexual contact and injection drug use 732 8 31434 9Hemophiliacoagulation disorder 26 0 3989 1High-risk heterosexual contactb 416 4 7850 2

Sex with injection drug user 74 1 2310 1

Sex with person with hemophilia 0 0 36 0

Sex with HIV-infected transfusion recipient 2 0 176 0

Sex with HIV-infected person risk factor not specified 340 4 5328 2Receipt of blood transfusion blood components or tissue 20 0 3194 1Otherrisk factor not reported or identified 1400 15 16469 5

Total 9578 100 348600 100

Black not HispanicMale-to-male sexual contact 4309 36 103297 37Injection drug use 1635 14 83369 30Male-to-male sexual contact and injection drug use 526 4 22134 8Hemophiliacoagulation disorder 10 0 604 0High-risk heterosexual contactb 1875 16 29952 11

Sex with injection drug user 167 1 6823 2Sex with person with hemophilia 1 0 36 0Sex with HIV-infected transfusion recipient 15 0 237 0Sex with HIV-infected person risk factor not specified 1692 14 22856 8

Receipt of blood transfusion blood components or tissue 24 0 1218 0Otherrisk factor not reported or identified 3579 30 40268 14

Total 11958 100 280842 100

HispanicMale-to-male sexual contact 2816 47 64893 44Injection drug use 965 16 46337 31Male-to-male sexual contact and injection drug use 287 5 10884 7Hemophiliacoagulation disorder 6 0 466 0High-risk heterosexual contactb 638 11 10950 7

Sex with injection drug user 84 1 2409 2Sex with person with hemophilia 0 0 11 0Sex with HIV-infected transfusion recipient 5 0 125 0Sex with HIV-infected person risk factor not specified 549 9 8405 6

Receipt of blood transfusion blood components or tissue 17 0 657 0Otherrisk factor not reported or identified 1326 22 14832 10

Total 6055 100 149019 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 39

a

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulative

No No

AsianPacific IslanderMale-to-male sexual contact 225 54 4475 68Injection drug use 20 5 317 5Male-to-male sexual contact and injection drug use 17 4 284 4Hemophiliacoagulation disorder 1 0 70 1High-risk heterosexual contactb 34 8 376 6

Sex with injection drug user 1 0 54 1Sex with person with hemophilia 0 0 1 0Sex with HIV-infected transfusion recipient 0 0 8 0Sex with HIV-infected person risk factor not specified 33 8 313 5

Receipt of blood transfusion blood components or tissue 2 0 112 2Otherrisk factor not reported or identified 114 28 949 14

Total 413 100 6583 100

American IndianAlaska NativeMale-to-male sexual contact 61 49 1403 55Injection drug use 15 12 395 15Male-to-male sexual contact and injection drug use 23 19 457 18Hemophiliacoagulation disorder 0 0 27 1High-risk heterosexual contactb 9 7 118 5

Sex with injection drug user 1 1 33 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 8 6 82 3

Receipt of blood transfusion blood components or tissue 0 0 8 0Otherrisk factor not reported or identified 16 13 155 6

Total 124 100 2563 100

Total casesMale-to-male sexual contact 13775 49 429897 54Injection drug use 3413 12 163070 21Male-to-male sexual contact and injection drug use 1603 6 65524 8Hemophiliacoagulation disorder 43 0 5176 1High-risk heterosexual contactb 2997 11 49610 6

Sex with injection drug user 330 1 11683 1Sex with person with hemophilia 1 0 84 0Sex with HIV-infected transfusion recipient 22 0 553 0Sex with HIV-infected person risk factor not specified 2644 9 37290 5

Receipt of blood transfusion blood components or tissue 63 0 5213 1Otherrisk factor not reported or identified 6484 23 73136 9

Total 28378c 100 791626d 100a From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 4019 males of unknown race or multiple races

40 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 11963 73 55725 69Injection drug use 858 5 5512 7Male-to-male sexual contact and injection drug use 1092 7 5578 7Hemophiliacoagulation disorder 29 0 355 0High-risk heterosexual contactb 522 3 2658 3

Sex with injection drug user 65 0 544 1Sex with person with hemophilia 0 0 8 0Sex with HIV-infected transfusion recipient 3 0 33 0Sex with HIV-infected person risk factor not specified 454 3 2073 3

Receipt of blood transfusion blood components or tissue 14 0 197 0Otherrisk factor not reported or identified 1956 12 11147 14

Total 16434 100 81172 100

Black not HispanicMale-to-male sexual contact 6203 44 30148 37Injection drug use 1594 11 11997 15Male-to-male sexual contact and injection drug use 483 3 3489 4Hemophiliacoagulation disorder 10 0 109 0High-risk heterosexual contactb 1714 12 10905 13

Sex with injection drug user 169 1 1554 2Sex with person with hemophilia 4 0 17 0Sex with HIV-infected transfusion recipient 6 0 77 0Sex with HIV-infected person risk factor not specified 1535 11 9257 11

Receipt of blood transfusion blood components or tissue 32 0 223 0Otherrisk factor not reported or identified 4151 29 24632 30

Total 14187 100 81503 100

HispanicMale-to-male sexual contact 4094 55 15623 47Injection drug use 993 13 6407 19Male-to-male sexual contact and injection drug use 316 4 1402 4Hemophiliacoagulation disorder 3 0 26 0High-risk heterosexual contactb 582 8 2963 9

Sex with injection drug user 65 1 455 1Sex with person with hemophilia 0 0 6 0Sex with HIV-infected transfusion recipient 4 0 18 0Sex with HIV-infected person risk factor not specified 513 7 2484 7

Receipt of blood transfusion blood components or tissue 11 0 55 0Otherrisk factor not reported or identified 1475 20 6977 21

Total 7474 100 33453 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 41

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderMale-to-male sexual contact 402 70 1006 63Injection drug use 17 3 55 3Male-to-male sexual contact and injection drug use 15 3 38 2Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 25 4 96 6

Sex with injection drug user 3 1 10 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 22 4 83 5

Receipt of blood transfusion blood components or tissue 4 1 7 0Otherrisk factor not reported or identified 109 19 397 25

Total 572 100 1600 100

American IndianAlaska NativeMale-to-male sexual contact 104 61 516 57Injection drug use 13 8 101 11Male-to-male sexual contact and injection drug use 19 11 110 12Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 10 6 53 6

Sex with injection drug user 2 1 14 2Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 8 5 39 4

Receipt of blood transfusion blood components or tissue 0 0 2 0Otherrisk factor not reported or identified 24 14 125 14

Total 170 100 907 100

Total casesMale-to-male sexual contact 22912 59 103679 52Injection drug use 3503 9 24255 12Male-to-male sexual contact and injection drug use 1946 5 10704 5Hemophiliacoagulation disorder 43 0 495 0High-risk heterosexual contactb 2874 7 16830 8

Sex with injection drug user 308 1 2601 1Sex with person with hemophilia 4 0 31 0Sex with HIV-infected transfusion recipient 13 0 131 0Sex with HIV-infected person risk factor not specified 2549 7 14067 7

Receipt of blood transfusion blood components or tissue 61 0 489 0Otherrisk factor not reported or identified 7748 20 44021 22

Total 39087c 100 200473d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 1838 males of unknown race or multiple races

42 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race

ethnicity 2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 482 28 14981 40Hemophiliacoagulation disorder 4 0 123 0High-risk heterosexual contactb 725 42 15799 42

Sex with injection drug user 153 9 5650 15Sex with bisexual male 63 4 1859 5Sex with person with hemophilia 5 0 329 1Sex with HIV-infected transfusion recipient 5 0 338 1Sex with HIV-infected person risk factor not specified 499 29 7623 20

Receipt of blood transfusion blood components or tissue 15 1 1870 5Otherrisk factor not reported or identified 499 29 4801 13

Total 1725 100 37574 100

Black not HispanicInjection drug use 982 15 38914 34Hemophiliacoagulation disorder 3 0 145 0High-risk heterosexual contactb 3103 46 49876 44

Sex with injection drug user 373 6 13530 12Sex with bisexual male 136 2 2352 2Sex with person with hemophilia 4 0 121 0Sex with HIV-infected transfusion recipient 8 0 277 0Sex with HIV-infected person risk factor not specified 2582 38 33596 29

Receipt of blood transfusion blood components or tissue 39 1 1546 1Otherrisk factor not reported or identified 2612 39 23894 21

Total 6739 100 114375 100

HispanicInjection drug use 322 18 12892 35Hemophiliacoagulation disorder 4 0 67 0High-risk heterosexual contactb 894 49 17995 49

Sex with injection drug user 166 9 6522 18Sex with bisexual male 32 2 818 2Sex with person with hemophilia 1 0 45 0Sex with HIV-infected transfusion recipient 7 0 141 0Sex with HIV-infected person risk factor not specified 688 38 10469 29

Receipt of blood transfusion blood components or tissue 12 1 619 2Otherrisk factor not reported or identified 592 32 5023 14

Total 1824 100 36596 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 43

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 8 8 125 12Hemophiliacoagulation disorder 0 0 7 1High-risk heterosexual contactb 49 47 574 53

Sex with injection drug user 4 4 114 11Sex with bisexual male 2 2 80 7Sex with person with hemophilia 0 0 4 0Sex with HIV-infected transfusion recipient 1 1 25 2Sex with HIV-infected person risk factor not specified 42 40 351 33

Receipt of blood transfusion blood components or tissue 1 1 93 9Otherrisk factor not reported or identified 46 44 279 26

Total 104 100 1078 100

American IndianAlaska NativeInjection drug use 13 32 280 42Hemophiliacoagulation disorder 0 0 3 0High-risk heterosexual contactb 15 37 277 41

Sex with injection drug user 4 10 107 16Sex with bisexual male 1 2 27 4Sex with person with hemophilia 0 0 2 0Sex with HIV-infected transfusion recipient 0 0 6 1Sex with HIV-infected person risk factor not specified 10 24 135 20

Receipt of blood transfusion blood components or tissue 1 2 17 3Otherrisk factor not reported or identified 12 29 95 14

Total 41 100 672 100

Total casesInjection drug use 1826 17 67693 35Hemophiliacoagulation disorder 11 0 348 0High-risk heterosexual contactb 4839 46 85186 44

Sex with injection drug user 706 7 26073 14Sex with bisexual male 234 2 5162 3Sex with person with hemophilia 11 0 502 0Sex with HIV-infected transfusion recipient 21 0 793 0Sex with HIV-infected person risk factor not specified 3867 37 52656 27

Receipt of blood transfusion blood components or tissue 68 1 4176 2Otherrisk factor not reported or identified 3793 36 34311 18

Total 10537c 100 191714d 100a From the beginning of the epidemic through 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 104 females of unknown race or multiple racesd Includes 1419 females of unknown race or multiple races

44 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 690 26 4260 26Hemophiliacoagulation disorder 3 0 24 0

bHigh-risk heterosexual contact 1132 42 7593 46Sex with injection drug user 205 8 1876 11Sex with bisexual male 98 4 659 4Sex with person with hemophilia 10 0 115 1Sex with HIV-infected transfusion recipient 7 0 64 0Sex with HIV-infected person risk factor not specified 812 30 4879 29

Receipt of blood transfusion blood components or tissue 12 0 146 1Otherrisk factor not reported or identified 850 32 4567 28

Total 2687 100 16590 100

Black not HispanicInjection drug use 1034 13 7105 14Hemophiliacoagulation disorder 1 0 35 0

bHigh-risk heterosexual contact 3451 44 23732 46Sex with injection drug user 313 4 3473 7Sex with bisexual male 155 2 1294 3Sex with person with hemophilia 5 0 71 0Sex with HIV-infected transfusion recipient 14 0 120 0Sex with HIV-infected person risk factor not specified 2964 38 18774 36

Receipt of blood transfusion blood components or tissue 26 0 324 1Otherrisk factor not reported or identified 3370 43 20244 39

Total 7882 100 51440 100

HispanicInjection drug use 339 15 2280 18Hemophiliacoagulation disorder 2 0 11 0

bHigh-risk heterosexual contact 1198 52 6264 50Sex with injection drug user 218 9 1324 11Sex with bisexual male 62 3 266 2Sex with person with hemophilia 1 0 11 0Sex with HIV-infected transfusion recipient 7 0 39 0Sex with HIV-infected person risk factor not specified 910 39 4624 37

Receipt of blood transfusion blood components or tissue 12 1 58 0Otherrisk factor not reported or identified 767 33 3843 31

Total 2318 100 12456 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 45

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 20: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission categorymdash33 states with confidential name-based HIV infection reporting

Transmission category

White not Hispanic

Black not Hispanic Hispanic

AsianPacific Islander

American IndianAlaska

Native Totala

No No No No No No

Male adult or adolescentMale-to-male sexual contact 108259 77 70242 49 36043 57 1669 68 938 62 218676 62Injection drug use 12328 9 31339 22 14472 23 264 11 216 14 59077 17Male-to-male sexual contact

and injection drug use 11283 8 9587 7 3720 6 93 4 205 13 25085 7High-risk heterosexual contactb 6667 5 31140 22 8788 14 395 16 143 9 47562 13Otherc 1458 1 1492 1 404 1 30 1 17 1 3424 1Subtotal 139994 100 143799 100 63427 100 2450 100 1519 100 353825 100

Female adult or adolescentInjection drug use 8262 33 19136 23 5528 28 106 15 175 30 33470 26High-risk heterosexual contactb 16338 65 63204 75 14132 71 573 82 392 68 95403 73Otherc 450 2 1469 2 344 2 24 3 12 2 2321 2Subtotal 25050 100 83809 100 20004 100 703 100 578 100 131195 100

Child (lt13 yrs at diagnosis)Perinatal 801 84 4064 93 1183 92 28 82 20 95 6143 92Otherd 154 16 283 7 107 8 6 18 1 5 560 8Subtotal 955 100 4347 100 1290 100 34 100 21 100 6703 100

Totale 166000 231957 84720 3187 2119 491727Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportingData include persons with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSSee Technical Notes for the list of 33 states that have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003a Includes 3745 persons of unknown race or multiple racesb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes 5 persons of unknown sex Because column totals were calculated independently of the values for the subpopulations the values

in each column may not sum to the column total

20 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Map 1 Estimated rates (per 100000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

Note Rates adjusted for reporting delays Rates of HIV infection include only persons living with HIV infection that has not progressed to AIDSSince 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 Islandsa Includes persons whose area of residence is unknown

Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

Note Rates adjusted for reporting delays Rates of HIV infection include only persons living with HIV infection that has not progressed to AIDSSince 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 Islandsa Includes persons whose area of residence is unknown

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 21

Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002ndash2006mdashUnited States and dependent areas

2002 2003 2004 2005 2006Data for 50 states and the District of Columbia

Age at end of year (yrs)lt13 2308 2006 1684 1394 111513ndash14 685 747 784 762 71115ndash19 1465 1694 1974 2243 248720ndash24 3910 4292 4629 5033 536725ndash29 12725 12743 13045 13505 1435930ndash34 35558 33870 32057 29949 2882435ndash39 70107 68106 65076 62235 5964940ndash44 80377 86294 91335 94021 9517445ndash49 64702 71276 77417 84153 9077550ndash54 41270 46855 53333 59256 6647655ndash59 20113 24145 28356 33522 3901460ndash64 9681 11293 13305 15380 18072gt65 7520 8946 10604 12430 14669

RaceethnicityWhite not Hispanic 129426 135278 141508 147426 154495Black not Hispanic 150488 161326 171654 181056 191590Hispanic 63424 67895 72024 76334 80815AsianPacific Islander 3060 3426 3759 4121 4526American IndianAlaska Native 1254 1356 1458 1562 1651

Transmission categoryMale adult or adolescentMale-to-male sexual contact 158092 168233 178551 188622 199693Injection drug use 56708 58436 59940 61229 62998Male-to-male sexual contact and injection drug use 24726 25457 26144 26785 27523High-risk heterosexual contacta 27329 30300 33181 35916 39004Otherb 3588 3665 3769 3888 4026Subtotal 270444 286091 301585 316440 333244

Female adult or adolescentInjection drug use 27863 28874 29828 30646 31575High-risk heterosexual contacta 46445 51489 56229 60693 65631Otherb 1903 2033 2178 2315 2465Subtotal 76210 82395 88236 93653 99671

Child (lt13 yrs at diagnosis)Perinatal 3633 3654 3651 3664 3660Otherc 129 124 123 122 115Subtotal 3762 3778 3774 3786 3775

Region of residenceNortheast 105599 110929 115562 120208 125620Midwest 36011 38571 41178 44171 47010South 137081 147284 157975 166962 177591West 71729 75483 78883 82540 86473

Subtotal for 50 states and the District of Columbia 350419 372267 393598 413882 436693

Data for US dependent areas 9880 10365 10713 11106 11359

Totald 360617 383024 404849 425646 448871Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

22 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission categorymdash50 states and the District of Columbia

Transmission category

White not Hispanic

Black not Hispanic Hispanic

AsianPacific Islander

American IndianAlaska

Native Totala

No No No No No No

Male adult or adolescentMale-to-male sexual contact 101299 75 57520 45 36087 57 2715 72 704 57 199693 60Injection drug use 13168 10 33911 27 14795 23 325 9 201 16 62998 19Male-to-male sexual contact and

injection drug use 12393 9 10121 8 4352 7 198 5 220 18 27523 8High-risk heterosexual contactb 6081 5 24205 19 7816 12 444 12 105 8 39004 12Otherc 1743 1 1602 1 574 1 69 2 16 1 4026 1Subtotal 134683 100 127359 100 63623 100 3752 100 1246 100 333244 100

Female adult or adolescentInjection drug use 7407 38 18531 30 5025 30 115 15 153 39 31575 32High-risk heterosexual contactb 11350 59 41741 68 11092 67 588 78 227 58 65631 66Otherc 508 3 1456 2 413 2 51 7 13 3 2465 2Subtotal 19264 100 61728 100 16531 100 753 100 393 100 99671 100

Child (lt13 yrs at diagnosis)Perinatal 500 92 2468 99 629 95 20 94 12 100 3660 97Otherd 46 8 34 1 33 5 1 6 0 0 115 3Subtotal 546 100 2503 100 662 100 21 100 12 100 3775 100

Totale 154495 191590 80815 4526 1651 436693

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Includes 3616 persons of unknown race or multiple racesb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes 3 person of unknown sex Because column totals were calculated independently of the values for the subpopulations the values in each column

may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 23

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by

area of residence and age categorymdashUnited States and dependent areas

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

Alabama 5469 17 5486 3744 11 3755Alaska 272 1 273 330 1 331Arizona 5744 49 5793 4922 7 4929Arkansas 2291 7 2298 2139 6 2145California mdash mdash mdash 61451 105 61555Colorado 5855 13 5869 4083 2 4085Connecticut mdash mdash mdash 7406 15 7421Delaware mdash mdash mdash 1753 7 1760District of Columbia mdash mdash mdash 10059 30 10089Floridab 35461 263 35723 46469 194 46663Georgia mdash mdash mdash 17336 47 17383Hawaii mdash mdash mdash 1234 3 1237Idaho 356 0 356 313 0 313Illinois mdash mdash mdash 16139 46 16185Indiana 3849 21 3870 3996 14 4010Iowa 588 2 590 869 3 872Kansas 1230 7 1237 1272 2 1274Kentucky mdash mdash mdash 2589 13 2602Louisiana 7361 101 7462 8052 21 8074Maine mdash mdash mdash 512 2 514Maryland mdash mdash mdash 14540 41 14581Massachusetts mdash mdash mdash 8806 20 8826Michigan 6118 55 6173 6615 12 6627Minnesota 3227 21 3248 2314 9 2323Mississippi 4200 32 4232 3155 13 3168Missouri 4999 33 5033 5479 7 5486Montana mdash mdash mdash 205 0 205Nebraska 688 12 700 771 2 773Nevada 3402 13 3415 2969 3 2972New Hampshire mdash mdash mdash 556 3 559New Jersey 16059 153 16212 17168 57 17226New Mexico 910 0 909 1252 3 1255New York 42220 801 43021 70697 148 70845North Carolina 11700 60 11760 8451 12 8463North Dakota 87 2 89 73 1 74Ohio 8266 57 8323 7054 30 7084Oklahoma 2191 17 2208 2191 3 2194Oregon mdash mdash mdash 2840 4 2844Pennsylvania mdash mdash mdash 18633 71 18703Rhode Island mdash mdash mdash 1296 7 1303South Carolina 6349 45 6394 7035 23 7058South Dakota 195 4 199 139 1 140Tennessee 6579 51 6631 6403 11 6414Texas 24741 262 25003 34010 53 34063Utah 893 10 903 1164 0 1164Vermont mdash mdash mdash 238 2 240Virginia 9937 41 9978 8423 24 8447Washington mdash mdash mdash 5471 5 5476West Virginia 660 5 665 749 5 754Wisconsin 2322 15 2337 2153 12 2165Wyoming 86 2 88 102 1 103

Subtotal 224303 2174 226477 435621 1115 436736

24 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age categorymdashUnited States and dependent areas (cont)

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

US dependent areasAmerican Samoa 2 0 2 1 0 1Guam 63 0 63 36 0 36Northern Mariana Islands 7 0 7 3 0 3Puerto Rico 6269 31 6300 10971 26 10997US Virgin Islands 228 2 230 312 2 314Otherc mdash mdash mdash 1 0 1

Totald 230872 2207 233079 447724 1147 448871

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reporting a See Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at

least 2003b Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterc Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasd Total number of persons living with HIV infection (not AIDS) includes persons reported from areas with confidential name-based HIV

infection reporting who were residents of other states or whose area of residence is unknown Total number of persons living with AIDS includes persons whose area of residence is unknown Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 25

Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristicsmdashUnited States and dependent areas

No of persons

Survival in months

gt12 gt24 gt36Data for 50 states and the District of Columbia

Age at diagnosis (yrs)lt13 101 096 094 09413ndash14 60 098 098 09515ndash19 305 098 096 09520ndash24 1351 096 093 09225ndash29 3034 095 092 09130ndash34 5499 094 091 08935ndash39 7888 093 090 08740ndash44 7085 092 088 08545ndash49 5090 089 085 08250ndash54 3067 086 081 07855ndash59 1505 083 078 07460ndash64 806 080 073 069gt65 614 073 068 065

RaceethnicityWhite not Hispanic 10706 092 089 087Black not Hispanic 18406 090 086 082Hispanic 6398 092 090 088AsianPacific Islander 404 094 092 090American IndianAlaska Native 167 084 081 075

Transmission categoryMale adult or adolescentMale-to-male sexual contact 12830 093 090 088Injection drug use 4048 089 084 081Male-to-male sexual contact and injection drug use 1701 093 089 086High-risk heterosexual contacta 3170 091 088 085Otherb 5019 086 083 080Subtotal 26768 091 088 085

Female adult or adolescentInjection drug use 2101 089 083 078High-risk heterosexual contacta 4686 093 089 086Otherb 2749 090 085 083Subtotal 9536 091 087 083

Child (lt13 yrs at diagnosis)Perinatal 98 096 095 095Otherc 3 100 067 067Subtotal 101 096 094 094

Subtotal for 50 states and the District of Columbia 36405 091 087 085

Data for US dependent areas 891 083 078 075

Total 37352d 091 087 084Note Excludes persons whose date of death was before or in the same month as date of diagnosis Excludes persons whose month of diagnosis or month of death is unknowna Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes 325 persons of unknown race or multiple races

26 Survival after AIDS Diagnosis

Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by year of diagnosismdashUnited States and dependent areas

Months after AIDS diagnosis

Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by age groupmdashUnited States and dependent areas

Months after AIDS diagnosis

Survival after AIDS Diagnosis 27

Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by raceethnicitymdashUnited States and dependent areas

Months after AIDS diagnosis

28 Survival after AIDS Diagnosis

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006

and cumulativemdashUnited States and dependent areas

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Alabama 510 112 462 100 8626 76 8702Alaska 24 36 38 57 648 7 655Arizona 626 105 539 87 10396 46 10442Arkansas 237 85 252 90 3891 36 3927California 4069 113 3960 109 142254 664 142918Colorado 351 75 322 68 8742 31 8773Connecticut 658 188 422 120 14716 183 14899Delaware 177 210 116 136 3547 26 3573District of Columbia 672 1155 853 1467 17372 189 17561Florida 4921 277 4932 273 104084 1530 105614Georgia 2325 255 1605 171 31734 231 31965Hawaii 105 82 93 72 2927 17 2944Idaho 24 17 26 18 604 2 606Illinois 1886 148 1382 108 33620 282 33902Indiana 407 65 346 55 8239 56 8295Iowa 93 31 86 29 1727 13 1740Kansas 105 38 120 43 2781 14 2795Kentucky 249 60 207 49 4600 32 4632Louisiana 936 208 824 192 17612 128 17740Maine 21 16 68 51 1110 8 1118Maryland 1558 279 1626 290 30252 319 30571Massachusetts 666 104 533 83 19181 214 19395Michigan 821 81 672 67 14941 113 15054Minnesota 226 44 212 41 4817 28 4845Mississippi 368 127 365 125 6642 56 6698Missouri 385 66 469 80 11016 61 11077Montana 21 22 7 07 373 3 376Nebraska 53 30 118 67 1479 11 1490Nevada 293 121 294 118 5733 29 5762New Hampshire 33 25 55 42 1074 10 1084New Jersey 1262 145 1065 122 48750 778 49528New Mexico 134 70 93 48 2603 7 2610New York 6201 321 5495 285 174908 2354 177262North Carolina 916 106 1229 139 15954 118 16072North Dakota 10 16 6 09 144 1 145Ohio 753 66 767 67 14957 138 15095Oklahoma 281 79 205 57 4836 26 4862Oregon 217 60 281 76 5995 20 6015Pennsylvania 1486 120 1893 152 33417 365 33782Rhode Island 87 81 111 104 2580 28 2608South Carolina 682 161 705 163 13301 105 13406South Dakota 18 23 18 23 255 5 260Tennessee 818 137 680 113 12457 59 12516Texas 3045 133 2998 128 69735 392 70127Utah 63 25 57 22 2295 20 2315Vermont 5 08 18 29 461 6 467Virginia 638 84 605 79 16802 177 16979Washington 485 77 389 61 11792 34 11826West Virginia 74 41 67 37 1500 11 1511Wisconsin 122 22 217 39 4513 33 4546Wyoming 6 12 8 16 228 2 230

Subtotal 40123 135 37911 127 952221 9094 961315

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 29

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulativemdashUnited States and dependent areas (cont)

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

US dependent areasAmerican Samoa 0 0 0 0 1 0 1Guam 0 0 0 0 68 1 69Northern Mariana Islands 0 0 0 0 3 0 3Puerto Rico 1029 263 850 216 29511 400 29911US Virgin Islands 17 156 32 295 629 18 647Otherb 0 0 0 0 3 0 3

Totalc 41357 138 39002 129 983343 9522 992865d

a From the beginning of the epidemic through 2006b Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasc Includes persons whose state or area of residence is unknownd Includes 916 persons whose state or area of residence is unknown

30 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

MSA (population gt 500000)

Akron Ohio 66 94 32 46 762 1 763

AlbanyndashSchenectadyndashTroy NY 97 114 105 123 2253 24 2277

Albuquerque N Mex 70 88 50 61 1404 2 1406

AllentownndashBethlehemndashEaston PandashNJ 72 91 119 149 1352 17 1369

AtlantandashSandy SpringsndashMarietta Ga 1586 319 1006 196 21896 128 22024

AugustandashRichmond County GandashSC 106 205 32 61 1851 24 1875

AustinndashRound Rock Tex 227 156 186 123 4830 26 4856

Bakersfield Calif 76 100 122 156 1528 8 1536

BaltimorendashTowson Md 1064 401 1001 377 20352 218 20570

Baton Rouge La 222 304 231 301 3732 20 3752

BirminghamndashHoover Ala 151 139 110 100 2614 25 2639

Boise CityndashNampa Idaho 14 26 14 25 281 0 281

Boston MassndashNHa 441 99 355 80 13476 147 13623

Boston Division 269 146 185 101 8451 91 8542

Cambridge Division 108 74 102 70 3126 35 3161

Essex Division 52 71 51 69 1577 20 1597

BridgeportndashStamfordndashNorwalk Conn 181 201 135 150 3733 57 3790

BuffalondashNiagara Falls NY 117 102 96 84 2476 20 2496

Cape CoralndashFort Myers Fla 44 81 91 159 1692 24 1716

CharlestonndashNorth Charleston SC 92 155 91 151 2034 18 2052

CharlottendashGastoniandashConcord NCndashSC 214 141 285 180 3242 22 3264

Chicago IllndashIndndashWis 1716 182 1159 122 30118 261 30379

Chicago Division 1604 203 1073 135 28300 248 28548

Gary Division 61 88 50 71 1038 8 1046

Lake Division 51 59 36 41 780 5 785

CincinnatindashMiddletown OhiondashKyndashInd 111 53 199 95 2735 17 2752

ClevelandndashElyriandashMentor Ohio 228 107 170 80 4226 48 4274

Colorado Springs Colo 19 32 21 35 576 5 581

Columbia SC 177 256 197 280 3274 24 3298

Columbus Ohio 166 97 165 96 3112 15 3127

Dallas Tex 874 150 929 155 20238 63 20301

Dallas Division 681 175 714 178 16038 37 16075

Fort Worth Division 193 100 215 108 4200 26 4226

Dayton Ohio 58 69 54 64 1217 15 1232

DenverndashAurora Colo 274 116 236 98 6899 22 6921

Des Moines Iowa 30 57 23 43 530 4 534

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 31

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Detroit Mich 570 127 445 100 10373 73 10446

Detroit Division 443 223 330 167 8268 57 8325

Warren Division 127 51 115 46 2105 16 2121

El Paso Tex 56 78 40 54 1476 10 1486

Fresno Calif 52 59 64 72 1430 11 1441

Grand RapidsndashWyoming Mich 46 60 51 66 816 6 822

GreensborondashHigh Point NC 52 77 66 96 1265 14 1279

Greenville SC 70 119 67 111 1292 4 1296

HarrisburgndashCarlisle Pa 23 44 67 128 1224 8 1232

HartfordndashWest HartfordndashEast Hartford Conn 256 216 135 114 5126 46 5172

Honolulu Hawaii 54 60 69 76 2121 14 2135

HoustonndashBaytownndashSugar Land Tex 1017 190 1092 197 25821 172 25993

Indianapolis Ind 191 116 150 90 3824 25 3849

Jackson Miss 134 257 117 221 2419 30 2449

Jacksonville Fla 309 248 315 246 6020 75 6095

Kansas City MondashKans 183 94 160 81 4669 15 4684

Knoxville Tenn 47 72 35 52 882 5 887

Lakeland Fla 103 190 112 199 1811 21 1832

Las VegasndashParadise Nev 245 143 258 145 4616 28 4644

Little RockndashNorth Little Rock Ark 87 135 75 115 1383 14 1397

Los Angeles Calif 1529 118 1684 130 57953 293 58246

Los Angeles Division 1339 135 1435 144 51098 250 51348

Santa Anna Division 190 63 249 83 6855 43 6898

Louisville KyndashInd 123 102 97 79 2286 22 2308

Madison Wis 10 19 29 53 520 4 524

McAllenndashEdinburgndashPharr Tex 57 84 45 64 630 11 641

Memphis TennndashMissndashArk 402 320 346 271 5128 19 5147

Miami Fla 2420 446 2289 419 55807 997 56804

Fort Lauderdale Division 810 455 769 430 16412 262 16674

Miami Division 1243 523 1165 485 29703 512 30215

West Palm Beach Division 367 290 355 279 9692 223 9915

MilwaukeendashWaukeshandashWest Allis Wis 68 45 109 72 2507 18 2525

MinneapolisndashSt PaulndashBloomington MinnndashWis 186 59 184 58 4259 22 4281

Modesto Calif 36 71 22 43 671 6 677

NashvillendashDavidsonndashMurfreesboro Tenn 224 158 172 118 3848 20 3868

New HavenndashMilford Conn 169 200 107 127 4573 73 4646

New OrleansndashMetairiendashKenner La 393 299 271 264 8835 67 8902

32 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

New York NYndashNJndashPa 6215 330 5500 292 195177 2906 198083

Edison Division 191 83 130 56 6709 139 6848

Nassau Division 262 93 246 88 8141 110 8251

New York Division 5266 456 4716 408 160408 2323 162731

Newark Division 496 231 408 190 19919 334 20253

Oklahoma City Okla 125 108 88 75 2255 5 2260

OmahandashCouncil Bluffs NebndashIowa 37 46 80 97 1035 3 1038

Orlando Fla 544 282 517 260 8653 92 8745

OxnardndashThousand OaksndashVentura Calif 49 62 21 26 1008 3 1011

Palm BayndashMelbournendashTitusville Fla 68 129 61 114 1512 11 1523

Philadelphia PandashNJndashDelndashMd 1261 217 1348 231 28221 313 28534

Camden Division 108 87 111 89 3118 42 3160

Philadelphia Division 1022 263 1144 294 22112 250 22362

Wilmington Division 131 191 93 134 2991 21 3012

PhoenixndashMesandashScottsdale Ariz 460 119 376 93 7459 31 7490

Pittsburgh Pa 143 60 135 57 3182 19 3201

PortlandndashSouth Portland Maine 9 18 34 66 562 1 563

PortlandndashVancouverndashBeaverton OrendashWash 170 81 215 101 4825 10 4835

PoughkeepsiendashNewburghndashMiddletown NY 136 204 113 168 3162 24 3186

ProvidencendashNew BedfordndashFall River RIndashMass 132 82 155 96 3900 44 3944

RaleighndashCary NC 138 145 201 202 1987 13 2000

Richmond Va 119 101 122 102 3371 35 3406

RiversidendashSan BernardinondashOntario Calif 361 92 306 76 8568 60 8628

Rochester NY 165 159 124 120 3134 13 3147

SacramentondashArden-ArcadendashRoseville Calif 154 75 169 82 4000 26 4026

St Louis MondashIll 192 69 366 131 5965 40 6005

Salt Lake City Utah 46 44 40 37 1743 10 1753

San Antonio Tex 215 114 247 127 4987 30 5017

San DiegondashCarlsbadndashSan Marcos Calif 491 167 384 131 12934 61 12995

San Francisco Calif 867 209 690 165 40152 96 40248

Oakland Division 312 126 246 99 9546 48 9594

San Francisco Division 555 329 444 261 30606 48 30654

San JosendashSunnyvalendashSanta Clara Calif 88 50 145 81 3747 15 3762

San JuanndashCaguasndashGuaynabo PR 745 289 578 223 21402 277 21679

SarasotandashBradentonndashVenice Fla 82 122 104 152 1978 27 2005

ScrantonndashWilkes-Barre Pa 27 49 47 85 572 6 578

Seattle Wash 353 110 280 86 9172 27 9199

Seattle Division 316 129 255 102 8161 18 8179

Tacoma Division 37 49 25 33 1011 9 1020

Springfield Mass 88 128 45 66 2075 26 2101

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 33

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Stockton Calif 52 78 52 77 1076 15 1091

Syracuse NY 52 80 49 75 1317 8 1325

TampandashSt PetersburgndashClearwater Fla 559 211 605 224 11174 112 11286

Toledo Ohio 25 38 66 101 812 14 826

Tucson Ariz 103 111 100 106 2010 10 2020

Tulsa Okla 83 94 65 72 1494 10 1504

Virginia BeachndashNorfolkndashNewport News VandashNC 183 111 132 80 4711 63 4774

Washington DCndashVandashMdndashWV 1322 252 1684 318 31130 315 31445

Bethesda Division 135 118 173 150 2774 23 2797

Washington Division 1187 289 1511 365 28356 292 28648

Wichita Kans 35 60 38 64 851 2 853

Worcester Mass 76 97 79 101 1783 20 1803

YoungstownndashWarrenndashBoardman OhiondashPa 27 46 26 44 519 0 519

Subtotal for MSAs (population gt500000) 33602 173 31274 159 829633 8171 837804

Metropolitan areas (population of 50000 to 499999) 4477 80 4466 79 94829 847 95676

Nonmetropolitan areas 2666 54 2732 55 52063 445 52508

Totalb 41144 137 38749 128 981708 9494 991202

Note Because of the lack of census information for all US dependent areas includes data for only the 50 states the District of Columbia and Puerto RicoMSA metropolitan statistical areaMSA definitions for this report can be found at httpwwwcensusgovpopulationwwwestimatesmetrodefhtmla Reported case counts for the metropolitan divisions do not sum to the MSA total MSA total includes data from 1 metropolitan division with

population of lt500000b Includes persons whose county of residence is unknown

34 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Alabama (January 1988) 502 6041 48 6089

Alaska (February 1999) 38 285 2 287

Arizona (January 1987) 617 5877 80 5957

Arkansas (July 1989) 206 2349 20 2369

California (April 2006) 6581 7056 92 7148

Colorado (November 1985) 319 6084 31 6115

Connecticut (January 2005)b 826 2500 101 2601

Delaware (February 2006) 788 801 18 819

Florida (July 1997)c 4163 36386 397 36783

Georgia (December 2003) 2245 8197 194 8391

Idaho (June 1986) 35 340 4 344

Illinois (January 2006) 6241 6661 162 6823

Indiana (July 1988) 399 4027 43 4070

Iowa (July 1998) 69 586 5 591

Kansas (July 1999) 142 1225 15 1240

Kentucky (October 2004) 333 1303 13 1316

Louisiana (February 1993) 728 8149 166 8315

Maine (January 2006) 386 393 3 396

Michigan (April 1992) 635 6702 134 6836

Minnesota (October 1985) 309 3356 40 3396

Mississippi (August 1988) 352 4549 59 4608

Missouri (October 1987) 502 5086 55 5141

Nebraska (September 1995) 91 672 14 686

Nevada (February 1992) 339 3532 24 3556

New Hampshire (January 2005) 59 466 9 475

New Jersey (January 1992) 1477 17513 325 17838

New Mexico (January 1998) 114 949 4 953

New York (June 2000) 5326 42345 1820 44165

North Carolina (February 1990) 1615 13879 143 14022

North Dakota (January 1988) 4 82 1 83

Ohio (June 1990) 867 8222 101 8323

Oklahoma (June 1988) 229 2401 30 2431

Oregon (April 2006) 49 95 19 114

Pennsylvania (October 2002)d 4269 9537 179 9716

Rhode Island (July 2006) 14 21 0 21

South Carolina (February 1986) 493 6970 93 7063

South Dakota (January 1988) 18 215 6 221

Tennessee (January 1992) 732 7115 90 7205

Texas (January 1999)e 3370 24282 417 24699

Utah (April 1989) 106 893 14 907

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 35

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Virginia (July 1989) 864 10257 95 10352

Washington (March 2006) 4048 4157 40 4197

West Virginia (January 1989) 66 673 8 681

Wisconsin (November 1985) 261 2500 31 2531

Wyoming (June 1989) 7 93 1 94

Subtotal 50834 274822 5146 279968

US dependent areas

American Samoa (August 2001) 0 1 0 1

Guam (March 2000) 2 66 0 66

Northern Mariana Islands (October 2001) 2 7 0 7

Puerto Rico (January 2003) 1471 5610 91 5701

US Virgin Islands (December 1998) 22 247 6 253

Persons reported from areas with confidential name-based HIV infection reporting but who were residents of other areas 132 685 21 706

Totalf 52878 282640 5314 287954

Note Includes data from 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through 2006b Beginning in 1992 Connecticut had name-based HIV reporting for cases in children only From January 2002 through December 2004

Connecticut had name- or code-based HIV reporting for cases in adolescents and adults As of January 2005 Connecticut has name-based reporting of all cases of HIV infection

c Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterd On October 18 2002 Pennsylvania initiated confidential name-based HIV infection reporting in all areas except Philadelphia Code-based

reporting was implemented in Philadelphia in March 2004 and the switch to name-based reporting was made in October 2005e From February 1994 through December 1998 Texas reported HIV infection in children onlyf Includes 1252 persons reported from areas with confidential name-based HIV infection reporting but whose area of residence is unknown

36 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulativemdashUnited States and dependent areas

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No Adult or adolescentMale-to-male sexual contact 13775 49 429897 54 mdash mdash mdash mdash 13775 35 429897 44Injection drug use 3413 12 163070 21 1826 17 67693 35 5239 13 230763 23Male-to-male sexual contact and

injection drug use 1603 6 65524 8 mdash mdash mdash mdash 1603 4 65524 7Hemophiliacoagulation disorder 43 0 5176 1 11 0 348 0 54 0 5524 1High-risk heterosexual contactc 2997 11 49610 6 4839 46 85186 44 7836 20 134796 14

Sex with injection drug user 330 1 11683 1 706 7 26073 14 1036 3 37756 4Sex with bisexual male mdash mdash mdash mdash 234 2 5162 3 234 1 5162 1Sex with person with hemophilia 1 0 84 0 11 0 502 0 12 0 586 0Sex with HIV-infected transfusion

recipient 22 0 553 0 21 0 793 0 43 0 1346 0Sex with HIV-infected person risk

factor not specified 2644 9 37290 5 3867 37 52656 27 6511 17 89946 9Receipt of blood transfusion blood

d components or tissue 63 0 5213 1 68 1 4176 2 131 0 9389 1Otherrisk factor not reported or

identifiede 6484 23 73136 9 3793 36 34311 18 10278 26 107450 11Subtotal 28378 100 791626 100 10537 100 191714 100 38916 100 983343 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 0 0 222 5 0 0 7 0 0 0 229 2Mother with documented HIV infection or

1 of the following risk factors 24 75 4315 89 50 93 4423 95 74 86 8738 92Injection drug use 4 13 1676 35 4 7 1665 36 8 9 3341 35Sex with injection drug user 4 13 789 16 4 7 750 16 8 9 1539 16Sex with bisexual male 1 3 101 2 2 4 110 2 3 3 211 2Sex with person with hemophilia 0 0 20 0 0 0 16 0 0 0 36 0Sex with HIV-infected transfusion

recipient 0 0 11 0 0 0 15 0 0 0 26 0Sex with HIV-infected person risk

factor not specified 6 19 742 15 17 31 790 17 23 27 1532 16Receipt of blood transfusion blood

components or tissue 0 0 70 1 0 0 82 2 0 0 152 2Has HIV infection risk factor not

specified 9 28 906 19 23 43 995 21 32 37 1901 20Receipt of blood transfusion blood

fcomponents or tissue 1 3 243 5 0 0 144 3 1 1 387 4Otherrisk factor not reported or

identifiedg 7 22 75 2 4 7 93 2 11 13 168 2Subtotal 32 100 4855 100 54 100 4667 100 86 100 9522 100

Total 28410 100 796481 100 10591 100 196381 100 39002 100 992865 100a From the beginning of the epidemic through 2006b From the beginning of the epidemic through 2006 Includes 3 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infectiond AIDS developed in 47 adultsadolescents after they received blood that had tested negative for HIV antibodies AIDS developed in 14 additional adults

after they received tissue organs or artificial insemination from HIV-infected donors Four of the 14 received tissue or organs from a donor who was negative for HIV antibody at the time of donation

e Includes 37 adultsadolescents who were exposed to HIV-infected blood body fluids or concentrated virus in health care laboratory or household settings as supported by seroconversion epidemiologic andor laboratory evidence One person was infected after intentional inoculation with HIV-infected blood Includes an additional 740 persons who acquired HIV infection perinatally but who were more than 12 years of age when AIDS was diagnosed These 740 persons are not counted in the values for the pediatric transmission category

f AIDS developed in 3 children after they received blood that had tested negative for HIV antibodiesg Includes 5 children who were exposed to HIV-infected blood as supported by seroconversion epidemiologic andor laboratory evidence 1 child was

infected after intentional inoculation with HIV-infected blood and 5 children were exposed to HIV-infected blood in a household setting Of the 168 children 26 had sexual contact with an adult with or at high risk for HIV infection

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 37

Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No

Adult or adolescentMale-to-male sexual contact 22912 59 103679 52 mdash mdash mdash mdash 22912 44 103679 37

Injection drug use 3503 9 24255 12 2124 16 13925 17 5627 11 38181 14

Male-to-male sexual contact and injection drug use 1946 5 10704 5 mdash mdash mdash mdash 1946 4 10704 4

Hemophiliacoagulation disorder 43 0 495 0 6 0 73 0 49 0 568 0

High-risk heterosexual contactc 2874 7 16830 8 5939 45 38315 47 8813 17 55145 20

Sex with injection drug user 308 1 2601 1 757 6 6791 8 1065 2 9392 3

Sex with bisexual male mdash mdash mdash mdash 328 2 2265 3 328 1 2265 1

Sex with person with hemophilia 4 0 31 0 16 0 201 0 20 0 232 0

Sex with HIV-infected transfusion recipient 13 0 131 0 28 0 223 0 41 0 354 0

Sex with HIV-infected person risk factor not specified 2549 7 14067 7 4810 36 28835 35 7359 14 42902 15

Receipt of blood transfusion blood components or tissue 61 0 489 0 50 0 536 1 111 0 1025 0

Otherrisk factor not reported or identified 7748 20 44021 22 5106 39 29312 36 12854 25 73338 26

Subtotal 39087 100 200473 100 13225 100 82161 100 52312 100 282640 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 8 3 106 4 0 0 1 0 8 1 107 2

Mother with documented HIV infection or 1 of the following risk factors 197 74 2195 85 254 85 2417 89 451 80 4612 87

Injection drug use 34 13 532 21 53 18 561 21 87 15 1093 21

Sex with injection drug user 12 5 208 8 21 7 213 8 33 6 421 8

Sex with bisexual male 5 2 37 1 4 1 32 1 9 2 69 1

Sex with person with hemophilia 0 0 3 0 1 0 7 0 1 0 10 0

Sex with HIV-infected transfusion recipient 0 0 4 0 0 0 4 0 0 0 8 0

Sex with HIV-infected person risk factor not specified 54 20 534 21 76 25 629 23 130 23 1163 22

Receipt of blood transfusion blood components or tissue 0 0 17 1 2 1 20 1 2 0 37 1

Has HIV infection risk factor not specified 92 35 860 33 97 32 951 35 189 33 1811 34

Receipt of blood transfusion blood components or tissue 6 2 28 1 3 1 24 1 9 2 52 1

Otherrisk factor not reported or identified 55 21 260 10 43 14 283 10 98 17 543 10

Subtotal 266 100 2589 100 300 100 2725 100 566 100 5314 100

Total 39353 100 203062 100 13525 100 84886 100 52878 100 287954 100

Note See Table 16 for the list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006b From the beginning of the epidemic through December 2006 Includes 6 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infection

38 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity

2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 6251 65 253927 73Injection drug use 733 8 31737 9Male-to-male sexual contact and injection drug use 732 8 31434 9Hemophiliacoagulation disorder 26 0 3989 1High-risk heterosexual contactb 416 4 7850 2

Sex with injection drug user 74 1 2310 1

Sex with person with hemophilia 0 0 36 0

Sex with HIV-infected transfusion recipient 2 0 176 0

Sex with HIV-infected person risk factor not specified 340 4 5328 2Receipt of blood transfusion blood components or tissue 20 0 3194 1Otherrisk factor not reported or identified 1400 15 16469 5

Total 9578 100 348600 100

Black not HispanicMale-to-male sexual contact 4309 36 103297 37Injection drug use 1635 14 83369 30Male-to-male sexual contact and injection drug use 526 4 22134 8Hemophiliacoagulation disorder 10 0 604 0High-risk heterosexual contactb 1875 16 29952 11

Sex with injection drug user 167 1 6823 2Sex with person with hemophilia 1 0 36 0Sex with HIV-infected transfusion recipient 15 0 237 0Sex with HIV-infected person risk factor not specified 1692 14 22856 8

Receipt of blood transfusion blood components or tissue 24 0 1218 0Otherrisk factor not reported or identified 3579 30 40268 14

Total 11958 100 280842 100

HispanicMale-to-male sexual contact 2816 47 64893 44Injection drug use 965 16 46337 31Male-to-male sexual contact and injection drug use 287 5 10884 7Hemophiliacoagulation disorder 6 0 466 0High-risk heterosexual contactb 638 11 10950 7

Sex with injection drug user 84 1 2409 2Sex with person with hemophilia 0 0 11 0Sex with HIV-infected transfusion recipient 5 0 125 0Sex with HIV-infected person risk factor not specified 549 9 8405 6

Receipt of blood transfusion blood components or tissue 17 0 657 0Otherrisk factor not reported or identified 1326 22 14832 10

Total 6055 100 149019 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 39

a

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulative

No No

AsianPacific IslanderMale-to-male sexual contact 225 54 4475 68Injection drug use 20 5 317 5Male-to-male sexual contact and injection drug use 17 4 284 4Hemophiliacoagulation disorder 1 0 70 1High-risk heterosexual contactb 34 8 376 6

Sex with injection drug user 1 0 54 1Sex with person with hemophilia 0 0 1 0Sex with HIV-infected transfusion recipient 0 0 8 0Sex with HIV-infected person risk factor not specified 33 8 313 5

Receipt of blood transfusion blood components or tissue 2 0 112 2Otherrisk factor not reported or identified 114 28 949 14

Total 413 100 6583 100

American IndianAlaska NativeMale-to-male sexual contact 61 49 1403 55Injection drug use 15 12 395 15Male-to-male sexual contact and injection drug use 23 19 457 18Hemophiliacoagulation disorder 0 0 27 1High-risk heterosexual contactb 9 7 118 5

Sex with injection drug user 1 1 33 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 8 6 82 3

Receipt of blood transfusion blood components or tissue 0 0 8 0Otherrisk factor not reported or identified 16 13 155 6

Total 124 100 2563 100

Total casesMale-to-male sexual contact 13775 49 429897 54Injection drug use 3413 12 163070 21Male-to-male sexual contact and injection drug use 1603 6 65524 8Hemophiliacoagulation disorder 43 0 5176 1High-risk heterosexual contactb 2997 11 49610 6

Sex with injection drug user 330 1 11683 1Sex with person with hemophilia 1 0 84 0Sex with HIV-infected transfusion recipient 22 0 553 0Sex with HIV-infected person risk factor not specified 2644 9 37290 5

Receipt of blood transfusion blood components or tissue 63 0 5213 1Otherrisk factor not reported or identified 6484 23 73136 9

Total 28378c 100 791626d 100a From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 4019 males of unknown race or multiple races

40 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 11963 73 55725 69Injection drug use 858 5 5512 7Male-to-male sexual contact and injection drug use 1092 7 5578 7Hemophiliacoagulation disorder 29 0 355 0High-risk heterosexual contactb 522 3 2658 3

Sex with injection drug user 65 0 544 1Sex with person with hemophilia 0 0 8 0Sex with HIV-infected transfusion recipient 3 0 33 0Sex with HIV-infected person risk factor not specified 454 3 2073 3

Receipt of blood transfusion blood components or tissue 14 0 197 0Otherrisk factor not reported or identified 1956 12 11147 14

Total 16434 100 81172 100

Black not HispanicMale-to-male sexual contact 6203 44 30148 37Injection drug use 1594 11 11997 15Male-to-male sexual contact and injection drug use 483 3 3489 4Hemophiliacoagulation disorder 10 0 109 0High-risk heterosexual contactb 1714 12 10905 13

Sex with injection drug user 169 1 1554 2Sex with person with hemophilia 4 0 17 0Sex with HIV-infected transfusion recipient 6 0 77 0Sex with HIV-infected person risk factor not specified 1535 11 9257 11

Receipt of blood transfusion blood components or tissue 32 0 223 0Otherrisk factor not reported or identified 4151 29 24632 30

Total 14187 100 81503 100

HispanicMale-to-male sexual contact 4094 55 15623 47Injection drug use 993 13 6407 19Male-to-male sexual contact and injection drug use 316 4 1402 4Hemophiliacoagulation disorder 3 0 26 0High-risk heterosexual contactb 582 8 2963 9

Sex with injection drug user 65 1 455 1Sex with person with hemophilia 0 0 6 0Sex with HIV-infected transfusion recipient 4 0 18 0Sex with HIV-infected person risk factor not specified 513 7 2484 7

Receipt of blood transfusion blood components or tissue 11 0 55 0Otherrisk factor not reported or identified 1475 20 6977 21

Total 7474 100 33453 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 41

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderMale-to-male sexual contact 402 70 1006 63Injection drug use 17 3 55 3Male-to-male sexual contact and injection drug use 15 3 38 2Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 25 4 96 6

Sex with injection drug user 3 1 10 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 22 4 83 5

Receipt of blood transfusion blood components or tissue 4 1 7 0Otherrisk factor not reported or identified 109 19 397 25

Total 572 100 1600 100

American IndianAlaska NativeMale-to-male sexual contact 104 61 516 57Injection drug use 13 8 101 11Male-to-male sexual contact and injection drug use 19 11 110 12Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 10 6 53 6

Sex with injection drug user 2 1 14 2Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 8 5 39 4

Receipt of blood transfusion blood components or tissue 0 0 2 0Otherrisk factor not reported or identified 24 14 125 14

Total 170 100 907 100

Total casesMale-to-male sexual contact 22912 59 103679 52Injection drug use 3503 9 24255 12Male-to-male sexual contact and injection drug use 1946 5 10704 5Hemophiliacoagulation disorder 43 0 495 0High-risk heterosexual contactb 2874 7 16830 8

Sex with injection drug user 308 1 2601 1Sex with person with hemophilia 4 0 31 0Sex with HIV-infected transfusion recipient 13 0 131 0Sex with HIV-infected person risk factor not specified 2549 7 14067 7

Receipt of blood transfusion blood components or tissue 61 0 489 0Otherrisk factor not reported or identified 7748 20 44021 22

Total 39087c 100 200473d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 1838 males of unknown race or multiple races

42 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race

ethnicity 2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 482 28 14981 40Hemophiliacoagulation disorder 4 0 123 0High-risk heterosexual contactb 725 42 15799 42

Sex with injection drug user 153 9 5650 15Sex with bisexual male 63 4 1859 5Sex with person with hemophilia 5 0 329 1Sex with HIV-infected transfusion recipient 5 0 338 1Sex with HIV-infected person risk factor not specified 499 29 7623 20

Receipt of blood transfusion blood components or tissue 15 1 1870 5Otherrisk factor not reported or identified 499 29 4801 13

Total 1725 100 37574 100

Black not HispanicInjection drug use 982 15 38914 34Hemophiliacoagulation disorder 3 0 145 0High-risk heterosexual contactb 3103 46 49876 44

Sex with injection drug user 373 6 13530 12Sex with bisexual male 136 2 2352 2Sex with person with hemophilia 4 0 121 0Sex with HIV-infected transfusion recipient 8 0 277 0Sex with HIV-infected person risk factor not specified 2582 38 33596 29

Receipt of blood transfusion blood components or tissue 39 1 1546 1Otherrisk factor not reported or identified 2612 39 23894 21

Total 6739 100 114375 100

HispanicInjection drug use 322 18 12892 35Hemophiliacoagulation disorder 4 0 67 0High-risk heterosexual contactb 894 49 17995 49

Sex with injection drug user 166 9 6522 18Sex with bisexual male 32 2 818 2Sex with person with hemophilia 1 0 45 0Sex with HIV-infected transfusion recipient 7 0 141 0Sex with HIV-infected person risk factor not specified 688 38 10469 29

Receipt of blood transfusion blood components or tissue 12 1 619 2Otherrisk factor not reported or identified 592 32 5023 14

Total 1824 100 36596 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 43

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 8 8 125 12Hemophiliacoagulation disorder 0 0 7 1High-risk heterosexual contactb 49 47 574 53

Sex with injection drug user 4 4 114 11Sex with bisexual male 2 2 80 7Sex with person with hemophilia 0 0 4 0Sex with HIV-infected transfusion recipient 1 1 25 2Sex with HIV-infected person risk factor not specified 42 40 351 33

Receipt of blood transfusion blood components or tissue 1 1 93 9Otherrisk factor not reported or identified 46 44 279 26

Total 104 100 1078 100

American IndianAlaska NativeInjection drug use 13 32 280 42Hemophiliacoagulation disorder 0 0 3 0High-risk heterosexual contactb 15 37 277 41

Sex with injection drug user 4 10 107 16Sex with bisexual male 1 2 27 4Sex with person with hemophilia 0 0 2 0Sex with HIV-infected transfusion recipient 0 0 6 1Sex with HIV-infected person risk factor not specified 10 24 135 20

Receipt of blood transfusion blood components or tissue 1 2 17 3Otherrisk factor not reported or identified 12 29 95 14

Total 41 100 672 100

Total casesInjection drug use 1826 17 67693 35Hemophiliacoagulation disorder 11 0 348 0High-risk heterosexual contactb 4839 46 85186 44

Sex with injection drug user 706 7 26073 14Sex with bisexual male 234 2 5162 3Sex with person with hemophilia 11 0 502 0Sex with HIV-infected transfusion recipient 21 0 793 0Sex with HIV-infected person risk factor not specified 3867 37 52656 27

Receipt of blood transfusion blood components or tissue 68 1 4176 2Otherrisk factor not reported or identified 3793 36 34311 18

Total 10537c 100 191714d 100a From the beginning of the epidemic through 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 104 females of unknown race or multiple racesd Includes 1419 females of unknown race or multiple races

44 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 690 26 4260 26Hemophiliacoagulation disorder 3 0 24 0

bHigh-risk heterosexual contact 1132 42 7593 46Sex with injection drug user 205 8 1876 11Sex with bisexual male 98 4 659 4Sex with person with hemophilia 10 0 115 1Sex with HIV-infected transfusion recipient 7 0 64 0Sex with HIV-infected person risk factor not specified 812 30 4879 29

Receipt of blood transfusion blood components or tissue 12 0 146 1Otherrisk factor not reported or identified 850 32 4567 28

Total 2687 100 16590 100

Black not HispanicInjection drug use 1034 13 7105 14Hemophiliacoagulation disorder 1 0 35 0

bHigh-risk heterosexual contact 3451 44 23732 46Sex with injection drug user 313 4 3473 7Sex with bisexual male 155 2 1294 3Sex with person with hemophilia 5 0 71 0Sex with HIV-infected transfusion recipient 14 0 120 0Sex with HIV-infected person risk factor not specified 2964 38 18774 36

Receipt of blood transfusion blood components or tissue 26 0 324 1Otherrisk factor not reported or identified 3370 43 20244 39

Total 7882 100 51440 100

HispanicInjection drug use 339 15 2280 18Hemophiliacoagulation disorder 2 0 11 0

bHigh-risk heterosexual contact 1198 52 6264 50Sex with injection drug user 218 9 1324 11Sex with bisexual male 62 3 266 2Sex with person with hemophilia 1 0 11 0Sex with HIV-infected transfusion recipient 7 0 39 0Sex with HIV-infected person risk factor not specified 910 39 4624 37

Receipt of blood transfusion blood components or tissue 12 1 58 0Otherrisk factor not reported or identified 767 33 3843 31

Total 2318 100 12456 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 45

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 21: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Map 1 Estimated rates (per 100000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

Note Rates adjusted for reporting delays Rates of HIV infection include only persons living with HIV infection that has not progressed to AIDSSince 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 Islandsa Includes persons whose area of residence is unknown

Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006mdashUnited States and dependent areas

Note Rates adjusted for reporting delays Rates of HIV infection include only persons living with HIV infection that has not progressed to AIDSSince 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 Islandsa Includes persons whose area of residence is unknown

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 21

Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002ndash2006mdashUnited States and dependent areas

2002 2003 2004 2005 2006Data for 50 states and the District of Columbia

Age at end of year (yrs)lt13 2308 2006 1684 1394 111513ndash14 685 747 784 762 71115ndash19 1465 1694 1974 2243 248720ndash24 3910 4292 4629 5033 536725ndash29 12725 12743 13045 13505 1435930ndash34 35558 33870 32057 29949 2882435ndash39 70107 68106 65076 62235 5964940ndash44 80377 86294 91335 94021 9517445ndash49 64702 71276 77417 84153 9077550ndash54 41270 46855 53333 59256 6647655ndash59 20113 24145 28356 33522 3901460ndash64 9681 11293 13305 15380 18072gt65 7520 8946 10604 12430 14669

RaceethnicityWhite not Hispanic 129426 135278 141508 147426 154495Black not Hispanic 150488 161326 171654 181056 191590Hispanic 63424 67895 72024 76334 80815AsianPacific Islander 3060 3426 3759 4121 4526American IndianAlaska Native 1254 1356 1458 1562 1651

Transmission categoryMale adult or adolescentMale-to-male sexual contact 158092 168233 178551 188622 199693Injection drug use 56708 58436 59940 61229 62998Male-to-male sexual contact and injection drug use 24726 25457 26144 26785 27523High-risk heterosexual contacta 27329 30300 33181 35916 39004Otherb 3588 3665 3769 3888 4026Subtotal 270444 286091 301585 316440 333244

Female adult or adolescentInjection drug use 27863 28874 29828 30646 31575High-risk heterosexual contacta 46445 51489 56229 60693 65631Otherb 1903 2033 2178 2315 2465Subtotal 76210 82395 88236 93653 99671

Child (lt13 yrs at diagnosis)Perinatal 3633 3654 3651 3664 3660Otherc 129 124 123 122 115Subtotal 3762 3778 3774 3786 3775

Region of residenceNortheast 105599 110929 115562 120208 125620Midwest 36011 38571 41178 44171 47010South 137081 147284 157975 166962 177591West 71729 75483 78883 82540 86473

Subtotal for 50 states and the District of Columbia 350419 372267 393598 413882 436693

Data for US dependent areas 9880 10365 10713 11106 11359

Totald 360617 383024 404849 425646 448871Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

22 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission categorymdash50 states and the District of Columbia

Transmission category

White not Hispanic

Black not Hispanic Hispanic

AsianPacific Islander

American IndianAlaska

Native Totala

No No No No No No

Male adult or adolescentMale-to-male sexual contact 101299 75 57520 45 36087 57 2715 72 704 57 199693 60Injection drug use 13168 10 33911 27 14795 23 325 9 201 16 62998 19Male-to-male sexual contact and

injection drug use 12393 9 10121 8 4352 7 198 5 220 18 27523 8High-risk heterosexual contactb 6081 5 24205 19 7816 12 444 12 105 8 39004 12Otherc 1743 1 1602 1 574 1 69 2 16 1 4026 1Subtotal 134683 100 127359 100 63623 100 3752 100 1246 100 333244 100

Female adult or adolescentInjection drug use 7407 38 18531 30 5025 30 115 15 153 39 31575 32High-risk heterosexual contactb 11350 59 41741 68 11092 67 588 78 227 58 65631 66Otherc 508 3 1456 2 413 2 51 7 13 3 2465 2Subtotal 19264 100 61728 100 16531 100 753 100 393 100 99671 100

Child (lt13 yrs at diagnosis)Perinatal 500 92 2468 99 629 95 20 94 12 100 3660 97Otherd 46 8 34 1 33 5 1 6 0 0 115 3Subtotal 546 100 2503 100 662 100 21 100 12 100 3775 100

Totale 154495 191590 80815 4526 1651 436693

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Includes 3616 persons of unknown race or multiple racesb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes 3 person of unknown sex Because column totals were calculated independently of the values for the subpopulations the values in each column

may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 23

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by

area of residence and age categorymdashUnited States and dependent areas

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

Alabama 5469 17 5486 3744 11 3755Alaska 272 1 273 330 1 331Arizona 5744 49 5793 4922 7 4929Arkansas 2291 7 2298 2139 6 2145California mdash mdash mdash 61451 105 61555Colorado 5855 13 5869 4083 2 4085Connecticut mdash mdash mdash 7406 15 7421Delaware mdash mdash mdash 1753 7 1760District of Columbia mdash mdash mdash 10059 30 10089Floridab 35461 263 35723 46469 194 46663Georgia mdash mdash mdash 17336 47 17383Hawaii mdash mdash mdash 1234 3 1237Idaho 356 0 356 313 0 313Illinois mdash mdash mdash 16139 46 16185Indiana 3849 21 3870 3996 14 4010Iowa 588 2 590 869 3 872Kansas 1230 7 1237 1272 2 1274Kentucky mdash mdash mdash 2589 13 2602Louisiana 7361 101 7462 8052 21 8074Maine mdash mdash mdash 512 2 514Maryland mdash mdash mdash 14540 41 14581Massachusetts mdash mdash mdash 8806 20 8826Michigan 6118 55 6173 6615 12 6627Minnesota 3227 21 3248 2314 9 2323Mississippi 4200 32 4232 3155 13 3168Missouri 4999 33 5033 5479 7 5486Montana mdash mdash mdash 205 0 205Nebraska 688 12 700 771 2 773Nevada 3402 13 3415 2969 3 2972New Hampshire mdash mdash mdash 556 3 559New Jersey 16059 153 16212 17168 57 17226New Mexico 910 0 909 1252 3 1255New York 42220 801 43021 70697 148 70845North Carolina 11700 60 11760 8451 12 8463North Dakota 87 2 89 73 1 74Ohio 8266 57 8323 7054 30 7084Oklahoma 2191 17 2208 2191 3 2194Oregon mdash mdash mdash 2840 4 2844Pennsylvania mdash mdash mdash 18633 71 18703Rhode Island mdash mdash mdash 1296 7 1303South Carolina 6349 45 6394 7035 23 7058South Dakota 195 4 199 139 1 140Tennessee 6579 51 6631 6403 11 6414Texas 24741 262 25003 34010 53 34063Utah 893 10 903 1164 0 1164Vermont mdash mdash mdash 238 2 240Virginia 9937 41 9978 8423 24 8447Washington mdash mdash mdash 5471 5 5476West Virginia 660 5 665 749 5 754Wisconsin 2322 15 2337 2153 12 2165Wyoming 86 2 88 102 1 103

Subtotal 224303 2174 226477 435621 1115 436736

24 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age categorymdashUnited States and dependent areas (cont)

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

US dependent areasAmerican Samoa 2 0 2 1 0 1Guam 63 0 63 36 0 36Northern Mariana Islands 7 0 7 3 0 3Puerto Rico 6269 31 6300 10971 26 10997US Virgin Islands 228 2 230 312 2 314Otherc mdash mdash mdash 1 0 1

Totald 230872 2207 233079 447724 1147 448871

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reporting a See Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at

least 2003b Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterc Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasd Total number of persons living with HIV infection (not AIDS) includes persons reported from areas with confidential name-based HIV

infection reporting who were residents of other states or whose area of residence is unknown Total number of persons living with AIDS includes persons whose area of residence is unknown Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 25

Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristicsmdashUnited States and dependent areas

No of persons

Survival in months

gt12 gt24 gt36Data for 50 states and the District of Columbia

Age at diagnosis (yrs)lt13 101 096 094 09413ndash14 60 098 098 09515ndash19 305 098 096 09520ndash24 1351 096 093 09225ndash29 3034 095 092 09130ndash34 5499 094 091 08935ndash39 7888 093 090 08740ndash44 7085 092 088 08545ndash49 5090 089 085 08250ndash54 3067 086 081 07855ndash59 1505 083 078 07460ndash64 806 080 073 069gt65 614 073 068 065

RaceethnicityWhite not Hispanic 10706 092 089 087Black not Hispanic 18406 090 086 082Hispanic 6398 092 090 088AsianPacific Islander 404 094 092 090American IndianAlaska Native 167 084 081 075

Transmission categoryMale adult or adolescentMale-to-male sexual contact 12830 093 090 088Injection drug use 4048 089 084 081Male-to-male sexual contact and injection drug use 1701 093 089 086High-risk heterosexual contacta 3170 091 088 085Otherb 5019 086 083 080Subtotal 26768 091 088 085

Female adult or adolescentInjection drug use 2101 089 083 078High-risk heterosexual contacta 4686 093 089 086Otherb 2749 090 085 083Subtotal 9536 091 087 083

Child (lt13 yrs at diagnosis)Perinatal 98 096 095 095Otherc 3 100 067 067Subtotal 101 096 094 094

Subtotal for 50 states and the District of Columbia 36405 091 087 085

Data for US dependent areas 891 083 078 075

Total 37352d 091 087 084Note Excludes persons whose date of death was before or in the same month as date of diagnosis Excludes persons whose month of diagnosis or month of death is unknowna Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes 325 persons of unknown race or multiple races

26 Survival after AIDS Diagnosis

Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by year of diagnosismdashUnited States and dependent areas

Months after AIDS diagnosis

Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by age groupmdashUnited States and dependent areas

Months after AIDS diagnosis

Survival after AIDS Diagnosis 27

Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by raceethnicitymdashUnited States and dependent areas

Months after AIDS diagnosis

28 Survival after AIDS Diagnosis

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006

and cumulativemdashUnited States and dependent areas

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Alabama 510 112 462 100 8626 76 8702Alaska 24 36 38 57 648 7 655Arizona 626 105 539 87 10396 46 10442Arkansas 237 85 252 90 3891 36 3927California 4069 113 3960 109 142254 664 142918Colorado 351 75 322 68 8742 31 8773Connecticut 658 188 422 120 14716 183 14899Delaware 177 210 116 136 3547 26 3573District of Columbia 672 1155 853 1467 17372 189 17561Florida 4921 277 4932 273 104084 1530 105614Georgia 2325 255 1605 171 31734 231 31965Hawaii 105 82 93 72 2927 17 2944Idaho 24 17 26 18 604 2 606Illinois 1886 148 1382 108 33620 282 33902Indiana 407 65 346 55 8239 56 8295Iowa 93 31 86 29 1727 13 1740Kansas 105 38 120 43 2781 14 2795Kentucky 249 60 207 49 4600 32 4632Louisiana 936 208 824 192 17612 128 17740Maine 21 16 68 51 1110 8 1118Maryland 1558 279 1626 290 30252 319 30571Massachusetts 666 104 533 83 19181 214 19395Michigan 821 81 672 67 14941 113 15054Minnesota 226 44 212 41 4817 28 4845Mississippi 368 127 365 125 6642 56 6698Missouri 385 66 469 80 11016 61 11077Montana 21 22 7 07 373 3 376Nebraska 53 30 118 67 1479 11 1490Nevada 293 121 294 118 5733 29 5762New Hampshire 33 25 55 42 1074 10 1084New Jersey 1262 145 1065 122 48750 778 49528New Mexico 134 70 93 48 2603 7 2610New York 6201 321 5495 285 174908 2354 177262North Carolina 916 106 1229 139 15954 118 16072North Dakota 10 16 6 09 144 1 145Ohio 753 66 767 67 14957 138 15095Oklahoma 281 79 205 57 4836 26 4862Oregon 217 60 281 76 5995 20 6015Pennsylvania 1486 120 1893 152 33417 365 33782Rhode Island 87 81 111 104 2580 28 2608South Carolina 682 161 705 163 13301 105 13406South Dakota 18 23 18 23 255 5 260Tennessee 818 137 680 113 12457 59 12516Texas 3045 133 2998 128 69735 392 70127Utah 63 25 57 22 2295 20 2315Vermont 5 08 18 29 461 6 467Virginia 638 84 605 79 16802 177 16979Washington 485 77 389 61 11792 34 11826West Virginia 74 41 67 37 1500 11 1511Wisconsin 122 22 217 39 4513 33 4546Wyoming 6 12 8 16 228 2 230

Subtotal 40123 135 37911 127 952221 9094 961315

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 29

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulativemdashUnited States and dependent areas (cont)

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

US dependent areasAmerican Samoa 0 0 0 0 1 0 1Guam 0 0 0 0 68 1 69Northern Mariana Islands 0 0 0 0 3 0 3Puerto Rico 1029 263 850 216 29511 400 29911US Virgin Islands 17 156 32 295 629 18 647Otherb 0 0 0 0 3 0 3

Totalc 41357 138 39002 129 983343 9522 992865d

a From the beginning of the epidemic through 2006b Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasc Includes persons whose state or area of residence is unknownd Includes 916 persons whose state or area of residence is unknown

30 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

MSA (population gt 500000)

Akron Ohio 66 94 32 46 762 1 763

AlbanyndashSchenectadyndashTroy NY 97 114 105 123 2253 24 2277

Albuquerque N Mex 70 88 50 61 1404 2 1406

AllentownndashBethlehemndashEaston PandashNJ 72 91 119 149 1352 17 1369

AtlantandashSandy SpringsndashMarietta Ga 1586 319 1006 196 21896 128 22024

AugustandashRichmond County GandashSC 106 205 32 61 1851 24 1875

AustinndashRound Rock Tex 227 156 186 123 4830 26 4856

Bakersfield Calif 76 100 122 156 1528 8 1536

BaltimorendashTowson Md 1064 401 1001 377 20352 218 20570

Baton Rouge La 222 304 231 301 3732 20 3752

BirminghamndashHoover Ala 151 139 110 100 2614 25 2639

Boise CityndashNampa Idaho 14 26 14 25 281 0 281

Boston MassndashNHa 441 99 355 80 13476 147 13623

Boston Division 269 146 185 101 8451 91 8542

Cambridge Division 108 74 102 70 3126 35 3161

Essex Division 52 71 51 69 1577 20 1597

BridgeportndashStamfordndashNorwalk Conn 181 201 135 150 3733 57 3790

BuffalondashNiagara Falls NY 117 102 96 84 2476 20 2496

Cape CoralndashFort Myers Fla 44 81 91 159 1692 24 1716

CharlestonndashNorth Charleston SC 92 155 91 151 2034 18 2052

CharlottendashGastoniandashConcord NCndashSC 214 141 285 180 3242 22 3264

Chicago IllndashIndndashWis 1716 182 1159 122 30118 261 30379

Chicago Division 1604 203 1073 135 28300 248 28548

Gary Division 61 88 50 71 1038 8 1046

Lake Division 51 59 36 41 780 5 785

CincinnatindashMiddletown OhiondashKyndashInd 111 53 199 95 2735 17 2752

ClevelandndashElyriandashMentor Ohio 228 107 170 80 4226 48 4274

Colorado Springs Colo 19 32 21 35 576 5 581

Columbia SC 177 256 197 280 3274 24 3298

Columbus Ohio 166 97 165 96 3112 15 3127

Dallas Tex 874 150 929 155 20238 63 20301

Dallas Division 681 175 714 178 16038 37 16075

Fort Worth Division 193 100 215 108 4200 26 4226

Dayton Ohio 58 69 54 64 1217 15 1232

DenverndashAurora Colo 274 116 236 98 6899 22 6921

Des Moines Iowa 30 57 23 43 530 4 534

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 31

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Detroit Mich 570 127 445 100 10373 73 10446

Detroit Division 443 223 330 167 8268 57 8325

Warren Division 127 51 115 46 2105 16 2121

El Paso Tex 56 78 40 54 1476 10 1486

Fresno Calif 52 59 64 72 1430 11 1441

Grand RapidsndashWyoming Mich 46 60 51 66 816 6 822

GreensborondashHigh Point NC 52 77 66 96 1265 14 1279

Greenville SC 70 119 67 111 1292 4 1296

HarrisburgndashCarlisle Pa 23 44 67 128 1224 8 1232

HartfordndashWest HartfordndashEast Hartford Conn 256 216 135 114 5126 46 5172

Honolulu Hawaii 54 60 69 76 2121 14 2135

HoustonndashBaytownndashSugar Land Tex 1017 190 1092 197 25821 172 25993

Indianapolis Ind 191 116 150 90 3824 25 3849

Jackson Miss 134 257 117 221 2419 30 2449

Jacksonville Fla 309 248 315 246 6020 75 6095

Kansas City MondashKans 183 94 160 81 4669 15 4684

Knoxville Tenn 47 72 35 52 882 5 887

Lakeland Fla 103 190 112 199 1811 21 1832

Las VegasndashParadise Nev 245 143 258 145 4616 28 4644

Little RockndashNorth Little Rock Ark 87 135 75 115 1383 14 1397

Los Angeles Calif 1529 118 1684 130 57953 293 58246

Los Angeles Division 1339 135 1435 144 51098 250 51348

Santa Anna Division 190 63 249 83 6855 43 6898

Louisville KyndashInd 123 102 97 79 2286 22 2308

Madison Wis 10 19 29 53 520 4 524

McAllenndashEdinburgndashPharr Tex 57 84 45 64 630 11 641

Memphis TennndashMissndashArk 402 320 346 271 5128 19 5147

Miami Fla 2420 446 2289 419 55807 997 56804

Fort Lauderdale Division 810 455 769 430 16412 262 16674

Miami Division 1243 523 1165 485 29703 512 30215

West Palm Beach Division 367 290 355 279 9692 223 9915

MilwaukeendashWaukeshandashWest Allis Wis 68 45 109 72 2507 18 2525

MinneapolisndashSt PaulndashBloomington MinnndashWis 186 59 184 58 4259 22 4281

Modesto Calif 36 71 22 43 671 6 677

NashvillendashDavidsonndashMurfreesboro Tenn 224 158 172 118 3848 20 3868

New HavenndashMilford Conn 169 200 107 127 4573 73 4646

New OrleansndashMetairiendashKenner La 393 299 271 264 8835 67 8902

32 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

New York NYndashNJndashPa 6215 330 5500 292 195177 2906 198083

Edison Division 191 83 130 56 6709 139 6848

Nassau Division 262 93 246 88 8141 110 8251

New York Division 5266 456 4716 408 160408 2323 162731

Newark Division 496 231 408 190 19919 334 20253

Oklahoma City Okla 125 108 88 75 2255 5 2260

OmahandashCouncil Bluffs NebndashIowa 37 46 80 97 1035 3 1038

Orlando Fla 544 282 517 260 8653 92 8745

OxnardndashThousand OaksndashVentura Calif 49 62 21 26 1008 3 1011

Palm BayndashMelbournendashTitusville Fla 68 129 61 114 1512 11 1523

Philadelphia PandashNJndashDelndashMd 1261 217 1348 231 28221 313 28534

Camden Division 108 87 111 89 3118 42 3160

Philadelphia Division 1022 263 1144 294 22112 250 22362

Wilmington Division 131 191 93 134 2991 21 3012

PhoenixndashMesandashScottsdale Ariz 460 119 376 93 7459 31 7490

Pittsburgh Pa 143 60 135 57 3182 19 3201

PortlandndashSouth Portland Maine 9 18 34 66 562 1 563

PortlandndashVancouverndashBeaverton OrendashWash 170 81 215 101 4825 10 4835

PoughkeepsiendashNewburghndashMiddletown NY 136 204 113 168 3162 24 3186

ProvidencendashNew BedfordndashFall River RIndashMass 132 82 155 96 3900 44 3944

RaleighndashCary NC 138 145 201 202 1987 13 2000

Richmond Va 119 101 122 102 3371 35 3406

RiversidendashSan BernardinondashOntario Calif 361 92 306 76 8568 60 8628

Rochester NY 165 159 124 120 3134 13 3147

SacramentondashArden-ArcadendashRoseville Calif 154 75 169 82 4000 26 4026

St Louis MondashIll 192 69 366 131 5965 40 6005

Salt Lake City Utah 46 44 40 37 1743 10 1753

San Antonio Tex 215 114 247 127 4987 30 5017

San DiegondashCarlsbadndashSan Marcos Calif 491 167 384 131 12934 61 12995

San Francisco Calif 867 209 690 165 40152 96 40248

Oakland Division 312 126 246 99 9546 48 9594

San Francisco Division 555 329 444 261 30606 48 30654

San JosendashSunnyvalendashSanta Clara Calif 88 50 145 81 3747 15 3762

San JuanndashCaguasndashGuaynabo PR 745 289 578 223 21402 277 21679

SarasotandashBradentonndashVenice Fla 82 122 104 152 1978 27 2005

ScrantonndashWilkes-Barre Pa 27 49 47 85 572 6 578

Seattle Wash 353 110 280 86 9172 27 9199

Seattle Division 316 129 255 102 8161 18 8179

Tacoma Division 37 49 25 33 1011 9 1020

Springfield Mass 88 128 45 66 2075 26 2101

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 33

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Stockton Calif 52 78 52 77 1076 15 1091

Syracuse NY 52 80 49 75 1317 8 1325

TampandashSt PetersburgndashClearwater Fla 559 211 605 224 11174 112 11286

Toledo Ohio 25 38 66 101 812 14 826

Tucson Ariz 103 111 100 106 2010 10 2020

Tulsa Okla 83 94 65 72 1494 10 1504

Virginia BeachndashNorfolkndashNewport News VandashNC 183 111 132 80 4711 63 4774

Washington DCndashVandashMdndashWV 1322 252 1684 318 31130 315 31445

Bethesda Division 135 118 173 150 2774 23 2797

Washington Division 1187 289 1511 365 28356 292 28648

Wichita Kans 35 60 38 64 851 2 853

Worcester Mass 76 97 79 101 1783 20 1803

YoungstownndashWarrenndashBoardman OhiondashPa 27 46 26 44 519 0 519

Subtotal for MSAs (population gt500000) 33602 173 31274 159 829633 8171 837804

Metropolitan areas (population of 50000 to 499999) 4477 80 4466 79 94829 847 95676

Nonmetropolitan areas 2666 54 2732 55 52063 445 52508

Totalb 41144 137 38749 128 981708 9494 991202

Note Because of the lack of census information for all US dependent areas includes data for only the 50 states the District of Columbia and Puerto RicoMSA metropolitan statistical areaMSA definitions for this report can be found at httpwwwcensusgovpopulationwwwestimatesmetrodefhtmla Reported case counts for the metropolitan divisions do not sum to the MSA total MSA total includes data from 1 metropolitan division with

population of lt500000b Includes persons whose county of residence is unknown

34 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Alabama (January 1988) 502 6041 48 6089

Alaska (February 1999) 38 285 2 287

Arizona (January 1987) 617 5877 80 5957

Arkansas (July 1989) 206 2349 20 2369

California (April 2006) 6581 7056 92 7148

Colorado (November 1985) 319 6084 31 6115

Connecticut (January 2005)b 826 2500 101 2601

Delaware (February 2006) 788 801 18 819

Florida (July 1997)c 4163 36386 397 36783

Georgia (December 2003) 2245 8197 194 8391

Idaho (June 1986) 35 340 4 344

Illinois (January 2006) 6241 6661 162 6823

Indiana (July 1988) 399 4027 43 4070

Iowa (July 1998) 69 586 5 591

Kansas (July 1999) 142 1225 15 1240

Kentucky (October 2004) 333 1303 13 1316

Louisiana (February 1993) 728 8149 166 8315

Maine (January 2006) 386 393 3 396

Michigan (April 1992) 635 6702 134 6836

Minnesota (October 1985) 309 3356 40 3396

Mississippi (August 1988) 352 4549 59 4608

Missouri (October 1987) 502 5086 55 5141

Nebraska (September 1995) 91 672 14 686

Nevada (February 1992) 339 3532 24 3556

New Hampshire (January 2005) 59 466 9 475

New Jersey (January 1992) 1477 17513 325 17838

New Mexico (January 1998) 114 949 4 953

New York (June 2000) 5326 42345 1820 44165

North Carolina (February 1990) 1615 13879 143 14022

North Dakota (January 1988) 4 82 1 83

Ohio (June 1990) 867 8222 101 8323

Oklahoma (June 1988) 229 2401 30 2431

Oregon (April 2006) 49 95 19 114

Pennsylvania (October 2002)d 4269 9537 179 9716

Rhode Island (July 2006) 14 21 0 21

South Carolina (February 1986) 493 6970 93 7063

South Dakota (January 1988) 18 215 6 221

Tennessee (January 1992) 732 7115 90 7205

Texas (January 1999)e 3370 24282 417 24699

Utah (April 1989) 106 893 14 907

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 35

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Virginia (July 1989) 864 10257 95 10352

Washington (March 2006) 4048 4157 40 4197

West Virginia (January 1989) 66 673 8 681

Wisconsin (November 1985) 261 2500 31 2531

Wyoming (June 1989) 7 93 1 94

Subtotal 50834 274822 5146 279968

US dependent areas

American Samoa (August 2001) 0 1 0 1

Guam (March 2000) 2 66 0 66

Northern Mariana Islands (October 2001) 2 7 0 7

Puerto Rico (January 2003) 1471 5610 91 5701

US Virgin Islands (December 1998) 22 247 6 253

Persons reported from areas with confidential name-based HIV infection reporting but who were residents of other areas 132 685 21 706

Totalf 52878 282640 5314 287954

Note Includes data from 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through 2006b Beginning in 1992 Connecticut had name-based HIV reporting for cases in children only From January 2002 through December 2004

Connecticut had name- or code-based HIV reporting for cases in adolescents and adults As of January 2005 Connecticut has name-based reporting of all cases of HIV infection

c Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterd On October 18 2002 Pennsylvania initiated confidential name-based HIV infection reporting in all areas except Philadelphia Code-based

reporting was implemented in Philadelphia in March 2004 and the switch to name-based reporting was made in October 2005e From February 1994 through December 1998 Texas reported HIV infection in children onlyf Includes 1252 persons reported from areas with confidential name-based HIV infection reporting but whose area of residence is unknown

36 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulativemdashUnited States and dependent areas

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No Adult or adolescentMale-to-male sexual contact 13775 49 429897 54 mdash mdash mdash mdash 13775 35 429897 44Injection drug use 3413 12 163070 21 1826 17 67693 35 5239 13 230763 23Male-to-male sexual contact and

injection drug use 1603 6 65524 8 mdash mdash mdash mdash 1603 4 65524 7Hemophiliacoagulation disorder 43 0 5176 1 11 0 348 0 54 0 5524 1High-risk heterosexual contactc 2997 11 49610 6 4839 46 85186 44 7836 20 134796 14

Sex with injection drug user 330 1 11683 1 706 7 26073 14 1036 3 37756 4Sex with bisexual male mdash mdash mdash mdash 234 2 5162 3 234 1 5162 1Sex with person with hemophilia 1 0 84 0 11 0 502 0 12 0 586 0Sex with HIV-infected transfusion

recipient 22 0 553 0 21 0 793 0 43 0 1346 0Sex with HIV-infected person risk

factor not specified 2644 9 37290 5 3867 37 52656 27 6511 17 89946 9Receipt of blood transfusion blood

d components or tissue 63 0 5213 1 68 1 4176 2 131 0 9389 1Otherrisk factor not reported or

identifiede 6484 23 73136 9 3793 36 34311 18 10278 26 107450 11Subtotal 28378 100 791626 100 10537 100 191714 100 38916 100 983343 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 0 0 222 5 0 0 7 0 0 0 229 2Mother with documented HIV infection or

1 of the following risk factors 24 75 4315 89 50 93 4423 95 74 86 8738 92Injection drug use 4 13 1676 35 4 7 1665 36 8 9 3341 35Sex with injection drug user 4 13 789 16 4 7 750 16 8 9 1539 16Sex with bisexual male 1 3 101 2 2 4 110 2 3 3 211 2Sex with person with hemophilia 0 0 20 0 0 0 16 0 0 0 36 0Sex with HIV-infected transfusion

recipient 0 0 11 0 0 0 15 0 0 0 26 0Sex with HIV-infected person risk

factor not specified 6 19 742 15 17 31 790 17 23 27 1532 16Receipt of blood transfusion blood

components or tissue 0 0 70 1 0 0 82 2 0 0 152 2Has HIV infection risk factor not

specified 9 28 906 19 23 43 995 21 32 37 1901 20Receipt of blood transfusion blood

fcomponents or tissue 1 3 243 5 0 0 144 3 1 1 387 4Otherrisk factor not reported or

identifiedg 7 22 75 2 4 7 93 2 11 13 168 2Subtotal 32 100 4855 100 54 100 4667 100 86 100 9522 100

Total 28410 100 796481 100 10591 100 196381 100 39002 100 992865 100a From the beginning of the epidemic through 2006b From the beginning of the epidemic through 2006 Includes 3 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infectiond AIDS developed in 47 adultsadolescents after they received blood that had tested negative for HIV antibodies AIDS developed in 14 additional adults

after they received tissue organs or artificial insemination from HIV-infected donors Four of the 14 received tissue or organs from a donor who was negative for HIV antibody at the time of donation

e Includes 37 adultsadolescents who were exposed to HIV-infected blood body fluids or concentrated virus in health care laboratory or household settings as supported by seroconversion epidemiologic andor laboratory evidence One person was infected after intentional inoculation with HIV-infected blood Includes an additional 740 persons who acquired HIV infection perinatally but who were more than 12 years of age when AIDS was diagnosed These 740 persons are not counted in the values for the pediatric transmission category

f AIDS developed in 3 children after they received blood that had tested negative for HIV antibodiesg Includes 5 children who were exposed to HIV-infected blood as supported by seroconversion epidemiologic andor laboratory evidence 1 child was

infected after intentional inoculation with HIV-infected blood and 5 children were exposed to HIV-infected blood in a household setting Of the 168 children 26 had sexual contact with an adult with or at high risk for HIV infection

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 37

Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No

Adult or adolescentMale-to-male sexual contact 22912 59 103679 52 mdash mdash mdash mdash 22912 44 103679 37

Injection drug use 3503 9 24255 12 2124 16 13925 17 5627 11 38181 14

Male-to-male sexual contact and injection drug use 1946 5 10704 5 mdash mdash mdash mdash 1946 4 10704 4

Hemophiliacoagulation disorder 43 0 495 0 6 0 73 0 49 0 568 0

High-risk heterosexual contactc 2874 7 16830 8 5939 45 38315 47 8813 17 55145 20

Sex with injection drug user 308 1 2601 1 757 6 6791 8 1065 2 9392 3

Sex with bisexual male mdash mdash mdash mdash 328 2 2265 3 328 1 2265 1

Sex with person with hemophilia 4 0 31 0 16 0 201 0 20 0 232 0

Sex with HIV-infected transfusion recipient 13 0 131 0 28 0 223 0 41 0 354 0

Sex with HIV-infected person risk factor not specified 2549 7 14067 7 4810 36 28835 35 7359 14 42902 15

Receipt of blood transfusion blood components or tissue 61 0 489 0 50 0 536 1 111 0 1025 0

Otherrisk factor not reported or identified 7748 20 44021 22 5106 39 29312 36 12854 25 73338 26

Subtotal 39087 100 200473 100 13225 100 82161 100 52312 100 282640 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 8 3 106 4 0 0 1 0 8 1 107 2

Mother with documented HIV infection or 1 of the following risk factors 197 74 2195 85 254 85 2417 89 451 80 4612 87

Injection drug use 34 13 532 21 53 18 561 21 87 15 1093 21

Sex with injection drug user 12 5 208 8 21 7 213 8 33 6 421 8

Sex with bisexual male 5 2 37 1 4 1 32 1 9 2 69 1

Sex with person with hemophilia 0 0 3 0 1 0 7 0 1 0 10 0

Sex with HIV-infected transfusion recipient 0 0 4 0 0 0 4 0 0 0 8 0

Sex with HIV-infected person risk factor not specified 54 20 534 21 76 25 629 23 130 23 1163 22

Receipt of blood transfusion blood components or tissue 0 0 17 1 2 1 20 1 2 0 37 1

Has HIV infection risk factor not specified 92 35 860 33 97 32 951 35 189 33 1811 34

Receipt of blood transfusion blood components or tissue 6 2 28 1 3 1 24 1 9 2 52 1

Otherrisk factor not reported or identified 55 21 260 10 43 14 283 10 98 17 543 10

Subtotal 266 100 2589 100 300 100 2725 100 566 100 5314 100

Total 39353 100 203062 100 13525 100 84886 100 52878 100 287954 100

Note See Table 16 for the list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006b From the beginning of the epidemic through December 2006 Includes 6 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infection

38 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity

2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 6251 65 253927 73Injection drug use 733 8 31737 9Male-to-male sexual contact and injection drug use 732 8 31434 9Hemophiliacoagulation disorder 26 0 3989 1High-risk heterosexual contactb 416 4 7850 2

Sex with injection drug user 74 1 2310 1

Sex with person with hemophilia 0 0 36 0

Sex with HIV-infected transfusion recipient 2 0 176 0

Sex with HIV-infected person risk factor not specified 340 4 5328 2Receipt of blood transfusion blood components or tissue 20 0 3194 1Otherrisk factor not reported or identified 1400 15 16469 5

Total 9578 100 348600 100

Black not HispanicMale-to-male sexual contact 4309 36 103297 37Injection drug use 1635 14 83369 30Male-to-male sexual contact and injection drug use 526 4 22134 8Hemophiliacoagulation disorder 10 0 604 0High-risk heterosexual contactb 1875 16 29952 11

Sex with injection drug user 167 1 6823 2Sex with person with hemophilia 1 0 36 0Sex with HIV-infected transfusion recipient 15 0 237 0Sex with HIV-infected person risk factor not specified 1692 14 22856 8

Receipt of blood transfusion blood components or tissue 24 0 1218 0Otherrisk factor not reported or identified 3579 30 40268 14

Total 11958 100 280842 100

HispanicMale-to-male sexual contact 2816 47 64893 44Injection drug use 965 16 46337 31Male-to-male sexual contact and injection drug use 287 5 10884 7Hemophiliacoagulation disorder 6 0 466 0High-risk heterosexual contactb 638 11 10950 7

Sex with injection drug user 84 1 2409 2Sex with person with hemophilia 0 0 11 0Sex with HIV-infected transfusion recipient 5 0 125 0Sex with HIV-infected person risk factor not specified 549 9 8405 6

Receipt of blood transfusion blood components or tissue 17 0 657 0Otherrisk factor not reported or identified 1326 22 14832 10

Total 6055 100 149019 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 39

a

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulative

No No

AsianPacific IslanderMale-to-male sexual contact 225 54 4475 68Injection drug use 20 5 317 5Male-to-male sexual contact and injection drug use 17 4 284 4Hemophiliacoagulation disorder 1 0 70 1High-risk heterosexual contactb 34 8 376 6

Sex with injection drug user 1 0 54 1Sex with person with hemophilia 0 0 1 0Sex with HIV-infected transfusion recipient 0 0 8 0Sex with HIV-infected person risk factor not specified 33 8 313 5

Receipt of blood transfusion blood components or tissue 2 0 112 2Otherrisk factor not reported or identified 114 28 949 14

Total 413 100 6583 100

American IndianAlaska NativeMale-to-male sexual contact 61 49 1403 55Injection drug use 15 12 395 15Male-to-male sexual contact and injection drug use 23 19 457 18Hemophiliacoagulation disorder 0 0 27 1High-risk heterosexual contactb 9 7 118 5

Sex with injection drug user 1 1 33 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 8 6 82 3

Receipt of blood transfusion blood components or tissue 0 0 8 0Otherrisk factor not reported or identified 16 13 155 6

Total 124 100 2563 100

Total casesMale-to-male sexual contact 13775 49 429897 54Injection drug use 3413 12 163070 21Male-to-male sexual contact and injection drug use 1603 6 65524 8Hemophiliacoagulation disorder 43 0 5176 1High-risk heterosexual contactb 2997 11 49610 6

Sex with injection drug user 330 1 11683 1Sex with person with hemophilia 1 0 84 0Sex with HIV-infected transfusion recipient 22 0 553 0Sex with HIV-infected person risk factor not specified 2644 9 37290 5

Receipt of blood transfusion blood components or tissue 63 0 5213 1Otherrisk factor not reported or identified 6484 23 73136 9

Total 28378c 100 791626d 100a From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 4019 males of unknown race or multiple races

40 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 11963 73 55725 69Injection drug use 858 5 5512 7Male-to-male sexual contact and injection drug use 1092 7 5578 7Hemophiliacoagulation disorder 29 0 355 0High-risk heterosexual contactb 522 3 2658 3

Sex with injection drug user 65 0 544 1Sex with person with hemophilia 0 0 8 0Sex with HIV-infected transfusion recipient 3 0 33 0Sex with HIV-infected person risk factor not specified 454 3 2073 3

Receipt of blood transfusion blood components or tissue 14 0 197 0Otherrisk factor not reported or identified 1956 12 11147 14

Total 16434 100 81172 100

Black not HispanicMale-to-male sexual contact 6203 44 30148 37Injection drug use 1594 11 11997 15Male-to-male sexual contact and injection drug use 483 3 3489 4Hemophiliacoagulation disorder 10 0 109 0High-risk heterosexual contactb 1714 12 10905 13

Sex with injection drug user 169 1 1554 2Sex with person with hemophilia 4 0 17 0Sex with HIV-infected transfusion recipient 6 0 77 0Sex with HIV-infected person risk factor not specified 1535 11 9257 11

Receipt of blood transfusion blood components or tissue 32 0 223 0Otherrisk factor not reported or identified 4151 29 24632 30

Total 14187 100 81503 100

HispanicMale-to-male sexual contact 4094 55 15623 47Injection drug use 993 13 6407 19Male-to-male sexual contact and injection drug use 316 4 1402 4Hemophiliacoagulation disorder 3 0 26 0High-risk heterosexual contactb 582 8 2963 9

Sex with injection drug user 65 1 455 1Sex with person with hemophilia 0 0 6 0Sex with HIV-infected transfusion recipient 4 0 18 0Sex with HIV-infected person risk factor not specified 513 7 2484 7

Receipt of blood transfusion blood components or tissue 11 0 55 0Otherrisk factor not reported or identified 1475 20 6977 21

Total 7474 100 33453 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 41

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderMale-to-male sexual contact 402 70 1006 63Injection drug use 17 3 55 3Male-to-male sexual contact and injection drug use 15 3 38 2Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 25 4 96 6

Sex with injection drug user 3 1 10 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 22 4 83 5

Receipt of blood transfusion blood components or tissue 4 1 7 0Otherrisk factor not reported or identified 109 19 397 25

Total 572 100 1600 100

American IndianAlaska NativeMale-to-male sexual contact 104 61 516 57Injection drug use 13 8 101 11Male-to-male sexual contact and injection drug use 19 11 110 12Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 10 6 53 6

Sex with injection drug user 2 1 14 2Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 8 5 39 4

Receipt of blood transfusion blood components or tissue 0 0 2 0Otherrisk factor not reported or identified 24 14 125 14

Total 170 100 907 100

Total casesMale-to-male sexual contact 22912 59 103679 52Injection drug use 3503 9 24255 12Male-to-male sexual contact and injection drug use 1946 5 10704 5Hemophiliacoagulation disorder 43 0 495 0High-risk heterosexual contactb 2874 7 16830 8

Sex with injection drug user 308 1 2601 1Sex with person with hemophilia 4 0 31 0Sex with HIV-infected transfusion recipient 13 0 131 0Sex with HIV-infected person risk factor not specified 2549 7 14067 7

Receipt of blood transfusion blood components or tissue 61 0 489 0Otherrisk factor not reported or identified 7748 20 44021 22

Total 39087c 100 200473d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 1838 males of unknown race or multiple races

42 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race

ethnicity 2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 482 28 14981 40Hemophiliacoagulation disorder 4 0 123 0High-risk heterosexual contactb 725 42 15799 42

Sex with injection drug user 153 9 5650 15Sex with bisexual male 63 4 1859 5Sex with person with hemophilia 5 0 329 1Sex with HIV-infected transfusion recipient 5 0 338 1Sex with HIV-infected person risk factor not specified 499 29 7623 20

Receipt of blood transfusion blood components or tissue 15 1 1870 5Otherrisk factor not reported or identified 499 29 4801 13

Total 1725 100 37574 100

Black not HispanicInjection drug use 982 15 38914 34Hemophiliacoagulation disorder 3 0 145 0High-risk heterosexual contactb 3103 46 49876 44

Sex with injection drug user 373 6 13530 12Sex with bisexual male 136 2 2352 2Sex with person with hemophilia 4 0 121 0Sex with HIV-infected transfusion recipient 8 0 277 0Sex with HIV-infected person risk factor not specified 2582 38 33596 29

Receipt of blood transfusion blood components or tissue 39 1 1546 1Otherrisk factor not reported or identified 2612 39 23894 21

Total 6739 100 114375 100

HispanicInjection drug use 322 18 12892 35Hemophiliacoagulation disorder 4 0 67 0High-risk heterosexual contactb 894 49 17995 49

Sex with injection drug user 166 9 6522 18Sex with bisexual male 32 2 818 2Sex with person with hemophilia 1 0 45 0Sex with HIV-infected transfusion recipient 7 0 141 0Sex with HIV-infected person risk factor not specified 688 38 10469 29

Receipt of blood transfusion blood components or tissue 12 1 619 2Otherrisk factor not reported or identified 592 32 5023 14

Total 1824 100 36596 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 43

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 8 8 125 12Hemophiliacoagulation disorder 0 0 7 1High-risk heterosexual contactb 49 47 574 53

Sex with injection drug user 4 4 114 11Sex with bisexual male 2 2 80 7Sex with person with hemophilia 0 0 4 0Sex with HIV-infected transfusion recipient 1 1 25 2Sex with HIV-infected person risk factor not specified 42 40 351 33

Receipt of blood transfusion blood components or tissue 1 1 93 9Otherrisk factor not reported or identified 46 44 279 26

Total 104 100 1078 100

American IndianAlaska NativeInjection drug use 13 32 280 42Hemophiliacoagulation disorder 0 0 3 0High-risk heterosexual contactb 15 37 277 41

Sex with injection drug user 4 10 107 16Sex with bisexual male 1 2 27 4Sex with person with hemophilia 0 0 2 0Sex with HIV-infected transfusion recipient 0 0 6 1Sex with HIV-infected person risk factor not specified 10 24 135 20

Receipt of blood transfusion blood components or tissue 1 2 17 3Otherrisk factor not reported or identified 12 29 95 14

Total 41 100 672 100

Total casesInjection drug use 1826 17 67693 35Hemophiliacoagulation disorder 11 0 348 0High-risk heterosexual contactb 4839 46 85186 44

Sex with injection drug user 706 7 26073 14Sex with bisexual male 234 2 5162 3Sex with person with hemophilia 11 0 502 0Sex with HIV-infected transfusion recipient 21 0 793 0Sex with HIV-infected person risk factor not specified 3867 37 52656 27

Receipt of blood transfusion blood components or tissue 68 1 4176 2Otherrisk factor not reported or identified 3793 36 34311 18

Total 10537c 100 191714d 100a From the beginning of the epidemic through 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 104 females of unknown race or multiple racesd Includes 1419 females of unknown race or multiple races

44 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 690 26 4260 26Hemophiliacoagulation disorder 3 0 24 0

bHigh-risk heterosexual contact 1132 42 7593 46Sex with injection drug user 205 8 1876 11Sex with bisexual male 98 4 659 4Sex with person with hemophilia 10 0 115 1Sex with HIV-infected transfusion recipient 7 0 64 0Sex with HIV-infected person risk factor not specified 812 30 4879 29

Receipt of blood transfusion blood components or tissue 12 0 146 1Otherrisk factor not reported or identified 850 32 4567 28

Total 2687 100 16590 100

Black not HispanicInjection drug use 1034 13 7105 14Hemophiliacoagulation disorder 1 0 35 0

bHigh-risk heterosexual contact 3451 44 23732 46Sex with injection drug user 313 4 3473 7Sex with bisexual male 155 2 1294 3Sex with person with hemophilia 5 0 71 0Sex with HIV-infected transfusion recipient 14 0 120 0Sex with HIV-infected person risk factor not specified 2964 38 18774 36

Receipt of blood transfusion blood components or tissue 26 0 324 1Otherrisk factor not reported or identified 3370 43 20244 39

Total 7882 100 51440 100

HispanicInjection drug use 339 15 2280 18Hemophiliacoagulation disorder 2 0 11 0

bHigh-risk heterosexual contact 1198 52 6264 50Sex with injection drug user 218 9 1324 11Sex with bisexual male 62 3 266 2Sex with person with hemophilia 1 0 11 0Sex with HIV-infected transfusion recipient 7 0 39 0Sex with HIV-infected person risk factor not specified 910 39 4624 37

Receipt of blood transfusion blood components or tissue 12 1 58 0Otherrisk factor not reported or identified 767 33 3843 31

Total 2318 100 12456 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 45

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 22: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002ndash2006mdashUnited States and dependent areas

2002 2003 2004 2005 2006Data for 50 states and the District of Columbia

Age at end of year (yrs)lt13 2308 2006 1684 1394 111513ndash14 685 747 784 762 71115ndash19 1465 1694 1974 2243 248720ndash24 3910 4292 4629 5033 536725ndash29 12725 12743 13045 13505 1435930ndash34 35558 33870 32057 29949 2882435ndash39 70107 68106 65076 62235 5964940ndash44 80377 86294 91335 94021 9517445ndash49 64702 71276 77417 84153 9077550ndash54 41270 46855 53333 59256 6647655ndash59 20113 24145 28356 33522 3901460ndash64 9681 11293 13305 15380 18072gt65 7520 8946 10604 12430 14669

RaceethnicityWhite not Hispanic 129426 135278 141508 147426 154495Black not Hispanic 150488 161326 171654 181056 191590Hispanic 63424 67895 72024 76334 80815AsianPacific Islander 3060 3426 3759 4121 4526American IndianAlaska Native 1254 1356 1458 1562 1651

Transmission categoryMale adult or adolescentMale-to-male sexual contact 158092 168233 178551 188622 199693Injection drug use 56708 58436 59940 61229 62998Male-to-male sexual contact and injection drug use 24726 25457 26144 26785 27523High-risk heterosexual contacta 27329 30300 33181 35916 39004Otherb 3588 3665 3769 3888 4026Subtotal 270444 286091 301585 316440 333244

Female adult or adolescentInjection drug use 27863 28874 29828 30646 31575High-risk heterosexual contacta 46445 51489 56229 60693 65631Otherb 1903 2033 2178 2315 2465Subtotal 76210 82395 88236 93653 99671

Child (lt13 yrs at diagnosis)Perinatal 3633 3654 3651 3664 3660Otherc 129 124 123 122 115Subtotal 3762 3778 3774 3786 3775

Region of residenceNortheast 105599 110929 115562 120208 125620Midwest 36011 38571 41178 44171 47010South 137081 147284 157975 166962 177591West 71729 75483 78883 82540 86473

Subtotal for 50 states and the District of Columbia 350419 372267 393598 413882 436693

Data for US dependent areas 9880 10365 10713 11106 11359

Totald 360617 383024 404849 425646 448871Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes persons of unknown race or multiple races and persons of unknown sex Because column totals were calculated independently of

the values for the subpopulations the values in each column may not sum to the column total

22 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission categorymdash50 states and the District of Columbia

Transmission category

White not Hispanic

Black not Hispanic Hispanic

AsianPacific Islander

American IndianAlaska

Native Totala

No No No No No No

Male adult or adolescentMale-to-male sexual contact 101299 75 57520 45 36087 57 2715 72 704 57 199693 60Injection drug use 13168 10 33911 27 14795 23 325 9 201 16 62998 19Male-to-male sexual contact and

injection drug use 12393 9 10121 8 4352 7 198 5 220 18 27523 8High-risk heterosexual contactb 6081 5 24205 19 7816 12 444 12 105 8 39004 12Otherc 1743 1 1602 1 574 1 69 2 16 1 4026 1Subtotal 134683 100 127359 100 63623 100 3752 100 1246 100 333244 100

Female adult or adolescentInjection drug use 7407 38 18531 30 5025 30 115 15 153 39 31575 32High-risk heterosexual contactb 11350 59 41741 68 11092 67 588 78 227 58 65631 66Otherc 508 3 1456 2 413 2 51 7 13 3 2465 2Subtotal 19264 100 61728 100 16531 100 753 100 393 100 99671 100

Child (lt13 yrs at diagnosis)Perinatal 500 92 2468 99 629 95 20 94 12 100 3660 97Otherd 46 8 34 1 33 5 1 6 0 0 115 3Subtotal 546 100 2503 100 662 100 21 100 12 100 3775 100

Totale 154495 191590 80815 4526 1651 436693

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Includes 3616 persons of unknown race or multiple racesb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes 3 person of unknown sex Because column totals were calculated independently of the values for the subpopulations the values in each column

may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 23

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by

area of residence and age categorymdashUnited States and dependent areas

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

Alabama 5469 17 5486 3744 11 3755Alaska 272 1 273 330 1 331Arizona 5744 49 5793 4922 7 4929Arkansas 2291 7 2298 2139 6 2145California mdash mdash mdash 61451 105 61555Colorado 5855 13 5869 4083 2 4085Connecticut mdash mdash mdash 7406 15 7421Delaware mdash mdash mdash 1753 7 1760District of Columbia mdash mdash mdash 10059 30 10089Floridab 35461 263 35723 46469 194 46663Georgia mdash mdash mdash 17336 47 17383Hawaii mdash mdash mdash 1234 3 1237Idaho 356 0 356 313 0 313Illinois mdash mdash mdash 16139 46 16185Indiana 3849 21 3870 3996 14 4010Iowa 588 2 590 869 3 872Kansas 1230 7 1237 1272 2 1274Kentucky mdash mdash mdash 2589 13 2602Louisiana 7361 101 7462 8052 21 8074Maine mdash mdash mdash 512 2 514Maryland mdash mdash mdash 14540 41 14581Massachusetts mdash mdash mdash 8806 20 8826Michigan 6118 55 6173 6615 12 6627Minnesota 3227 21 3248 2314 9 2323Mississippi 4200 32 4232 3155 13 3168Missouri 4999 33 5033 5479 7 5486Montana mdash mdash mdash 205 0 205Nebraska 688 12 700 771 2 773Nevada 3402 13 3415 2969 3 2972New Hampshire mdash mdash mdash 556 3 559New Jersey 16059 153 16212 17168 57 17226New Mexico 910 0 909 1252 3 1255New York 42220 801 43021 70697 148 70845North Carolina 11700 60 11760 8451 12 8463North Dakota 87 2 89 73 1 74Ohio 8266 57 8323 7054 30 7084Oklahoma 2191 17 2208 2191 3 2194Oregon mdash mdash mdash 2840 4 2844Pennsylvania mdash mdash mdash 18633 71 18703Rhode Island mdash mdash mdash 1296 7 1303South Carolina 6349 45 6394 7035 23 7058South Dakota 195 4 199 139 1 140Tennessee 6579 51 6631 6403 11 6414Texas 24741 262 25003 34010 53 34063Utah 893 10 903 1164 0 1164Vermont mdash mdash mdash 238 2 240Virginia 9937 41 9978 8423 24 8447Washington mdash mdash mdash 5471 5 5476West Virginia 660 5 665 749 5 754Wisconsin 2322 15 2337 2153 12 2165Wyoming 86 2 88 102 1 103

Subtotal 224303 2174 226477 435621 1115 436736

24 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age categorymdashUnited States and dependent areas (cont)

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

US dependent areasAmerican Samoa 2 0 2 1 0 1Guam 63 0 63 36 0 36Northern Mariana Islands 7 0 7 3 0 3Puerto Rico 6269 31 6300 10971 26 10997US Virgin Islands 228 2 230 312 2 314Otherc mdash mdash mdash 1 0 1

Totald 230872 2207 233079 447724 1147 448871

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reporting a See Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at

least 2003b Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterc Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasd Total number of persons living with HIV infection (not AIDS) includes persons reported from areas with confidential name-based HIV

infection reporting who were residents of other states or whose area of residence is unknown Total number of persons living with AIDS includes persons whose area of residence is unknown Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 25

Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristicsmdashUnited States and dependent areas

No of persons

Survival in months

gt12 gt24 gt36Data for 50 states and the District of Columbia

Age at diagnosis (yrs)lt13 101 096 094 09413ndash14 60 098 098 09515ndash19 305 098 096 09520ndash24 1351 096 093 09225ndash29 3034 095 092 09130ndash34 5499 094 091 08935ndash39 7888 093 090 08740ndash44 7085 092 088 08545ndash49 5090 089 085 08250ndash54 3067 086 081 07855ndash59 1505 083 078 07460ndash64 806 080 073 069gt65 614 073 068 065

RaceethnicityWhite not Hispanic 10706 092 089 087Black not Hispanic 18406 090 086 082Hispanic 6398 092 090 088AsianPacific Islander 404 094 092 090American IndianAlaska Native 167 084 081 075

Transmission categoryMale adult or adolescentMale-to-male sexual contact 12830 093 090 088Injection drug use 4048 089 084 081Male-to-male sexual contact and injection drug use 1701 093 089 086High-risk heterosexual contacta 3170 091 088 085Otherb 5019 086 083 080Subtotal 26768 091 088 085

Female adult or adolescentInjection drug use 2101 089 083 078High-risk heterosexual contacta 4686 093 089 086Otherb 2749 090 085 083Subtotal 9536 091 087 083

Child (lt13 yrs at diagnosis)Perinatal 98 096 095 095Otherc 3 100 067 067Subtotal 101 096 094 094

Subtotal for 50 states and the District of Columbia 36405 091 087 085

Data for US dependent areas 891 083 078 075

Total 37352d 091 087 084Note Excludes persons whose date of death was before or in the same month as date of diagnosis Excludes persons whose month of diagnosis or month of death is unknowna Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes 325 persons of unknown race or multiple races

26 Survival after AIDS Diagnosis

Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by year of diagnosismdashUnited States and dependent areas

Months after AIDS diagnosis

Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by age groupmdashUnited States and dependent areas

Months after AIDS diagnosis

Survival after AIDS Diagnosis 27

Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by raceethnicitymdashUnited States and dependent areas

Months after AIDS diagnosis

28 Survival after AIDS Diagnosis

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006

and cumulativemdashUnited States and dependent areas

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Alabama 510 112 462 100 8626 76 8702Alaska 24 36 38 57 648 7 655Arizona 626 105 539 87 10396 46 10442Arkansas 237 85 252 90 3891 36 3927California 4069 113 3960 109 142254 664 142918Colorado 351 75 322 68 8742 31 8773Connecticut 658 188 422 120 14716 183 14899Delaware 177 210 116 136 3547 26 3573District of Columbia 672 1155 853 1467 17372 189 17561Florida 4921 277 4932 273 104084 1530 105614Georgia 2325 255 1605 171 31734 231 31965Hawaii 105 82 93 72 2927 17 2944Idaho 24 17 26 18 604 2 606Illinois 1886 148 1382 108 33620 282 33902Indiana 407 65 346 55 8239 56 8295Iowa 93 31 86 29 1727 13 1740Kansas 105 38 120 43 2781 14 2795Kentucky 249 60 207 49 4600 32 4632Louisiana 936 208 824 192 17612 128 17740Maine 21 16 68 51 1110 8 1118Maryland 1558 279 1626 290 30252 319 30571Massachusetts 666 104 533 83 19181 214 19395Michigan 821 81 672 67 14941 113 15054Minnesota 226 44 212 41 4817 28 4845Mississippi 368 127 365 125 6642 56 6698Missouri 385 66 469 80 11016 61 11077Montana 21 22 7 07 373 3 376Nebraska 53 30 118 67 1479 11 1490Nevada 293 121 294 118 5733 29 5762New Hampshire 33 25 55 42 1074 10 1084New Jersey 1262 145 1065 122 48750 778 49528New Mexico 134 70 93 48 2603 7 2610New York 6201 321 5495 285 174908 2354 177262North Carolina 916 106 1229 139 15954 118 16072North Dakota 10 16 6 09 144 1 145Ohio 753 66 767 67 14957 138 15095Oklahoma 281 79 205 57 4836 26 4862Oregon 217 60 281 76 5995 20 6015Pennsylvania 1486 120 1893 152 33417 365 33782Rhode Island 87 81 111 104 2580 28 2608South Carolina 682 161 705 163 13301 105 13406South Dakota 18 23 18 23 255 5 260Tennessee 818 137 680 113 12457 59 12516Texas 3045 133 2998 128 69735 392 70127Utah 63 25 57 22 2295 20 2315Vermont 5 08 18 29 461 6 467Virginia 638 84 605 79 16802 177 16979Washington 485 77 389 61 11792 34 11826West Virginia 74 41 67 37 1500 11 1511Wisconsin 122 22 217 39 4513 33 4546Wyoming 6 12 8 16 228 2 230

Subtotal 40123 135 37911 127 952221 9094 961315

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 29

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulativemdashUnited States and dependent areas (cont)

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

US dependent areasAmerican Samoa 0 0 0 0 1 0 1Guam 0 0 0 0 68 1 69Northern Mariana Islands 0 0 0 0 3 0 3Puerto Rico 1029 263 850 216 29511 400 29911US Virgin Islands 17 156 32 295 629 18 647Otherb 0 0 0 0 3 0 3

Totalc 41357 138 39002 129 983343 9522 992865d

a From the beginning of the epidemic through 2006b Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasc Includes persons whose state or area of residence is unknownd Includes 916 persons whose state or area of residence is unknown

30 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

MSA (population gt 500000)

Akron Ohio 66 94 32 46 762 1 763

AlbanyndashSchenectadyndashTroy NY 97 114 105 123 2253 24 2277

Albuquerque N Mex 70 88 50 61 1404 2 1406

AllentownndashBethlehemndashEaston PandashNJ 72 91 119 149 1352 17 1369

AtlantandashSandy SpringsndashMarietta Ga 1586 319 1006 196 21896 128 22024

AugustandashRichmond County GandashSC 106 205 32 61 1851 24 1875

AustinndashRound Rock Tex 227 156 186 123 4830 26 4856

Bakersfield Calif 76 100 122 156 1528 8 1536

BaltimorendashTowson Md 1064 401 1001 377 20352 218 20570

Baton Rouge La 222 304 231 301 3732 20 3752

BirminghamndashHoover Ala 151 139 110 100 2614 25 2639

Boise CityndashNampa Idaho 14 26 14 25 281 0 281

Boston MassndashNHa 441 99 355 80 13476 147 13623

Boston Division 269 146 185 101 8451 91 8542

Cambridge Division 108 74 102 70 3126 35 3161

Essex Division 52 71 51 69 1577 20 1597

BridgeportndashStamfordndashNorwalk Conn 181 201 135 150 3733 57 3790

BuffalondashNiagara Falls NY 117 102 96 84 2476 20 2496

Cape CoralndashFort Myers Fla 44 81 91 159 1692 24 1716

CharlestonndashNorth Charleston SC 92 155 91 151 2034 18 2052

CharlottendashGastoniandashConcord NCndashSC 214 141 285 180 3242 22 3264

Chicago IllndashIndndashWis 1716 182 1159 122 30118 261 30379

Chicago Division 1604 203 1073 135 28300 248 28548

Gary Division 61 88 50 71 1038 8 1046

Lake Division 51 59 36 41 780 5 785

CincinnatindashMiddletown OhiondashKyndashInd 111 53 199 95 2735 17 2752

ClevelandndashElyriandashMentor Ohio 228 107 170 80 4226 48 4274

Colorado Springs Colo 19 32 21 35 576 5 581

Columbia SC 177 256 197 280 3274 24 3298

Columbus Ohio 166 97 165 96 3112 15 3127

Dallas Tex 874 150 929 155 20238 63 20301

Dallas Division 681 175 714 178 16038 37 16075

Fort Worth Division 193 100 215 108 4200 26 4226

Dayton Ohio 58 69 54 64 1217 15 1232

DenverndashAurora Colo 274 116 236 98 6899 22 6921

Des Moines Iowa 30 57 23 43 530 4 534

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 31

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Detroit Mich 570 127 445 100 10373 73 10446

Detroit Division 443 223 330 167 8268 57 8325

Warren Division 127 51 115 46 2105 16 2121

El Paso Tex 56 78 40 54 1476 10 1486

Fresno Calif 52 59 64 72 1430 11 1441

Grand RapidsndashWyoming Mich 46 60 51 66 816 6 822

GreensborondashHigh Point NC 52 77 66 96 1265 14 1279

Greenville SC 70 119 67 111 1292 4 1296

HarrisburgndashCarlisle Pa 23 44 67 128 1224 8 1232

HartfordndashWest HartfordndashEast Hartford Conn 256 216 135 114 5126 46 5172

Honolulu Hawaii 54 60 69 76 2121 14 2135

HoustonndashBaytownndashSugar Land Tex 1017 190 1092 197 25821 172 25993

Indianapolis Ind 191 116 150 90 3824 25 3849

Jackson Miss 134 257 117 221 2419 30 2449

Jacksonville Fla 309 248 315 246 6020 75 6095

Kansas City MondashKans 183 94 160 81 4669 15 4684

Knoxville Tenn 47 72 35 52 882 5 887

Lakeland Fla 103 190 112 199 1811 21 1832

Las VegasndashParadise Nev 245 143 258 145 4616 28 4644

Little RockndashNorth Little Rock Ark 87 135 75 115 1383 14 1397

Los Angeles Calif 1529 118 1684 130 57953 293 58246

Los Angeles Division 1339 135 1435 144 51098 250 51348

Santa Anna Division 190 63 249 83 6855 43 6898

Louisville KyndashInd 123 102 97 79 2286 22 2308

Madison Wis 10 19 29 53 520 4 524

McAllenndashEdinburgndashPharr Tex 57 84 45 64 630 11 641

Memphis TennndashMissndashArk 402 320 346 271 5128 19 5147

Miami Fla 2420 446 2289 419 55807 997 56804

Fort Lauderdale Division 810 455 769 430 16412 262 16674

Miami Division 1243 523 1165 485 29703 512 30215

West Palm Beach Division 367 290 355 279 9692 223 9915

MilwaukeendashWaukeshandashWest Allis Wis 68 45 109 72 2507 18 2525

MinneapolisndashSt PaulndashBloomington MinnndashWis 186 59 184 58 4259 22 4281

Modesto Calif 36 71 22 43 671 6 677

NashvillendashDavidsonndashMurfreesboro Tenn 224 158 172 118 3848 20 3868

New HavenndashMilford Conn 169 200 107 127 4573 73 4646

New OrleansndashMetairiendashKenner La 393 299 271 264 8835 67 8902

32 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

New York NYndashNJndashPa 6215 330 5500 292 195177 2906 198083

Edison Division 191 83 130 56 6709 139 6848

Nassau Division 262 93 246 88 8141 110 8251

New York Division 5266 456 4716 408 160408 2323 162731

Newark Division 496 231 408 190 19919 334 20253

Oklahoma City Okla 125 108 88 75 2255 5 2260

OmahandashCouncil Bluffs NebndashIowa 37 46 80 97 1035 3 1038

Orlando Fla 544 282 517 260 8653 92 8745

OxnardndashThousand OaksndashVentura Calif 49 62 21 26 1008 3 1011

Palm BayndashMelbournendashTitusville Fla 68 129 61 114 1512 11 1523

Philadelphia PandashNJndashDelndashMd 1261 217 1348 231 28221 313 28534

Camden Division 108 87 111 89 3118 42 3160

Philadelphia Division 1022 263 1144 294 22112 250 22362

Wilmington Division 131 191 93 134 2991 21 3012

PhoenixndashMesandashScottsdale Ariz 460 119 376 93 7459 31 7490

Pittsburgh Pa 143 60 135 57 3182 19 3201

PortlandndashSouth Portland Maine 9 18 34 66 562 1 563

PortlandndashVancouverndashBeaverton OrendashWash 170 81 215 101 4825 10 4835

PoughkeepsiendashNewburghndashMiddletown NY 136 204 113 168 3162 24 3186

ProvidencendashNew BedfordndashFall River RIndashMass 132 82 155 96 3900 44 3944

RaleighndashCary NC 138 145 201 202 1987 13 2000

Richmond Va 119 101 122 102 3371 35 3406

RiversidendashSan BernardinondashOntario Calif 361 92 306 76 8568 60 8628

Rochester NY 165 159 124 120 3134 13 3147

SacramentondashArden-ArcadendashRoseville Calif 154 75 169 82 4000 26 4026

St Louis MondashIll 192 69 366 131 5965 40 6005

Salt Lake City Utah 46 44 40 37 1743 10 1753

San Antonio Tex 215 114 247 127 4987 30 5017

San DiegondashCarlsbadndashSan Marcos Calif 491 167 384 131 12934 61 12995

San Francisco Calif 867 209 690 165 40152 96 40248

Oakland Division 312 126 246 99 9546 48 9594

San Francisco Division 555 329 444 261 30606 48 30654

San JosendashSunnyvalendashSanta Clara Calif 88 50 145 81 3747 15 3762

San JuanndashCaguasndashGuaynabo PR 745 289 578 223 21402 277 21679

SarasotandashBradentonndashVenice Fla 82 122 104 152 1978 27 2005

ScrantonndashWilkes-Barre Pa 27 49 47 85 572 6 578

Seattle Wash 353 110 280 86 9172 27 9199

Seattle Division 316 129 255 102 8161 18 8179

Tacoma Division 37 49 25 33 1011 9 1020

Springfield Mass 88 128 45 66 2075 26 2101

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 33

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Stockton Calif 52 78 52 77 1076 15 1091

Syracuse NY 52 80 49 75 1317 8 1325

TampandashSt PetersburgndashClearwater Fla 559 211 605 224 11174 112 11286

Toledo Ohio 25 38 66 101 812 14 826

Tucson Ariz 103 111 100 106 2010 10 2020

Tulsa Okla 83 94 65 72 1494 10 1504

Virginia BeachndashNorfolkndashNewport News VandashNC 183 111 132 80 4711 63 4774

Washington DCndashVandashMdndashWV 1322 252 1684 318 31130 315 31445

Bethesda Division 135 118 173 150 2774 23 2797

Washington Division 1187 289 1511 365 28356 292 28648

Wichita Kans 35 60 38 64 851 2 853

Worcester Mass 76 97 79 101 1783 20 1803

YoungstownndashWarrenndashBoardman OhiondashPa 27 46 26 44 519 0 519

Subtotal for MSAs (population gt500000) 33602 173 31274 159 829633 8171 837804

Metropolitan areas (population of 50000 to 499999) 4477 80 4466 79 94829 847 95676

Nonmetropolitan areas 2666 54 2732 55 52063 445 52508

Totalb 41144 137 38749 128 981708 9494 991202

Note Because of the lack of census information for all US dependent areas includes data for only the 50 states the District of Columbia and Puerto RicoMSA metropolitan statistical areaMSA definitions for this report can be found at httpwwwcensusgovpopulationwwwestimatesmetrodefhtmla Reported case counts for the metropolitan divisions do not sum to the MSA total MSA total includes data from 1 metropolitan division with

population of lt500000b Includes persons whose county of residence is unknown

34 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Alabama (January 1988) 502 6041 48 6089

Alaska (February 1999) 38 285 2 287

Arizona (January 1987) 617 5877 80 5957

Arkansas (July 1989) 206 2349 20 2369

California (April 2006) 6581 7056 92 7148

Colorado (November 1985) 319 6084 31 6115

Connecticut (January 2005)b 826 2500 101 2601

Delaware (February 2006) 788 801 18 819

Florida (July 1997)c 4163 36386 397 36783

Georgia (December 2003) 2245 8197 194 8391

Idaho (June 1986) 35 340 4 344

Illinois (January 2006) 6241 6661 162 6823

Indiana (July 1988) 399 4027 43 4070

Iowa (July 1998) 69 586 5 591

Kansas (July 1999) 142 1225 15 1240

Kentucky (October 2004) 333 1303 13 1316

Louisiana (February 1993) 728 8149 166 8315

Maine (January 2006) 386 393 3 396

Michigan (April 1992) 635 6702 134 6836

Minnesota (October 1985) 309 3356 40 3396

Mississippi (August 1988) 352 4549 59 4608

Missouri (October 1987) 502 5086 55 5141

Nebraska (September 1995) 91 672 14 686

Nevada (February 1992) 339 3532 24 3556

New Hampshire (January 2005) 59 466 9 475

New Jersey (January 1992) 1477 17513 325 17838

New Mexico (January 1998) 114 949 4 953

New York (June 2000) 5326 42345 1820 44165

North Carolina (February 1990) 1615 13879 143 14022

North Dakota (January 1988) 4 82 1 83

Ohio (June 1990) 867 8222 101 8323

Oklahoma (June 1988) 229 2401 30 2431

Oregon (April 2006) 49 95 19 114

Pennsylvania (October 2002)d 4269 9537 179 9716

Rhode Island (July 2006) 14 21 0 21

South Carolina (February 1986) 493 6970 93 7063

South Dakota (January 1988) 18 215 6 221

Tennessee (January 1992) 732 7115 90 7205

Texas (January 1999)e 3370 24282 417 24699

Utah (April 1989) 106 893 14 907

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 35

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Virginia (July 1989) 864 10257 95 10352

Washington (March 2006) 4048 4157 40 4197

West Virginia (January 1989) 66 673 8 681

Wisconsin (November 1985) 261 2500 31 2531

Wyoming (June 1989) 7 93 1 94

Subtotal 50834 274822 5146 279968

US dependent areas

American Samoa (August 2001) 0 1 0 1

Guam (March 2000) 2 66 0 66

Northern Mariana Islands (October 2001) 2 7 0 7

Puerto Rico (January 2003) 1471 5610 91 5701

US Virgin Islands (December 1998) 22 247 6 253

Persons reported from areas with confidential name-based HIV infection reporting but who were residents of other areas 132 685 21 706

Totalf 52878 282640 5314 287954

Note Includes data from 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through 2006b Beginning in 1992 Connecticut had name-based HIV reporting for cases in children only From January 2002 through December 2004

Connecticut had name- or code-based HIV reporting for cases in adolescents and adults As of January 2005 Connecticut has name-based reporting of all cases of HIV infection

c Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterd On October 18 2002 Pennsylvania initiated confidential name-based HIV infection reporting in all areas except Philadelphia Code-based

reporting was implemented in Philadelphia in March 2004 and the switch to name-based reporting was made in October 2005e From February 1994 through December 1998 Texas reported HIV infection in children onlyf Includes 1252 persons reported from areas with confidential name-based HIV infection reporting but whose area of residence is unknown

36 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulativemdashUnited States and dependent areas

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No Adult or adolescentMale-to-male sexual contact 13775 49 429897 54 mdash mdash mdash mdash 13775 35 429897 44Injection drug use 3413 12 163070 21 1826 17 67693 35 5239 13 230763 23Male-to-male sexual contact and

injection drug use 1603 6 65524 8 mdash mdash mdash mdash 1603 4 65524 7Hemophiliacoagulation disorder 43 0 5176 1 11 0 348 0 54 0 5524 1High-risk heterosexual contactc 2997 11 49610 6 4839 46 85186 44 7836 20 134796 14

Sex with injection drug user 330 1 11683 1 706 7 26073 14 1036 3 37756 4Sex with bisexual male mdash mdash mdash mdash 234 2 5162 3 234 1 5162 1Sex with person with hemophilia 1 0 84 0 11 0 502 0 12 0 586 0Sex with HIV-infected transfusion

recipient 22 0 553 0 21 0 793 0 43 0 1346 0Sex with HIV-infected person risk

factor not specified 2644 9 37290 5 3867 37 52656 27 6511 17 89946 9Receipt of blood transfusion blood

d components or tissue 63 0 5213 1 68 1 4176 2 131 0 9389 1Otherrisk factor not reported or

identifiede 6484 23 73136 9 3793 36 34311 18 10278 26 107450 11Subtotal 28378 100 791626 100 10537 100 191714 100 38916 100 983343 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 0 0 222 5 0 0 7 0 0 0 229 2Mother with documented HIV infection or

1 of the following risk factors 24 75 4315 89 50 93 4423 95 74 86 8738 92Injection drug use 4 13 1676 35 4 7 1665 36 8 9 3341 35Sex with injection drug user 4 13 789 16 4 7 750 16 8 9 1539 16Sex with bisexual male 1 3 101 2 2 4 110 2 3 3 211 2Sex with person with hemophilia 0 0 20 0 0 0 16 0 0 0 36 0Sex with HIV-infected transfusion

recipient 0 0 11 0 0 0 15 0 0 0 26 0Sex with HIV-infected person risk

factor not specified 6 19 742 15 17 31 790 17 23 27 1532 16Receipt of blood transfusion blood

components or tissue 0 0 70 1 0 0 82 2 0 0 152 2Has HIV infection risk factor not

specified 9 28 906 19 23 43 995 21 32 37 1901 20Receipt of blood transfusion blood

fcomponents or tissue 1 3 243 5 0 0 144 3 1 1 387 4Otherrisk factor not reported or

identifiedg 7 22 75 2 4 7 93 2 11 13 168 2Subtotal 32 100 4855 100 54 100 4667 100 86 100 9522 100

Total 28410 100 796481 100 10591 100 196381 100 39002 100 992865 100a From the beginning of the epidemic through 2006b From the beginning of the epidemic through 2006 Includes 3 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infectiond AIDS developed in 47 adultsadolescents after they received blood that had tested negative for HIV antibodies AIDS developed in 14 additional adults

after they received tissue organs or artificial insemination from HIV-infected donors Four of the 14 received tissue or organs from a donor who was negative for HIV antibody at the time of donation

e Includes 37 adultsadolescents who were exposed to HIV-infected blood body fluids or concentrated virus in health care laboratory or household settings as supported by seroconversion epidemiologic andor laboratory evidence One person was infected after intentional inoculation with HIV-infected blood Includes an additional 740 persons who acquired HIV infection perinatally but who were more than 12 years of age when AIDS was diagnosed These 740 persons are not counted in the values for the pediatric transmission category

f AIDS developed in 3 children after they received blood that had tested negative for HIV antibodiesg Includes 5 children who were exposed to HIV-infected blood as supported by seroconversion epidemiologic andor laboratory evidence 1 child was

infected after intentional inoculation with HIV-infected blood and 5 children were exposed to HIV-infected blood in a household setting Of the 168 children 26 had sexual contact with an adult with or at high risk for HIV infection

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 37

Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No

Adult or adolescentMale-to-male sexual contact 22912 59 103679 52 mdash mdash mdash mdash 22912 44 103679 37

Injection drug use 3503 9 24255 12 2124 16 13925 17 5627 11 38181 14

Male-to-male sexual contact and injection drug use 1946 5 10704 5 mdash mdash mdash mdash 1946 4 10704 4

Hemophiliacoagulation disorder 43 0 495 0 6 0 73 0 49 0 568 0

High-risk heterosexual contactc 2874 7 16830 8 5939 45 38315 47 8813 17 55145 20

Sex with injection drug user 308 1 2601 1 757 6 6791 8 1065 2 9392 3

Sex with bisexual male mdash mdash mdash mdash 328 2 2265 3 328 1 2265 1

Sex with person with hemophilia 4 0 31 0 16 0 201 0 20 0 232 0

Sex with HIV-infected transfusion recipient 13 0 131 0 28 0 223 0 41 0 354 0

Sex with HIV-infected person risk factor not specified 2549 7 14067 7 4810 36 28835 35 7359 14 42902 15

Receipt of blood transfusion blood components or tissue 61 0 489 0 50 0 536 1 111 0 1025 0

Otherrisk factor not reported or identified 7748 20 44021 22 5106 39 29312 36 12854 25 73338 26

Subtotal 39087 100 200473 100 13225 100 82161 100 52312 100 282640 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 8 3 106 4 0 0 1 0 8 1 107 2

Mother with documented HIV infection or 1 of the following risk factors 197 74 2195 85 254 85 2417 89 451 80 4612 87

Injection drug use 34 13 532 21 53 18 561 21 87 15 1093 21

Sex with injection drug user 12 5 208 8 21 7 213 8 33 6 421 8

Sex with bisexual male 5 2 37 1 4 1 32 1 9 2 69 1

Sex with person with hemophilia 0 0 3 0 1 0 7 0 1 0 10 0

Sex with HIV-infected transfusion recipient 0 0 4 0 0 0 4 0 0 0 8 0

Sex with HIV-infected person risk factor not specified 54 20 534 21 76 25 629 23 130 23 1163 22

Receipt of blood transfusion blood components or tissue 0 0 17 1 2 1 20 1 2 0 37 1

Has HIV infection risk factor not specified 92 35 860 33 97 32 951 35 189 33 1811 34

Receipt of blood transfusion blood components or tissue 6 2 28 1 3 1 24 1 9 2 52 1

Otherrisk factor not reported or identified 55 21 260 10 43 14 283 10 98 17 543 10

Subtotal 266 100 2589 100 300 100 2725 100 566 100 5314 100

Total 39353 100 203062 100 13525 100 84886 100 52878 100 287954 100

Note See Table 16 for the list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006b From the beginning of the epidemic through December 2006 Includes 6 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infection

38 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity

2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 6251 65 253927 73Injection drug use 733 8 31737 9Male-to-male sexual contact and injection drug use 732 8 31434 9Hemophiliacoagulation disorder 26 0 3989 1High-risk heterosexual contactb 416 4 7850 2

Sex with injection drug user 74 1 2310 1

Sex with person with hemophilia 0 0 36 0

Sex with HIV-infected transfusion recipient 2 0 176 0

Sex with HIV-infected person risk factor not specified 340 4 5328 2Receipt of blood transfusion blood components or tissue 20 0 3194 1Otherrisk factor not reported or identified 1400 15 16469 5

Total 9578 100 348600 100

Black not HispanicMale-to-male sexual contact 4309 36 103297 37Injection drug use 1635 14 83369 30Male-to-male sexual contact and injection drug use 526 4 22134 8Hemophiliacoagulation disorder 10 0 604 0High-risk heterosexual contactb 1875 16 29952 11

Sex with injection drug user 167 1 6823 2Sex with person with hemophilia 1 0 36 0Sex with HIV-infected transfusion recipient 15 0 237 0Sex with HIV-infected person risk factor not specified 1692 14 22856 8

Receipt of blood transfusion blood components or tissue 24 0 1218 0Otherrisk factor not reported or identified 3579 30 40268 14

Total 11958 100 280842 100

HispanicMale-to-male sexual contact 2816 47 64893 44Injection drug use 965 16 46337 31Male-to-male sexual contact and injection drug use 287 5 10884 7Hemophiliacoagulation disorder 6 0 466 0High-risk heterosexual contactb 638 11 10950 7

Sex with injection drug user 84 1 2409 2Sex with person with hemophilia 0 0 11 0Sex with HIV-infected transfusion recipient 5 0 125 0Sex with HIV-infected person risk factor not specified 549 9 8405 6

Receipt of blood transfusion blood components or tissue 17 0 657 0Otherrisk factor not reported or identified 1326 22 14832 10

Total 6055 100 149019 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 39

a

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulative

No No

AsianPacific IslanderMale-to-male sexual contact 225 54 4475 68Injection drug use 20 5 317 5Male-to-male sexual contact and injection drug use 17 4 284 4Hemophiliacoagulation disorder 1 0 70 1High-risk heterosexual contactb 34 8 376 6

Sex with injection drug user 1 0 54 1Sex with person with hemophilia 0 0 1 0Sex with HIV-infected transfusion recipient 0 0 8 0Sex with HIV-infected person risk factor not specified 33 8 313 5

Receipt of blood transfusion blood components or tissue 2 0 112 2Otherrisk factor not reported or identified 114 28 949 14

Total 413 100 6583 100

American IndianAlaska NativeMale-to-male sexual contact 61 49 1403 55Injection drug use 15 12 395 15Male-to-male sexual contact and injection drug use 23 19 457 18Hemophiliacoagulation disorder 0 0 27 1High-risk heterosexual contactb 9 7 118 5

Sex with injection drug user 1 1 33 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 8 6 82 3

Receipt of blood transfusion blood components or tissue 0 0 8 0Otherrisk factor not reported or identified 16 13 155 6

Total 124 100 2563 100

Total casesMale-to-male sexual contact 13775 49 429897 54Injection drug use 3413 12 163070 21Male-to-male sexual contact and injection drug use 1603 6 65524 8Hemophiliacoagulation disorder 43 0 5176 1High-risk heterosexual contactb 2997 11 49610 6

Sex with injection drug user 330 1 11683 1Sex with person with hemophilia 1 0 84 0Sex with HIV-infected transfusion recipient 22 0 553 0Sex with HIV-infected person risk factor not specified 2644 9 37290 5

Receipt of blood transfusion blood components or tissue 63 0 5213 1Otherrisk factor not reported or identified 6484 23 73136 9

Total 28378c 100 791626d 100a From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 4019 males of unknown race or multiple races

40 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 11963 73 55725 69Injection drug use 858 5 5512 7Male-to-male sexual contact and injection drug use 1092 7 5578 7Hemophiliacoagulation disorder 29 0 355 0High-risk heterosexual contactb 522 3 2658 3

Sex with injection drug user 65 0 544 1Sex with person with hemophilia 0 0 8 0Sex with HIV-infected transfusion recipient 3 0 33 0Sex with HIV-infected person risk factor not specified 454 3 2073 3

Receipt of blood transfusion blood components or tissue 14 0 197 0Otherrisk factor not reported or identified 1956 12 11147 14

Total 16434 100 81172 100

Black not HispanicMale-to-male sexual contact 6203 44 30148 37Injection drug use 1594 11 11997 15Male-to-male sexual contact and injection drug use 483 3 3489 4Hemophiliacoagulation disorder 10 0 109 0High-risk heterosexual contactb 1714 12 10905 13

Sex with injection drug user 169 1 1554 2Sex with person with hemophilia 4 0 17 0Sex with HIV-infected transfusion recipient 6 0 77 0Sex with HIV-infected person risk factor not specified 1535 11 9257 11

Receipt of blood transfusion blood components or tissue 32 0 223 0Otherrisk factor not reported or identified 4151 29 24632 30

Total 14187 100 81503 100

HispanicMale-to-male sexual contact 4094 55 15623 47Injection drug use 993 13 6407 19Male-to-male sexual contact and injection drug use 316 4 1402 4Hemophiliacoagulation disorder 3 0 26 0High-risk heterosexual contactb 582 8 2963 9

Sex with injection drug user 65 1 455 1Sex with person with hemophilia 0 0 6 0Sex with HIV-infected transfusion recipient 4 0 18 0Sex with HIV-infected person risk factor not specified 513 7 2484 7

Receipt of blood transfusion blood components or tissue 11 0 55 0Otherrisk factor not reported or identified 1475 20 6977 21

Total 7474 100 33453 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 41

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderMale-to-male sexual contact 402 70 1006 63Injection drug use 17 3 55 3Male-to-male sexual contact and injection drug use 15 3 38 2Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 25 4 96 6

Sex with injection drug user 3 1 10 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 22 4 83 5

Receipt of blood transfusion blood components or tissue 4 1 7 0Otherrisk factor not reported or identified 109 19 397 25

Total 572 100 1600 100

American IndianAlaska NativeMale-to-male sexual contact 104 61 516 57Injection drug use 13 8 101 11Male-to-male sexual contact and injection drug use 19 11 110 12Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 10 6 53 6

Sex with injection drug user 2 1 14 2Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 8 5 39 4

Receipt of blood transfusion blood components or tissue 0 0 2 0Otherrisk factor not reported or identified 24 14 125 14

Total 170 100 907 100

Total casesMale-to-male sexual contact 22912 59 103679 52Injection drug use 3503 9 24255 12Male-to-male sexual contact and injection drug use 1946 5 10704 5Hemophiliacoagulation disorder 43 0 495 0High-risk heterosexual contactb 2874 7 16830 8

Sex with injection drug user 308 1 2601 1Sex with person with hemophilia 4 0 31 0Sex with HIV-infected transfusion recipient 13 0 131 0Sex with HIV-infected person risk factor not specified 2549 7 14067 7

Receipt of blood transfusion blood components or tissue 61 0 489 0Otherrisk factor not reported or identified 7748 20 44021 22

Total 39087c 100 200473d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 1838 males of unknown race or multiple races

42 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race

ethnicity 2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 482 28 14981 40Hemophiliacoagulation disorder 4 0 123 0High-risk heterosexual contactb 725 42 15799 42

Sex with injection drug user 153 9 5650 15Sex with bisexual male 63 4 1859 5Sex with person with hemophilia 5 0 329 1Sex with HIV-infected transfusion recipient 5 0 338 1Sex with HIV-infected person risk factor not specified 499 29 7623 20

Receipt of blood transfusion blood components or tissue 15 1 1870 5Otherrisk factor not reported or identified 499 29 4801 13

Total 1725 100 37574 100

Black not HispanicInjection drug use 982 15 38914 34Hemophiliacoagulation disorder 3 0 145 0High-risk heterosexual contactb 3103 46 49876 44

Sex with injection drug user 373 6 13530 12Sex with bisexual male 136 2 2352 2Sex with person with hemophilia 4 0 121 0Sex with HIV-infected transfusion recipient 8 0 277 0Sex with HIV-infected person risk factor not specified 2582 38 33596 29

Receipt of blood transfusion blood components or tissue 39 1 1546 1Otherrisk factor not reported or identified 2612 39 23894 21

Total 6739 100 114375 100

HispanicInjection drug use 322 18 12892 35Hemophiliacoagulation disorder 4 0 67 0High-risk heterosexual contactb 894 49 17995 49

Sex with injection drug user 166 9 6522 18Sex with bisexual male 32 2 818 2Sex with person with hemophilia 1 0 45 0Sex with HIV-infected transfusion recipient 7 0 141 0Sex with HIV-infected person risk factor not specified 688 38 10469 29

Receipt of blood transfusion blood components or tissue 12 1 619 2Otherrisk factor not reported or identified 592 32 5023 14

Total 1824 100 36596 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 43

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 8 8 125 12Hemophiliacoagulation disorder 0 0 7 1High-risk heterosexual contactb 49 47 574 53

Sex with injection drug user 4 4 114 11Sex with bisexual male 2 2 80 7Sex with person with hemophilia 0 0 4 0Sex with HIV-infected transfusion recipient 1 1 25 2Sex with HIV-infected person risk factor not specified 42 40 351 33

Receipt of blood transfusion blood components or tissue 1 1 93 9Otherrisk factor not reported or identified 46 44 279 26

Total 104 100 1078 100

American IndianAlaska NativeInjection drug use 13 32 280 42Hemophiliacoagulation disorder 0 0 3 0High-risk heterosexual contactb 15 37 277 41

Sex with injection drug user 4 10 107 16Sex with bisexual male 1 2 27 4Sex with person with hemophilia 0 0 2 0Sex with HIV-infected transfusion recipient 0 0 6 1Sex with HIV-infected person risk factor not specified 10 24 135 20

Receipt of blood transfusion blood components or tissue 1 2 17 3Otherrisk factor not reported or identified 12 29 95 14

Total 41 100 672 100

Total casesInjection drug use 1826 17 67693 35Hemophiliacoagulation disorder 11 0 348 0High-risk heterosexual contactb 4839 46 85186 44

Sex with injection drug user 706 7 26073 14Sex with bisexual male 234 2 5162 3Sex with person with hemophilia 11 0 502 0Sex with HIV-infected transfusion recipient 21 0 793 0Sex with HIV-infected person risk factor not specified 3867 37 52656 27

Receipt of blood transfusion blood components or tissue 68 1 4176 2Otherrisk factor not reported or identified 3793 36 34311 18

Total 10537c 100 191714d 100a From the beginning of the epidemic through 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 104 females of unknown race or multiple racesd Includes 1419 females of unknown race or multiple races

44 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 690 26 4260 26Hemophiliacoagulation disorder 3 0 24 0

bHigh-risk heterosexual contact 1132 42 7593 46Sex with injection drug user 205 8 1876 11Sex with bisexual male 98 4 659 4Sex with person with hemophilia 10 0 115 1Sex with HIV-infected transfusion recipient 7 0 64 0Sex with HIV-infected person risk factor not specified 812 30 4879 29

Receipt of blood transfusion blood components or tissue 12 0 146 1Otherrisk factor not reported or identified 850 32 4567 28

Total 2687 100 16590 100

Black not HispanicInjection drug use 1034 13 7105 14Hemophiliacoagulation disorder 1 0 35 0

bHigh-risk heterosexual contact 3451 44 23732 46Sex with injection drug user 313 4 3473 7Sex with bisexual male 155 2 1294 3Sex with person with hemophilia 5 0 71 0Sex with HIV-infected transfusion recipient 14 0 120 0Sex with HIV-infected person risk factor not specified 2964 38 18774 36

Receipt of blood transfusion blood components or tissue 26 0 324 1Otherrisk factor not reported or identified 3370 43 20244 39

Total 7882 100 51440 100

HispanicInjection drug use 339 15 2280 18Hemophiliacoagulation disorder 2 0 11 0

bHigh-risk heterosexual contact 1198 52 6264 50Sex with injection drug user 218 9 1324 11Sex with bisexual male 62 3 266 2Sex with person with hemophilia 1 0 11 0Sex with HIV-infected transfusion recipient 7 0 39 0Sex with HIV-infected person risk factor not specified 910 39 4624 37

Receipt of blood transfusion blood components or tissue 12 1 58 0Otherrisk factor not reported or identified 767 33 3843 31

Total 2318 100 12456 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 45

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 23: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission categorymdash50 states and the District of Columbia

Transmission category

White not Hispanic

Black not Hispanic Hispanic

AsianPacific Islander

American IndianAlaska

Native Totala

No No No No No No

Male adult or adolescentMale-to-male sexual contact 101299 75 57520 45 36087 57 2715 72 704 57 199693 60Injection drug use 13168 10 33911 27 14795 23 325 9 201 16 62998 19Male-to-male sexual contact and

injection drug use 12393 9 10121 8 4352 7 198 5 220 18 27523 8High-risk heterosexual contactb 6081 5 24205 19 7816 12 444 12 105 8 39004 12Otherc 1743 1 1602 1 574 1 69 2 16 1 4026 1Subtotal 134683 100 127359 100 63623 100 3752 100 1246 100 333244 100

Female adult or adolescentInjection drug use 7407 38 18531 30 5025 30 115 15 153 39 31575 32High-risk heterosexual contactb 11350 59 41741 68 11092 67 588 78 227 58 65631 66Otherc 508 3 1456 2 413 2 51 7 13 3 2465 2Subtotal 19264 100 61728 100 16531 100 753 100 393 100 99671 100

Child (lt13 yrs at diagnosis)Perinatal 500 92 2468 99 629 95 20 94 12 100 3660 97Otherd 46 8 34 1 33 5 1 6 0 0 115 3Subtotal 546 100 2503 100 662 100 21 100 12 100 3775 100

Totale 154495 191590 80815 4526 1651 436693

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor but not for incomplete reportinga Includes 3616 persons of unknown race or multiple racesb Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedd Includes hemophilia blood transfusion and risk factor not reported or not identifiede Includes 3 person of unknown sex Because column totals were calculated independently of the values for the subpopulations the values in each column

may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 23

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by

area of residence and age categorymdashUnited States and dependent areas

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

Alabama 5469 17 5486 3744 11 3755Alaska 272 1 273 330 1 331Arizona 5744 49 5793 4922 7 4929Arkansas 2291 7 2298 2139 6 2145California mdash mdash mdash 61451 105 61555Colorado 5855 13 5869 4083 2 4085Connecticut mdash mdash mdash 7406 15 7421Delaware mdash mdash mdash 1753 7 1760District of Columbia mdash mdash mdash 10059 30 10089Floridab 35461 263 35723 46469 194 46663Georgia mdash mdash mdash 17336 47 17383Hawaii mdash mdash mdash 1234 3 1237Idaho 356 0 356 313 0 313Illinois mdash mdash mdash 16139 46 16185Indiana 3849 21 3870 3996 14 4010Iowa 588 2 590 869 3 872Kansas 1230 7 1237 1272 2 1274Kentucky mdash mdash mdash 2589 13 2602Louisiana 7361 101 7462 8052 21 8074Maine mdash mdash mdash 512 2 514Maryland mdash mdash mdash 14540 41 14581Massachusetts mdash mdash mdash 8806 20 8826Michigan 6118 55 6173 6615 12 6627Minnesota 3227 21 3248 2314 9 2323Mississippi 4200 32 4232 3155 13 3168Missouri 4999 33 5033 5479 7 5486Montana mdash mdash mdash 205 0 205Nebraska 688 12 700 771 2 773Nevada 3402 13 3415 2969 3 2972New Hampshire mdash mdash mdash 556 3 559New Jersey 16059 153 16212 17168 57 17226New Mexico 910 0 909 1252 3 1255New York 42220 801 43021 70697 148 70845North Carolina 11700 60 11760 8451 12 8463North Dakota 87 2 89 73 1 74Ohio 8266 57 8323 7054 30 7084Oklahoma 2191 17 2208 2191 3 2194Oregon mdash mdash mdash 2840 4 2844Pennsylvania mdash mdash mdash 18633 71 18703Rhode Island mdash mdash mdash 1296 7 1303South Carolina 6349 45 6394 7035 23 7058South Dakota 195 4 199 139 1 140Tennessee 6579 51 6631 6403 11 6414Texas 24741 262 25003 34010 53 34063Utah 893 10 903 1164 0 1164Vermont mdash mdash mdash 238 2 240Virginia 9937 41 9978 8423 24 8447Washington mdash mdash mdash 5471 5 5476West Virginia 660 5 665 749 5 754Wisconsin 2322 15 2337 2153 12 2165Wyoming 86 2 88 102 1 103

Subtotal 224303 2174 226477 435621 1115 436736

24 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age categorymdashUnited States and dependent areas (cont)

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

US dependent areasAmerican Samoa 2 0 2 1 0 1Guam 63 0 63 36 0 36Northern Mariana Islands 7 0 7 3 0 3Puerto Rico 6269 31 6300 10971 26 10997US Virgin Islands 228 2 230 312 2 314Otherc mdash mdash mdash 1 0 1

Totald 230872 2207 233079 447724 1147 448871

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reporting a See Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at

least 2003b Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterc Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasd Total number of persons living with HIV infection (not AIDS) includes persons reported from areas with confidential name-based HIV

infection reporting who were residents of other states or whose area of residence is unknown Total number of persons living with AIDS includes persons whose area of residence is unknown Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 25

Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristicsmdashUnited States and dependent areas

No of persons

Survival in months

gt12 gt24 gt36Data for 50 states and the District of Columbia

Age at diagnosis (yrs)lt13 101 096 094 09413ndash14 60 098 098 09515ndash19 305 098 096 09520ndash24 1351 096 093 09225ndash29 3034 095 092 09130ndash34 5499 094 091 08935ndash39 7888 093 090 08740ndash44 7085 092 088 08545ndash49 5090 089 085 08250ndash54 3067 086 081 07855ndash59 1505 083 078 07460ndash64 806 080 073 069gt65 614 073 068 065

RaceethnicityWhite not Hispanic 10706 092 089 087Black not Hispanic 18406 090 086 082Hispanic 6398 092 090 088AsianPacific Islander 404 094 092 090American IndianAlaska Native 167 084 081 075

Transmission categoryMale adult or adolescentMale-to-male sexual contact 12830 093 090 088Injection drug use 4048 089 084 081Male-to-male sexual contact and injection drug use 1701 093 089 086High-risk heterosexual contacta 3170 091 088 085Otherb 5019 086 083 080Subtotal 26768 091 088 085

Female adult or adolescentInjection drug use 2101 089 083 078High-risk heterosexual contacta 4686 093 089 086Otherb 2749 090 085 083Subtotal 9536 091 087 083

Child (lt13 yrs at diagnosis)Perinatal 98 096 095 095Otherc 3 100 067 067Subtotal 101 096 094 094

Subtotal for 50 states and the District of Columbia 36405 091 087 085

Data for US dependent areas 891 083 078 075

Total 37352d 091 087 084Note Excludes persons whose date of death was before or in the same month as date of diagnosis Excludes persons whose month of diagnosis or month of death is unknowna Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes 325 persons of unknown race or multiple races

26 Survival after AIDS Diagnosis

Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by year of diagnosismdashUnited States and dependent areas

Months after AIDS diagnosis

Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by age groupmdashUnited States and dependent areas

Months after AIDS diagnosis

Survival after AIDS Diagnosis 27

Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by raceethnicitymdashUnited States and dependent areas

Months after AIDS diagnosis

28 Survival after AIDS Diagnosis

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006

and cumulativemdashUnited States and dependent areas

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Alabama 510 112 462 100 8626 76 8702Alaska 24 36 38 57 648 7 655Arizona 626 105 539 87 10396 46 10442Arkansas 237 85 252 90 3891 36 3927California 4069 113 3960 109 142254 664 142918Colorado 351 75 322 68 8742 31 8773Connecticut 658 188 422 120 14716 183 14899Delaware 177 210 116 136 3547 26 3573District of Columbia 672 1155 853 1467 17372 189 17561Florida 4921 277 4932 273 104084 1530 105614Georgia 2325 255 1605 171 31734 231 31965Hawaii 105 82 93 72 2927 17 2944Idaho 24 17 26 18 604 2 606Illinois 1886 148 1382 108 33620 282 33902Indiana 407 65 346 55 8239 56 8295Iowa 93 31 86 29 1727 13 1740Kansas 105 38 120 43 2781 14 2795Kentucky 249 60 207 49 4600 32 4632Louisiana 936 208 824 192 17612 128 17740Maine 21 16 68 51 1110 8 1118Maryland 1558 279 1626 290 30252 319 30571Massachusetts 666 104 533 83 19181 214 19395Michigan 821 81 672 67 14941 113 15054Minnesota 226 44 212 41 4817 28 4845Mississippi 368 127 365 125 6642 56 6698Missouri 385 66 469 80 11016 61 11077Montana 21 22 7 07 373 3 376Nebraska 53 30 118 67 1479 11 1490Nevada 293 121 294 118 5733 29 5762New Hampshire 33 25 55 42 1074 10 1084New Jersey 1262 145 1065 122 48750 778 49528New Mexico 134 70 93 48 2603 7 2610New York 6201 321 5495 285 174908 2354 177262North Carolina 916 106 1229 139 15954 118 16072North Dakota 10 16 6 09 144 1 145Ohio 753 66 767 67 14957 138 15095Oklahoma 281 79 205 57 4836 26 4862Oregon 217 60 281 76 5995 20 6015Pennsylvania 1486 120 1893 152 33417 365 33782Rhode Island 87 81 111 104 2580 28 2608South Carolina 682 161 705 163 13301 105 13406South Dakota 18 23 18 23 255 5 260Tennessee 818 137 680 113 12457 59 12516Texas 3045 133 2998 128 69735 392 70127Utah 63 25 57 22 2295 20 2315Vermont 5 08 18 29 461 6 467Virginia 638 84 605 79 16802 177 16979Washington 485 77 389 61 11792 34 11826West Virginia 74 41 67 37 1500 11 1511Wisconsin 122 22 217 39 4513 33 4546Wyoming 6 12 8 16 228 2 230

Subtotal 40123 135 37911 127 952221 9094 961315

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 29

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulativemdashUnited States and dependent areas (cont)

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

US dependent areasAmerican Samoa 0 0 0 0 1 0 1Guam 0 0 0 0 68 1 69Northern Mariana Islands 0 0 0 0 3 0 3Puerto Rico 1029 263 850 216 29511 400 29911US Virgin Islands 17 156 32 295 629 18 647Otherb 0 0 0 0 3 0 3

Totalc 41357 138 39002 129 983343 9522 992865d

a From the beginning of the epidemic through 2006b Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasc Includes persons whose state or area of residence is unknownd Includes 916 persons whose state or area of residence is unknown

30 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

MSA (population gt 500000)

Akron Ohio 66 94 32 46 762 1 763

AlbanyndashSchenectadyndashTroy NY 97 114 105 123 2253 24 2277

Albuquerque N Mex 70 88 50 61 1404 2 1406

AllentownndashBethlehemndashEaston PandashNJ 72 91 119 149 1352 17 1369

AtlantandashSandy SpringsndashMarietta Ga 1586 319 1006 196 21896 128 22024

AugustandashRichmond County GandashSC 106 205 32 61 1851 24 1875

AustinndashRound Rock Tex 227 156 186 123 4830 26 4856

Bakersfield Calif 76 100 122 156 1528 8 1536

BaltimorendashTowson Md 1064 401 1001 377 20352 218 20570

Baton Rouge La 222 304 231 301 3732 20 3752

BirminghamndashHoover Ala 151 139 110 100 2614 25 2639

Boise CityndashNampa Idaho 14 26 14 25 281 0 281

Boston MassndashNHa 441 99 355 80 13476 147 13623

Boston Division 269 146 185 101 8451 91 8542

Cambridge Division 108 74 102 70 3126 35 3161

Essex Division 52 71 51 69 1577 20 1597

BridgeportndashStamfordndashNorwalk Conn 181 201 135 150 3733 57 3790

BuffalondashNiagara Falls NY 117 102 96 84 2476 20 2496

Cape CoralndashFort Myers Fla 44 81 91 159 1692 24 1716

CharlestonndashNorth Charleston SC 92 155 91 151 2034 18 2052

CharlottendashGastoniandashConcord NCndashSC 214 141 285 180 3242 22 3264

Chicago IllndashIndndashWis 1716 182 1159 122 30118 261 30379

Chicago Division 1604 203 1073 135 28300 248 28548

Gary Division 61 88 50 71 1038 8 1046

Lake Division 51 59 36 41 780 5 785

CincinnatindashMiddletown OhiondashKyndashInd 111 53 199 95 2735 17 2752

ClevelandndashElyriandashMentor Ohio 228 107 170 80 4226 48 4274

Colorado Springs Colo 19 32 21 35 576 5 581

Columbia SC 177 256 197 280 3274 24 3298

Columbus Ohio 166 97 165 96 3112 15 3127

Dallas Tex 874 150 929 155 20238 63 20301

Dallas Division 681 175 714 178 16038 37 16075

Fort Worth Division 193 100 215 108 4200 26 4226

Dayton Ohio 58 69 54 64 1217 15 1232

DenverndashAurora Colo 274 116 236 98 6899 22 6921

Des Moines Iowa 30 57 23 43 530 4 534

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 31

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Detroit Mich 570 127 445 100 10373 73 10446

Detroit Division 443 223 330 167 8268 57 8325

Warren Division 127 51 115 46 2105 16 2121

El Paso Tex 56 78 40 54 1476 10 1486

Fresno Calif 52 59 64 72 1430 11 1441

Grand RapidsndashWyoming Mich 46 60 51 66 816 6 822

GreensborondashHigh Point NC 52 77 66 96 1265 14 1279

Greenville SC 70 119 67 111 1292 4 1296

HarrisburgndashCarlisle Pa 23 44 67 128 1224 8 1232

HartfordndashWest HartfordndashEast Hartford Conn 256 216 135 114 5126 46 5172

Honolulu Hawaii 54 60 69 76 2121 14 2135

HoustonndashBaytownndashSugar Land Tex 1017 190 1092 197 25821 172 25993

Indianapolis Ind 191 116 150 90 3824 25 3849

Jackson Miss 134 257 117 221 2419 30 2449

Jacksonville Fla 309 248 315 246 6020 75 6095

Kansas City MondashKans 183 94 160 81 4669 15 4684

Knoxville Tenn 47 72 35 52 882 5 887

Lakeland Fla 103 190 112 199 1811 21 1832

Las VegasndashParadise Nev 245 143 258 145 4616 28 4644

Little RockndashNorth Little Rock Ark 87 135 75 115 1383 14 1397

Los Angeles Calif 1529 118 1684 130 57953 293 58246

Los Angeles Division 1339 135 1435 144 51098 250 51348

Santa Anna Division 190 63 249 83 6855 43 6898

Louisville KyndashInd 123 102 97 79 2286 22 2308

Madison Wis 10 19 29 53 520 4 524

McAllenndashEdinburgndashPharr Tex 57 84 45 64 630 11 641

Memphis TennndashMissndashArk 402 320 346 271 5128 19 5147

Miami Fla 2420 446 2289 419 55807 997 56804

Fort Lauderdale Division 810 455 769 430 16412 262 16674

Miami Division 1243 523 1165 485 29703 512 30215

West Palm Beach Division 367 290 355 279 9692 223 9915

MilwaukeendashWaukeshandashWest Allis Wis 68 45 109 72 2507 18 2525

MinneapolisndashSt PaulndashBloomington MinnndashWis 186 59 184 58 4259 22 4281

Modesto Calif 36 71 22 43 671 6 677

NashvillendashDavidsonndashMurfreesboro Tenn 224 158 172 118 3848 20 3868

New HavenndashMilford Conn 169 200 107 127 4573 73 4646

New OrleansndashMetairiendashKenner La 393 299 271 264 8835 67 8902

32 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

New York NYndashNJndashPa 6215 330 5500 292 195177 2906 198083

Edison Division 191 83 130 56 6709 139 6848

Nassau Division 262 93 246 88 8141 110 8251

New York Division 5266 456 4716 408 160408 2323 162731

Newark Division 496 231 408 190 19919 334 20253

Oklahoma City Okla 125 108 88 75 2255 5 2260

OmahandashCouncil Bluffs NebndashIowa 37 46 80 97 1035 3 1038

Orlando Fla 544 282 517 260 8653 92 8745

OxnardndashThousand OaksndashVentura Calif 49 62 21 26 1008 3 1011

Palm BayndashMelbournendashTitusville Fla 68 129 61 114 1512 11 1523

Philadelphia PandashNJndashDelndashMd 1261 217 1348 231 28221 313 28534

Camden Division 108 87 111 89 3118 42 3160

Philadelphia Division 1022 263 1144 294 22112 250 22362

Wilmington Division 131 191 93 134 2991 21 3012

PhoenixndashMesandashScottsdale Ariz 460 119 376 93 7459 31 7490

Pittsburgh Pa 143 60 135 57 3182 19 3201

PortlandndashSouth Portland Maine 9 18 34 66 562 1 563

PortlandndashVancouverndashBeaverton OrendashWash 170 81 215 101 4825 10 4835

PoughkeepsiendashNewburghndashMiddletown NY 136 204 113 168 3162 24 3186

ProvidencendashNew BedfordndashFall River RIndashMass 132 82 155 96 3900 44 3944

RaleighndashCary NC 138 145 201 202 1987 13 2000

Richmond Va 119 101 122 102 3371 35 3406

RiversidendashSan BernardinondashOntario Calif 361 92 306 76 8568 60 8628

Rochester NY 165 159 124 120 3134 13 3147

SacramentondashArden-ArcadendashRoseville Calif 154 75 169 82 4000 26 4026

St Louis MondashIll 192 69 366 131 5965 40 6005

Salt Lake City Utah 46 44 40 37 1743 10 1753

San Antonio Tex 215 114 247 127 4987 30 5017

San DiegondashCarlsbadndashSan Marcos Calif 491 167 384 131 12934 61 12995

San Francisco Calif 867 209 690 165 40152 96 40248

Oakland Division 312 126 246 99 9546 48 9594

San Francisco Division 555 329 444 261 30606 48 30654

San JosendashSunnyvalendashSanta Clara Calif 88 50 145 81 3747 15 3762

San JuanndashCaguasndashGuaynabo PR 745 289 578 223 21402 277 21679

SarasotandashBradentonndashVenice Fla 82 122 104 152 1978 27 2005

ScrantonndashWilkes-Barre Pa 27 49 47 85 572 6 578

Seattle Wash 353 110 280 86 9172 27 9199

Seattle Division 316 129 255 102 8161 18 8179

Tacoma Division 37 49 25 33 1011 9 1020

Springfield Mass 88 128 45 66 2075 26 2101

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 33

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Stockton Calif 52 78 52 77 1076 15 1091

Syracuse NY 52 80 49 75 1317 8 1325

TampandashSt PetersburgndashClearwater Fla 559 211 605 224 11174 112 11286

Toledo Ohio 25 38 66 101 812 14 826

Tucson Ariz 103 111 100 106 2010 10 2020

Tulsa Okla 83 94 65 72 1494 10 1504

Virginia BeachndashNorfolkndashNewport News VandashNC 183 111 132 80 4711 63 4774

Washington DCndashVandashMdndashWV 1322 252 1684 318 31130 315 31445

Bethesda Division 135 118 173 150 2774 23 2797

Washington Division 1187 289 1511 365 28356 292 28648

Wichita Kans 35 60 38 64 851 2 853

Worcester Mass 76 97 79 101 1783 20 1803

YoungstownndashWarrenndashBoardman OhiondashPa 27 46 26 44 519 0 519

Subtotal for MSAs (population gt500000) 33602 173 31274 159 829633 8171 837804

Metropolitan areas (population of 50000 to 499999) 4477 80 4466 79 94829 847 95676

Nonmetropolitan areas 2666 54 2732 55 52063 445 52508

Totalb 41144 137 38749 128 981708 9494 991202

Note Because of the lack of census information for all US dependent areas includes data for only the 50 states the District of Columbia and Puerto RicoMSA metropolitan statistical areaMSA definitions for this report can be found at httpwwwcensusgovpopulationwwwestimatesmetrodefhtmla Reported case counts for the metropolitan divisions do not sum to the MSA total MSA total includes data from 1 metropolitan division with

population of lt500000b Includes persons whose county of residence is unknown

34 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Alabama (January 1988) 502 6041 48 6089

Alaska (February 1999) 38 285 2 287

Arizona (January 1987) 617 5877 80 5957

Arkansas (July 1989) 206 2349 20 2369

California (April 2006) 6581 7056 92 7148

Colorado (November 1985) 319 6084 31 6115

Connecticut (January 2005)b 826 2500 101 2601

Delaware (February 2006) 788 801 18 819

Florida (July 1997)c 4163 36386 397 36783

Georgia (December 2003) 2245 8197 194 8391

Idaho (June 1986) 35 340 4 344

Illinois (January 2006) 6241 6661 162 6823

Indiana (July 1988) 399 4027 43 4070

Iowa (July 1998) 69 586 5 591

Kansas (July 1999) 142 1225 15 1240

Kentucky (October 2004) 333 1303 13 1316

Louisiana (February 1993) 728 8149 166 8315

Maine (January 2006) 386 393 3 396

Michigan (April 1992) 635 6702 134 6836

Minnesota (October 1985) 309 3356 40 3396

Mississippi (August 1988) 352 4549 59 4608

Missouri (October 1987) 502 5086 55 5141

Nebraska (September 1995) 91 672 14 686

Nevada (February 1992) 339 3532 24 3556

New Hampshire (January 2005) 59 466 9 475

New Jersey (January 1992) 1477 17513 325 17838

New Mexico (January 1998) 114 949 4 953

New York (June 2000) 5326 42345 1820 44165

North Carolina (February 1990) 1615 13879 143 14022

North Dakota (January 1988) 4 82 1 83

Ohio (June 1990) 867 8222 101 8323

Oklahoma (June 1988) 229 2401 30 2431

Oregon (April 2006) 49 95 19 114

Pennsylvania (October 2002)d 4269 9537 179 9716

Rhode Island (July 2006) 14 21 0 21

South Carolina (February 1986) 493 6970 93 7063

South Dakota (January 1988) 18 215 6 221

Tennessee (January 1992) 732 7115 90 7205

Texas (January 1999)e 3370 24282 417 24699

Utah (April 1989) 106 893 14 907

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 35

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Virginia (July 1989) 864 10257 95 10352

Washington (March 2006) 4048 4157 40 4197

West Virginia (January 1989) 66 673 8 681

Wisconsin (November 1985) 261 2500 31 2531

Wyoming (June 1989) 7 93 1 94

Subtotal 50834 274822 5146 279968

US dependent areas

American Samoa (August 2001) 0 1 0 1

Guam (March 2000) 2 66 0 66

Northern Mariana Islands (October 2001) 2 7 0 7

Puerto Rico (January 2003) 1471 5610 91 5701

US Virgin Islands (December 1998) 22 247 6 253

Persons reported from areas with confidential name-based HIV infection reporting but who were residents of other areas 132 685 21 706

Totalf 52878 282640 5314 287954

Note Includes data from 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through 2006b Beginning in 1992 Connecticut had name-based HIV reporting for cases in children only From January 2002 through December 2004

Connecticut had name- or code-based HIV reporting for cases in adolescents and adults As of January 2005 Connecticut has name-based reporting of all cases of HIV infection

c Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterd On October 18 2002 Pennsylvania initiated confidential name-based HIV infection reporting in all areas except Philadelphia Code-based

reporting was implemented in Philadelphia in March 2004 and the switch to name-based reporting was made in October 2005e From February 1994 through December 1998 Texas reported HIV infection in children onlyf Includes 1252 persons reported from areas with confidential name-based HIV infection reporting but whose area of residence is unknown

36 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulativemdashUnited States and dependent areas

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No Adult or adolescentMale-to-male sexual contact 13775 49 429897 54 mdash mdash mdash mdash 13775 35 429897 44Injection drug use 3413 12 163070 21 1826 17 67693 35 5239 13 230763 23Male-to-male sexual contact and

injection drug use 1603 6 65524 8 mdash mdash mdash mdash 1603 4 65524 7Hemophiliacoagulation disorder 43 0 5176 1 11 0 348 0 54 0 5524 1High-risk heterosexual contactc 2997 11 49610 6 4839 46 85186 44 7836 20 134796 14

Sex with injection drug user 330 1 11683 1 706 7 26073 14 1036 3 37756 4Sex with bisexual male mdash mdash mdash mdash 234 2 5162 3 234 1 5162 1Sex with person with hemophilia 1 0 84 0 11 0 502 0 12 0 586 0Sex with HIV-infected transfusion

recipient 22 0 553 0 21 0 793 0 43 0 1346 0Sex with HIV-infected person risk

factor not specified 2644 9 37290 5 3867 37 52656 27 6511 17 89946 9Receipt of blood transfusion blood

d components or tissue 63 0 5213 1 68 1 4176 2 131 0 9389 1Otherrisk factor not reported or

identifiede 6484 23 73136 9 3793 36 34311 18 10278 26 107450 11Subtotal 28378 100 791626 100 10537 100 191714 100 38916 100 983343 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 0 0 222 5 0 0 7 0 0 0 229 2Mother with documented HIV infection or

1 of the following risk factors 24 75 4315 89 50 93 4423 95 74 86 8738 92Injection drug use 4 13 1676 35 4 7 1665 36 8 9 3341 35Sex with injection drug user 4 13 789 16 4 7 750 16 8 9 1539 16Sex with bisexual male 1 3 101 2 2 4 110 2 3 3 211 2Sex with person with hemophilia 0 0 20 0 0 0 16 0 0 0 36 0Sex with HIV-infected transfusion

recipient 0 0 11 0 0 0 15 0 0 0 26 0Sex with HIV-infected person risk

factor not specified 6 19 742 15 17 31 790 17 23 27 1532 16Receipt of blood transfusion blood

components or tissue 0 0 70 1 0 0 82 2 0 0 152 2Has HIV infection risk factor not

specified 9 28 906 19 23 43 995 21 32 37 1901 20Receipt of blood transfusion blood

fcomponents or tissue 1 3 243 5 0 0 144 3 1 1 387 4Otherrisk factor not reported or

identifiedg 7 22 75 2 4 7 93 2 11 13 168 2Subtotal 32 100 4855 100 54 100 4667 100 86 100 9522 100

Total 28410 100 796481 100 10591 100 196381 100 39002 100 992865 100a From the beginning of the epidemic through 2006b From the beginning of the epidemic through 2006 Includes 3 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infectiond AIDS developed in 47 adultsadolescents after they received blood that had tested negative for HIV antibodies AIDS developed in 14 additional adults

after they received tissue organs or artificial insemination from HIV-infected donors Four of the 14 received tissue or organs from a donor who was negative for HIV antibody at the time of donation

e Includes 37 adultsadolescents who were exposed to HIV-infected blood body fluids or concentrated virus in health care laboratory or household settings as supported by seroconversion epidemiologic andor laboratory evidence One person was infected after intentional inoculation with HIV-infected blood Includes an additional 740 persons who acquired HIV infection perinatally but who were more than 12 years of age when AIDS was diagnosed These 740 persons are not counted in the values for the pediatric transmission category

f AIDS developed in 3 children after they received blood that had tested negative for HIV antibodiesg Includes 5 children who were exposed to HIV-infected blood as supported by seroconversion epidemiologic andor laboratory evidence 1 child was

infected after intentional inoculation with HIV-infected blood and 5 children were exposed to HIV-infected blood in a household setting Of the 168 children 26 had sexual contact with an adult with or at high risk for HIV infection

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 37

Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No

Adult or adolescentMale-to-male sexual contact 22912 59 103679 52 mdash mdash mdash mdash 22912 44 103679 37

Injection drug use 3503 9 24255 12 2124 16 13925 17 5627 11 38181 14

Male-to-male sexual contact and injection drug use 1946 5 10704 5 mdash mdash mdash mdash 1946 4 10704 4

Hemophiliacoagulation disorder 43 0 495 0 6 0 73 0 49 0 568 0

High-risk heterosexual contactc 2874 7 16830 8 5939 45 38315 47 8813 17 55145 20

Sex with injection drug user 308 1 2601 1 757 6 6791 8 1065 2 9392 3

Sex with bisexual male mdash mdash mdash mdash 328 2 2265 3 328 1 2265 1

Sex with person with hemophilia 4 0 31 0 16 0 201 0 20 0 232 0

Sex with HIV-infected transfusion recipient 13 0 131 0 28 0 223 0 41 0 354 0

Sex with HIV-infected person risk factor not specified 2549 7 14067 7 4810 36 28835 35 7359 14 42902 15

Receipt of blood transfusion blood components or tissue 61 0 489 0 50 0 536 1 111 0 1025 0

Otherrisk factor not reported or identified 7748 20 44021 22 5106 39 29312 36 12854 25 73338 26

Subtotal 39087 100 200473 100 13225 100 82161 100 52312 100 282640 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 8 3 106 4 0 0 1 0 8 1 107 2

Mother with documented HIV infection or 1 of the following risk factors 197 74 2195 85 254 85 2417 89 451 80 4612 87

Injection drug use 34 13 532 21 53 18 561 21 87 15 1093 21

Sex with injection drug user 12 5 208 8 21 7 213 8 33 6 421 8

Sex with bisexual male 5 2 37 1 4 1 32 1 9 2 69 1

Sex with person with hemophilia 0 0 3 0 1 0 7 0 1 0 10 0

Sex with HIV-infected transfusion recipient 0 0 4 0 0 0 4 0 0 0 8 0

Sex with HIV-infected person risk factor not specified 54 20 534 21 76 25 629 23 130 23 1163 22

Receipt of blood transfusion blood components or tissue 0 0 17 1 2 1 20 1 2 0 37 1

Has HIV infection risk factor not specified 92 35 860 33 97 32 951 35 189 33 1811 34

Receipt of blood transfusion blood components or tissue 6 2 28 1 3 1 24 1 9 2 52 1

Otherrisk factor not reported or identified 55 21 260 10 43 14 283 10 98 17 543 10

Subtotal 266 100 2589 100 300 100 2725 100 566 100 5314 100

Total 39353 100 203062 100 13525 100 84886 100 52878 100 287954 100

Note See Table 16 for the list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006b From the beginning of the epidemic through December 2006 Includes 6 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infection

38 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity

2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 6251 65 253927 73Injection drug use 733 8 31737 9Male-to-male sexual contact and injection drug use 732 8 31434 9Hemophiliacoagulation disorder 26 0 3989 1High-risk heterosexual contactb 416 4 7850 2

Sex with injection drug user 74 1 2310 1

Sex with person with hemophilia 0 0 36 0

Sex with HIV-infected transfusion recipient 2 0 176 0

Sex with HIV-infected person risk factor not specified 340 4 5328 2Receipt of blood transfusion blood components or tissue 20 0 3194 1Otherrisk factor not reported or identified 1400 15 16469 5

Total 9578 100 348600 100

Black not HispanicMale-to-male sexual contact 4309 36 103297 37Injection drug use 1635 14 83369 30Male-to-male sexual contact and injection drug use 526 4 22134 8Hemophiliacoagulation disorder 10 0 604 0High-risk heterosexual contactb 1875 16 29952 11

Sex with injection drug user 167 1 6823 2Sex with person with hemophilia 1 0 36 0Sex with HIV-infected transfusion recipient 15 0 237 0Sex with HIV-infected person risk factor not specified 1692 14 22856 8

Receipt of blood transfusion blood components or tissue 24 0 1218 0Otherrisk factor not reported or identified 3579 30 40268 14

Total 11958 100 280842 100

HispanicMale-to-male sexual contact 2816 47 64893 44Injection drug use 965 16 46337 31Male-to-male sexual contact and injection drug use 287 5 10884 7Hemophiliacoagulation disorder 6 0 466 0High-risk heterosexual contactb 638 11 10950 7

Sex with injection drug user 84 1 2409 2Sex with person with hemophilia 0 0 11 0Sex with HIV-infected transfusion recipient 5 0 125 0Sex with HIV-infected person risk factor not specified 549 9 8405 6

Receipt of blood transfusion blood components or tissue 17 0 657 0Otherrisk factor not reported or identified 1326 22 14832 10

Total 6055 100 149019 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 39

a

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulative

No No

AsianPacific IslanderMale-to-male sexual contact 225 54 4475 68Injection drug use 20 5 317 5Male-to-male sexual contact and injection drug use 17 4 284 4Hemophiliacoagulation disorder 1 0 70 1High-risk heterosexual contactb 34 8 376 6

Sex with injection drug user 1 0 54 1Sex with person with hemophilia 0 0 1 0Sex with HIV-infected transfusion recipient 0 0 8 0Sex with HIV-infected person risk factor not specified 33 8 313 5

Receipt of blood transfusion blood components or tissue 2 0 112 2Otherrisk factor not reported or identified 114 28 949 14

Total 413 100 6583 100

American IndianAlaska NativeMale-to-male sexual contact 61 49 1403 55Injection drug use 15 12 395 15Male-to-male sexual contact and injection drug use 23 19 457 18Hemophiliacoagulation disorder 0 0 27 1High-risk heterosexual contactb 9 7 118 5

Sex with injection drug user 1 1 33 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 8 6 82 3

Receipt of blood transfusion blood components or tissue 0 0 8 0Otherrisk factor not reported or identified 16 13 155 6

Total 124 100 2563 100

Total casesMale-to-male sexual contact 13775 49 429897 54Injection drug use 3413 12 163070 21Male-to-male sexual contact and injection drug use 1603 6 65524 8Hemophiliacoagulation disorder 43 0 5176 1High-risk heterosexual contactb 2997 11 49610 6

Sex with injection drug user 330 1 11683 1Sex with person with hemophilia 1 0 84 0Sex with HIV-infected transfusion recipient 22 0 553 0Sex with HIV-infected person risk factor not specified 2644 9 37290 5

Receipt of blood transfusion blood components or tissue 63 0 5213 1Otherrisk factor not reported or identified 6484 23 73136 9

Total 28378c 100 791626d 100a From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 4019 males of unknown race or multiple races

40 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 11963 73 55725 69Injection drug use 858 5 5512 7Male-to-male sexual contact and injection drug use 1092 7 5578 7Hemophiliacoagulation disorder 29 0 355 0High-risk heterosexual contactb 522 3 2658 3

Sex with injection drug user 65 0 544 1Sex with person with hemophilia 0 0 8 0Sex with HIV-infected transfusion recipient 3 0 33 0Sex with HIV-infected person risk factor not specified 454 3 2073 3

Receipt of blood transfusion blood components or tissue 14 0 197 0Otherrisk factor not reported or identified 1956 12 11147 14

Total 16434 100 81172 100

Black not HispanicMale-to-male sexual contact 6203 44 30148 37Injection drug use 1594 11 11997 15Male-to-male sexual contact and injection drug use 483 3 3489 4Hemophiliacoagulation disorder 10 0 109 0High-risk heterosexual contactb 1714 12 10905 13

Sex with injection drug user 169 1 1554 2Sex with person with hemophilia 4 0 17 0Sex with HIV-infected transfusion recipient 6 0 77 0Sex with HIV-infected person risk factor not specified 1535 11 9257 11

Receipt of blood transfusion blood components or tissue 32 0 223 0Otherrisk factor not reported or identified 4151 29 24632 30

Total 14187 100 81503 100

HispanicMale-to-male sexual contact 4094 55 15623 47Injection drug use 993 13 6407 19Male-to-male sexual contact and injection drug use 316 4 1402 4Hemophiliacoagulation disorder 3 0 26 0High-risk heterosexual contactb 582 8 2963 9

Sex with injection drug user 65 1 455 1Sex with person with hemophilia 0 0 6 0Sex with HIV-infected transfusion recipient 4 0 18 0Sex with HIV-infected person risk factor not specified 513 7 2484 7

Receipt of blood transfusion blood components or tissue 11 0 55 0Otherrisk factor not reported or identified 1475 20 6977 21

Total 7474 100 33453 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 41

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderMale-to-male sexual contact 402 70 1006 63Injection drug use 17 3 55 3Male-to-male sexual contact and injection drug use 15 3 38 2Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 25 4 96 6

Sex with injection drug user 3 1 10 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 22 4 83 5

Receipt of blood transfusion blood components or tissue 4 1 7 0Otherrisk factor not reported or identified 109 19 397 25

Total 572 100 1600 100

American IndianAlaska NativeMale-to-male sexual contact 104 61 516 57Injection drug use 13 8 101 11Male-to-male sexual contact and injection drug use 19 11 110 12Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 10 6 53 6

Sex with injection drug user 2 1 14 2Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 8 5 39 4

Receipt of blood transfusion blood components or tissue 0 0 2 0Otherrisk factor not reported or identified 24 14 125 14

Total 170 100 907 100

Total casesMale-to-male sexual contact 22912 59 103679 52Injection drug use 3503 9 24255 12Male-to-male sexual contact and injection drug use 1946 5 10704 5Hemophiliacoagulation disorder 43 0 495 0High-risk heterosexual contactb 2874 7 16830 8

Sex with injection drug user 308 1 2601 1Sex with person with hemophilia 4 0 31 0Sex with HIV-infected transfusion recipient 13 0 131 0Sex with HIV-infected person risk factor not specified 2549 7 14067 7

Receipt of blood transfusion blood components or tissue 61 0 489 0Otherrisk factor not reported or identified 7748 20 44021 22

Total 39087c 100 200473d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 1838 males of unknown race or multiple races

42 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race

ethnicity 2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 482 28 14981 40Hemophiliacoagulation disorder 4 0 123 0High-risk heterosexual contactb 725 42 15799 42

Sex with injection drug user 153 9 5650 15Sex with bisexual male 63 4 1859 5Sex with person with hemophilia 5 0 329 1Sex with HIV-infected transfusion recipient 5 0 338 1Sex with HIV-infected person risk factor not specified 499 29 7623 20

Receipt of blood transfusion blood components or tissue 15 1 1870 5Otherrisk factor not reported or identified 499 29 4801 13

Total 1725 100 37574 100

Black not HispanicInjection drug use 982 15 38914 34Hemophiliacoagulation disorder 3 0 145 0High-risk heterosexual contactb 3103 46 49876 44

Sex with injection drug user 373 6 13530 12Sex with bisexual male 136 2 2352 2Sex with person with hemophilia 4 0 121 0Sex with HIV-infected transfusion recipient 8 0 277 0Sex with HIV-infected person risk factor not specified 2582 38 33596 29

Receipt of blood transfusion blood components or tissue 39 1 1546 1Otherrisk factor not reported or identified 2612 39 23894 21

Total 6739 100 114375 100

HispanicInjection drug use 322 18 12892 35Hemophiliacoagulation disorder 4 0 67 0High-risk heterosexual contactb 894 49 17995 49

Sex with injection drug user 166 9 6522 18Sex with bisexual male 32 2 818 2Sex with person with hemophilia 1 0 45 0Sex with HIV-infected transfusion recipient 7 0 141 0Sex with HIV-infected person risk factor not specified 688 38 10469 29

Receipt of blood transfusion blood components or tissue 12 1 619 2Otherrisk factor not reported or identified 592 32 5023 14

Total 1824 100 36596 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 43

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 8 8 125 12Hemophiliacoagulation disorder 0 0 7 1High-risk heterosexual contactb 49 47 574 53

Sex with injection drug user 4 4 114 11Sex with bisexual male 2 2 80 7Sex with person with hemophilia 0 0 4 0Sex with HIV-infected transfusion recipient 1 1 25 2Sex with HIV-infected person risk factor not specified 42 40 351 33

Receipt of blood transfusion blood components or tissue 1 1 93 9Otherrisk factor not reported or identified 46 44 279 26

Total 104 100 1078 100

American IndianAlaska NativeInjection drug use 13 32 280 42Hemophiliacoagulation disorder 0 0 3 0High-risk heterosexual contactb 15 37 277 41

Sex with injection drug user 4 10 107 16Sex with bisexual male 1 2 27 4Sex with person with hemophilia 0 0 2 0Sex with HIV-infected transfusion recipient 0 0 6 1Sex with HIV-infected person risk factor not specified 10 24 135 20

Receipt of blood transfusion blood components or tissue 1 2 17 3Otherrisk factor not reported or identified 12 29 95 14

Total 41 100 672 100

Total casesInjection drug use 1826 17 67693 35Hemophiliacoagulation disorder 11 0 348 0High-risk heterosexual contactb 4839 46 85186 44

Sex with injection drug user 706 7 26073 14Sex with bisexual male 234 2 5162 3Sex with person with hemophilia 11 0 502 0Sex with HIV-infected transfusion recipient 21 0 793 0Sex with HIV-infected person risk factor not specified 3867 37 52656 27

Receipt of blood transfusion blood components or tissue 68 1 4176 2Otherrisk factor not reported or identified 3793 36 34311 18

Total 10537c 100 191714d 100a From the beginning of the epidemic through 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 104 females of unknown race or multiple racesd Includes 1419 females of unknown race or multiple races

44 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 690 26 4260 26Hemophiliacoagulation disorder 3 0 24 0

bHigh-risk heterosexual contact 1132 42 7593 46Sex with injection drug user 205 8 1876 11Sex with bisexual male 98 4 659 4Sex with person with hemophilia 10 0 115 1Sex with HIV-infected transfusion recipient 7 0 64 0Sex with HIV-infected person risk factor not specified 812 30 4879 29

Receipt of blood transfusion blood components or tissue 12 0 146 1Otherrisk factor not reported or identified 850 32 4567 28

Total 2687 100 16590 100

Black not HispanicInjection drug use 1034 13 7105 14Hemophiliacoagulation disorder 1 0 35 0

bHigh-risk heterosexual contact 3451 44 23732 46Sex with injection drug user 313 4 3473 7Sex with bisexual male 155 2 1294 3Sex with person with hemophilia 5 0 71 0Sex with HIV-infected transfusion recipient 14 0 120 0Sex with HIV-infected person risk factor not specified 2964 38 18774 36

Receipt of blood transfusion blood components or tissue 26 0 324 1Otherrisk factor not reported or identified 3370 43 20244 39

Total 7882 100 51440 100

HispanicInjection drug use 339 15 2280 18Hemophiliacoagulation disorder 2 0 11 0

bHigh-risk heterosexual contact 1198 52 6264 50Sex with injection drug user 218 9 1324 11Sex with bisexual male 62 3 266 2Sex with person with hemophilia 1 0 11 0Sex with HIV-infected transfusion recipient 7 0 39 0Sex with HIV-infected person risk factor not specified 910 39 4624 37

Receipt of blood transfusion blood components or tissue 12 1 58 0Otherrisk factor not reported or identified 767 33 3843 31

Total 2318 100 12456 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 45

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 24: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by

area of residence and age categorymdashUnited States and dependent areas

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

Alabama 5469 17 5486 3744 11 3755Alaska 272 1 273 330 1 331Arizona 5744 49 5793 4922 7 4929Arkansas 2291 7 2298 2139 6 2145California mdash mdash mdash 61451 105 61555Colorado 5855 13 5869 4083 2 4085Connecticut mdash mdash mdash 7406 15 7421Delaware mdash mdash mdash 1753 7 1760District of Columbia mdash mdash mdash 10059 30 10089Floridab 35461 263 35723 46469 194 46663Georgia mdash mdash mdash 17336 47 17383Hawaii mdash mdash mdash 1234 3 1237Idaho 356 0 356 313 0 313Illinois mdash mdash mdash 16139 46 16185Indiana 3849 21 3870 3996 14 4010Iowa 588 2 590 869 3 872Kansas 1230 7 1237 1272 2 1274Kentucky mdash mdash mdash 2589 13 2602Louisiana 7361 101 7462 8052 21 8074Maine mdash mdash mdash 512 2 514Maryland mdash mdash mdash 14540 41 14581Massachusetts mdash mdash mdash 8806 20 8826Michigan 6118 55 6173 6615 12 6627Minnesota 3227 21 3248 2314 9 2323Mississippi 4200 32 4232 3155 13 3168Missouri 4999 33 5033 5479 7 5486Montana mdash mdash mdash 205 0 205Nebraska 688 12 700 771 2 773Nevada 3402 13 3415 2969 3 2972New Hampshire mdash mdash mdash 556 3 559New Jersey 16059 153 16212 17168 57 17226New Mexico 910 0 909 1252 3 1255New York 42220 801 43021 70697 148 70845North Carolina 11700 60 11760 8451 12 8463North Dakota 87 2 89 73 1 74Ohio 8266 57 8323 7054 30 7084Oklahoma 2191 17 2208 2191 3 2194Oregon mdash mdash mdash 2840 4 2844Pennsylvania mdash mdash mdash 18633 71 18703Rhode Island mdash mdash mdash 1296 7 1303South Carolina 6349 45 6394 7035 23 7058South Dakota 195 4 199 139 1 140Tennessee 6579 51 6631 6403 11 6414Texas 24741 262 25003 34010 53 34063Utah 893 10 903 1164 0 1164Vermont mdash mdash mdash 238 2 240Virginia 9937 41 9978 8423 24 8447Washington mdash mdash mdash 5471 5 5476West Virginia 660 5 665 749 5 754Wisconsin 2322 15 2337 2153 12 2165Wyoming 86 2 88 102 1 103

Subtotal 224303 2174 226477 435621 1115 436736

24 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age categorymdashUnited States and dependent areas (cont)

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

US dependent areasAmerican Samoa 2 0 2 1 0 1Guam 63 0 63 36 0 36Northern Mariana Islands 7 0 7 3 0 3Puerto Rico 6269 31 6300 10971 26 10997US Virgin Islands 228 2 230 312 2 314Otherc mdash mdash mdash 1 0 1

Totald 230872 2207 233079 447724 1147 448871

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reporting a See Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at

least 2003b Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterc Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasd Total number of persons living with HIV infection (not AIDS) includes persons reported from areas with confidential name-based HIV

infection reporting who were residents of other states or whose area of residence is unknown Total number of persons living with AIDS includes persons whose area of residence is unknown Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 25

Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristicsmdashUnited States and dependent areas

No of persons

Survival in months

gt12 gt24 gt36Data for 50 states and the District of Columbia

Age at diagnosis (yrs)lt13 101 096 094 09413ndash14 60 098 098 09515ndash19 305 098 096 09520ndash24 1351 096 093 09225ndash29 3034 095 092 09130ndash34 5499 094 091 08935ndash39 7888 093 090 08740ndash44 7085 092 088 08545ndash49 5090 089 085 08250ndash54 3067 086 081 07855ndash59 1505 083 078 07460ndash64 806 080 073 069gt65 614 073 068 065

RaceethnicityWhite not Hispanic 10706 092 089 087Black not Hispanic 18406 090 086 082Hispanic 6398 092 090 088AsianPacific Islander 404 094 092 090American IndianAlaska Native 167 084 081 075

Transmission categoryMale adult or adolescentMale-to-male sexual contact 12830 093 090 088Injection drug use 4048 089 084 081Male-to-male sexual contact and injection drug use 1701 093 089 086High-risk heterosexual contacta 3170 091 088 085Otherb 5019 086 083 080Subtotal 26768 091 088 085

Female adult or adolescentInjection drug use 2101 089 083 078High-risk heterosexual contacta 4686 093 089 086Otherb 2749 090 085 083Subtotal 9536 091 087 083

Child (lt13 yrs at diagnosis)Perinatal 98 096 095 095Otherc 3 100 067 067Subtotal 101 096 094 094

Subtotal for 50 states and the District of Columbia 36405 091 087 085

Data for US dependent areas 891 083 078 075

Total 37352d 091 087 084Note Excludes persons whose date of death was before or in the same month as date of diagnosis Excludes persons whose month of diagnosis or month of death is unknowna Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes 325 persons of unknown race or multiple races

26 Survival after AIDS Diagnosis

Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by year of diagnosismdashUnited States and dependent areas

Months after AIDS diagnosis

Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by age groupmdashUnited States and dependent areas

Months after AIDS diagnosis

Survival after AIDS Diagnosis 27

Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by raceethnicitymdashUnited States and dependent areas

Months after AIDS diagnosis

28 Survival after AIDS Diagnosis

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006

and cumulativemdashUnited States and dependent areas

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Alabama 510 112 462 100 8626 76 8702Alaska 24 36 38 57 648 7 655Arizona 626 105 539 87 10396 46 10442Arkansas 237 85 252 90 3891 36 3927California 4069 113 3960 109 142254 664 142918Colorado 351 75 322 68 8742 31 8773Connecticut 658 188 422 120 14716 183 14899Delaware 177 210 116 136 3547 26 3573District of Columbia 672 1155 853 1467 17372 189 17561Florida 4921 277 4932 273 104084 1530 105614Georgia 2325 255 1605 171 31734 231 31965Hawaii 105 82 93 72 2927 17 2944Idaho 24 17 26 18 604 2 606Illinois 1886 148 1382 108 33620 282 33902Indiana 407 65 346 55 8239 56 8295Iowa 93 31 86 29 1727 13 1740Kansas 105 38 120 43 2781 14 2795Kentucky 249 60 207 49 4600 32 4632Louisiana 936 208 824 192 17612 128 17740Maine 21 16 68 51 1110 8 1118Maryland 1558 279 1626 290 30252 319 30571Massachusetts 666 104 533 83 19181 214 19395Michigan 821 81 672 67 14941 113 15054Minnesota 226 44 212 41 4817 28 4845Mississippi 368 127 365 125 6642 56 6698Missouri 385 66 469 80 11016 61 11077Montana 21 22 7 07 373 3 376Nebraska 53 30 118 67 1479 11 1490Nevada 293 121 294 118 5733 29 5762New Hampshire 33 25 55 42 1074 10 1084New Jersey 1262 145 1065 122 48750 778 49528New Mexico 134 70 93 48 2603 7 2610New York 6201 321 5495 285 174908 2354 177262North Carolina 916 106 1229 139 15954 118 16072North Dakota 10 16 6 09 144 1 145Ohio 753 66 767 67 14957 138 15095Oklahoma 281 79 205 57 4836 26 4862Oregon 217 60 281 76 5995 20 6015Pennsylvania 1486 120 1893 152 33417 365 33782Rhode Island 87 81 111 104 2580 28 2608South Carolina 682 161 705 163 13301 105 13406South Dakota 18 23 18 23 255 5 260Tennessee 818 137 680 113 12457 59 12516Texas 3045 133 2998 128 69735 392 70127Utah 63 25 57 22 2295 20 2315Vermont 5 08 18 29 461 6 467Virginia 638 84 605 79 16802 177 16979Washington 485 77 389 61 11792 34 11826West Virginia 74 41 67 37 1500 11 1511Wisconsin 122 22 217 39 4513 33 4546Wyoming 6 12 8 16 228 2 230

Subtotal 40123 135 37911 127 952221 9094 961315

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 29

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulativemdashUnited States and dependent areas (cont)

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

US dependent areasAmerican Samoa 0 0 0 0 1 0 1Guam 0 0 0 0 68 1 69Northern Mariana Islands 0 0 0 0 3 0 3Puerto Rico 1029 263 850 216 29511 400 29911US Virgin Islands 17 156 32 295 629 18 647Otherb 0 0 0 0 3 0 3

Totalc 41357 138 39002 129 983343 9522 992865d

a From the beginning of the epidemic through 2006b Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasc Includes persons whose state or area of residence is unknownd Includes 916 persons whose state or area of residence is unknown

30 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

MSA (population gt 500000)

Akron Ohio 66 94 32 46 762 1 763

AlbanyndashSchenectadyndashTroy NY 97 114 105 123 2253 24 2277

Albuquerque N Mex 70 88 50 61 1404 2 1406

AllentownndashBethlehemndashEaston PandashNJ 72 91 119 149 1352 17 1369

AtlantandashSandy SpringsndashMarietta Ga 1586 319 1006 196 21896 128 22024

AugustandashRichmond County GandashSC 106 205 32 61 1851 24 1875

AustinndashRound Rock Tex 227 156 186 123 4830 26 4856

Bakersfield Calif 76 100 122 156 1528 8 1536

BaltimorendashTowson Md 1064 401 1001 377 20352 218 20570

Baton Rouge La 222 304 231 301 3732 20 3752

BirminghamndashHoover Ala 151 139 110 100 2614 25 2639

Boise CityndashNampa Idaho 14 26 14 25 281 0 281

Boston MassndashNHa 441 99 355 80 13476 147 13623

Boston Division 269 146 185 101 8451 91 8542

Cambridge Division 108 74 102 70 3126 35 3161

Essex Division 52 71 51 69 1577 20 1597

BridgeportndashStamfordndashNorwalk Conn 181 201 135 150 3733 57 3790

BuffalondashNiagara Falls NY 117 102 96 84 2476 20 2496

Cape CoralndashFort Myers Fla 44 81 91 159 1692 24 1716

CharlestonndashNorth Charleston SC 92 155 91 151 2034 18 2052

CharlottendashGastoniandashConcord NCndashSC 214 141 285 180 3242 22 3264

Chicago IllndashIndndashWis 1716 182 1159 122 30118 261 30379

Chicago Division 1604 203 1073 135 28300 248 28548

Gary Division 61 88 50 71 1038 8 1046

Lake Division 51 59 36 41 780 5 785

CincinnatindashMiddletown OhiondashKyndashInd 111 53 199 95 2735 17 2752

ClevelandndashElyriandashMentor Ohio 228 107 170 80 4226 48 4274

Colorado Springs Colo 19 32 21 35 576 5 581

Columbia SC 177 256 197 280 3274 24 3298

Columbus Ohio 166 97 165 96 3112 15 3127

Dallas Tex 874 150 929 155 20238 63 20301

Dallas Division 681 175 714 178 16038 37 16075

Fort Worth Division 193 100 215 108 4200 26 4226

Dayton Ohio 58 69 54 64 1217 15 1232

DenverndashAurora Colo 274 116 236 98 6899 22 6921

Des Moines Iowa 30 57 23 43 530 4 534

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 31

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Detroit Mich 570 127 445 100 10373 73 10446

Detroit Division 443 223 330 167 8268 57 8325

Warren Division 127 51 115 46 2105 16 2121

El Paso Tex 56 78 40 54 1476 10 1486

Fresno Calif 52 59 64 72 1430 11 1441

Grand RapidsndashWyoming Mich 46 60 51 66 816 6 822

GreensborondashHigh Point NC 52 77 66 96 1265 14 1279

Greenville SC 70 119 67 111 1292 4 1296

HarrisburgndashCarlisle Pa 23 44 67 128 1224 8 1232

HartfordndashWest HartfordndashEast Hartford Conn 256 216 135 114 5126 46 5172

Honolulu Hawaii 54 60 69 76 2121 14 2135

HoustonndashBaytownndashSugar Land Tex 1017 190 1092 197 25821 172 25993

Indianapolis Ind 191 116 150 90 3824 25 3849

Jackson Miss 134 257 117 221 2419 30 2449

Jacksonville Fla 309 248 315 246 6020 75 6095

Kansas City MondashKans 183 94 160 81 4669 15 4684

Knoxville Tenn 47 72 35 52 882 5 887

Lakeland Fla 103 190 112 199 1811 21 1832

Las VegasndashParadise Nev 245 143 258 145 4616 28 4644

Little RockndashNorth Little Rock Ark 87 135 75 115 1383 14 1397

Los Angeles Calif 1529 118 1684 130 57953 293 58246

Los Angeles Division 1339 135 1435 144 51098 250 51348

Santa Anna Division 190 63 249 83 6855 43 6898

Louisville KyndashInd 123 102 97 79 2286 22 2308

Madison Wis 10 19 29 53 520 4 524

McAllenndashEdinburgndashPharr Tex 57 84 45 64 630 11 641

Memphis TennndashMissndashArk 402 320 346 271 5128 19 5147

Miami Fla 2420 446 2289 419 55807 997 56804

Fort Lauderdale Division 810 455 769 430 16412 262 16674

Miami Division 1243 523 1165 485 29703 512 30215

West Palm Beach Division 367 290 355 279 9692 223 9915

MilwaukeendashWaukeshandashWest Allis Wis 68 45 109 72 2507 18 2525

MinneapolisndashSt PaulndashBloomington MinnndashWis 186 59 184 58 4259 22 4281

Modesto Calif 36 71 22 43 671 6 677

NashvillendashDavidsonndashMurfreesboro Tenn 224 158 172 118 3848 20 3868

New HavenndashMilford Conn 169 200 107 127 4573 73 4646

New OrleansndashMetairiendashKenner La 393 299 271 264 8835 67 8902

32 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

New York NYndashNJndashPa 6215 330 5500 292 195177 2906 198083

Edison Division 191 83 130 56 6709 139 6848

Nassau Division 262 93 246 88 8141 110 8251

New York Division 5266 456 4716 408 160408 2323 162731

Newark Division 496 231 408 190 19919 334 20253

Oklahoma City Okla 125 108 88 75 2255 5 2260

OmahandashCouncil Bluffs NebndashIowa 37 46 80 97 1035 3 1038

Orlando Fla 544 282 517 260 8653 92 8745

OxnardndashThousand OaksndashVentura Calif 49 62 21 26 1008 3 1011

Palm BayndashMelbournendashTitusville Fla 68 129 61 114 1512 11 1523

Philadelphia PandashNJndashDelndashMd 1261 217 1348 231 28221 313 28534

Camden Division 108 87 111 89 3118 42 3160

Philadelphia Division 1022 263 1144 294 22112 250 22362

Wilmington Division 131 191 93 134 2991 21 3012

PhoenixndashMesandashScottsdale Ariz 460 119 376 93 7459 31 7490

Pittsburgh Pa 143 60 135 57 3182 19 3201

PortlandndashSouth Portland Maine 9 18 34 66 562 1 563

PortlandndashVancouverndashBeaverton OrendashWash 170 81 215 101 4825 10 4835

PoughkeepsiendashNewburghndashMiddletown NY 136 204 113 168 3162 24 3186

ProvidencendashNew BedfordndashFall River RIndashMass 132 82 155 96 3900 44 3944

RaleighndashCary NC 138 145 201 202 1987 13 2000

Richmond Va 119 101 122 102 3371 35 3406

RiversidendashSan BernardinondashOntario Calif 361 92 306 76 8568 60 8628

Rochester NY 165 159 124 120 3134 13 3147

SacramentondashArden-ArcadendashRoseville Calif 154 75 169 82 4000 26 4026

St Louis MondashIll 192 69 366 131 5965 40 6005

Salt Lake City Utah 46 44 40 37 1743 10 1753

San Antonio Tex 215 114 247 127 4987 30 5017

San DiegondashCarlsbadndashSan Marcos Calif 491 167 384 131 12934 61 12995

San Francisco Calif 867 209 690 165 40152 96 40248

Oakland Division 312 126 246 99 9546 48 9594

San Francisco Division 555 329 444 261 30606 48 30654

San JosendashSunnyvalendashSanta Clara Calif 88 50 145 81 3747 15 3762

San JuanndashCaguasndashGuaynabo PR 745 289 578 223 21402 277 21679

SarasotandashBradentonndashVenice Fla 82 122 104 152 1978 27 2005

ScrantonndashWilkes-Barre Pa 27 49 47 85 572 6 578

Seattle Wash 353 110 280 86 9172 27 9199

Seattle Division 316 129 255 102 8161 18 8179

Tacoma Division 37 49 25 33 1011 9 1020

Springfield Mass 88 128 45 66 2075 26 2101

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 33

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Stockton Calif 52 78 52 77 1076 15 1091

Syracuse NY 52 80 49 75 1317 8 1325

TampandashSt PetersburgndashClearwater Fla 559 211 605 224 11174 112 11286

Toledo Ohio 25 38 66 101 812 14 826

Tucson Ariz 103 111 100 106 2010 10 2020

Tulsa Okla 83 94 65 72 1494 10 1504

Virginia BeachndashNorfolkndashNewport News VandashNC 183 111 132 80 4711 63 4774

Washington DCndashVandashMdndashWV 1322 252 1684 318 31130 315 31445

Bethesda Division 135 118 173 150 2774 23 2797

Washington Division 1187 289 1511 365 28356 292 28648

Wichita Kans 35 60 38 64 851 2 853

Worcester Mass 76 97 79 101 1783 20 1803

YoungstownndashWarrenndashBoardman OhiondashPa 27 46 26 44 519 0 519

Subtotal for MSAs (population gt500000) 33602 173 31274 159 829633 8171 837804

Metropolitan areas (population of 50000 to 499999) 4477 80 4466 79 94829 847 95676

Nonmetropolitan areas 2666 54 2732 55 52063 445 52508

Totalb 41144 137 38749 128 981708 9494 991202

Note Because of the lack of census information for all US dependent areas includes data for only the 50 states the District of Columbia and Puerto RicoMSA metropolitan statistical areaMSA definitions for this report can be found at httpwwwcensusgovpopulationwwwestimatesmetrodefhtmla Reported case counts for the metropolitan divisions do not sum to the MSA total MSA total includes data from 1 metropolitan division with

population of lt500000b Includes persons whose county of residence is unknown

34 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Alabama (January 1988) 502 6041 48 6089

Alaska (February 1999) 38 285 2 287

Arizona (January 1987) 617 5877 80 5957

Arkansas (July 1989) 206 2349 20 2369

California (April 2006) 6581 7056 92 7148

Colorado (November 1985) 319 6084 31 6115

Connecticut (January 2005)b 826 2500 101 2601

Delaware (February 2006) 788 801 18 819

Florida (July 1997)c 4163 36386 397 36783

Georgia (December 2003) 2245 8197 194 8391

Idaho (June 1986) 35 340 4 344

Illinois (January 2006) 6241 6661 162 6823

Indiana (July 1988) 399 4027 43 4070

Iowa (July 1998) 69 586 5 591

Kansas (July 1999) 142 1225 15 1240

Kentucky (October 2004) 333 1303 13 1316

Louisiana (February 1993) 728 8149 166 8315

Maine (January 2006) 386 393 3 396

Michigan (April 1992) 635 6702 134 6836

Minnesota (October 1985) 309 3356 40 3396

Mississippi (August 1988) 352 4549 59 4608

Missouri (October 1987) 502 5086 55 5141

Nebraska (September 1995) 91 672 14 686

Nevada (February 1992) 339 3532 24 3556

New Hampshire (January 2005) 59 466 9 475

New Jersey (January 1992) 1477 17513 325 17838

New Mexico (January 1998) 114 949 4 953

New York (June 2000) 5326 42345 1820 44165

North Carolina (February 1990) 1615 13879 143 14022

North Dakota (January 1988) 4 82 1 83

Ohio (June 1990) 867 8222 101 8323

Oklahoma (June 1988) 229 2401 30 2431

Oregon (April 2006) 49 95 19 114

Pennsylvania (October 2002)d 4269 9537 179 9716

Rhode Island (July 2006) 14 21 0 21

South Carolina (February 1986) 493 6970 93 7063

South Dakota (January 1988) 18 215 6 221

Tennessee (January 1992) 732 7115 90 7205

Texas (January 1999)e 3370 24282 417 24699

Utah (April 1989) 106 893 14 907

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 35

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Virginia (July 1989) 864 10257 95 10352

Washington (March 2006) 4048 4157 40 4197

West Virginia (January 1989) 66 673 8 681

Wisconsin (November 1985) 261 2500 31 2531

Wyoming (June 1989) 7 93 1 94

Subtotal 50834 274822 5146 279968

US dependent areas

American Samoa (August 2001) 0 1 0 1

Guam (March 2000) 2 66 0 66

Northern Mariana Islands (October 2001) 2 7 0 7

Puerto Rico (January 2003) 1471 5610 91 5701

US Virgin Islands (December 1998) 22 247 6 253

Persons reported from areas with confidential name-based HIV infection reporting but who were residents of other areas 132 685 21 706

Totalf 52878 282640 5314 287954

Note Includes data from 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through 2006b Beginning in 1992 Connecticut had name-based HIV reporting for cases in children only From January 2002 through December 2004

Connecticut had name- or code-based HIV reporting for cases in adolescents and adults As of January 2005 Connecticut has name-based reporting of all cases of HIV infection

c Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterd On October 18 2002 Pennsylvania initiated confidential name-based HIV infection reporting in all areas except Philadelphia Code-based

reporting was implemented in Philadelphia in March 2004 and the switch to name-based reporting was made in October 2005e From February 1994 through December 1998 Texas reported HIV infection in children onlyf Includes 1252 persons reported from areas with confidential name-based HIV infection reporting but whose area of residence is unknown

36 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulativemdashUnited States and dependent areas

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No Adult or adolescentMale-to-male sexual contact 13775 49 429897 54 mdash mdash mdash mdash 13775 35 429897 44Injection drug use 3413 12 163070 21 1826 17 67693 35 5239 13 230763 23Male-to-male sexual contact and

injection drug use 1603 6 65524 8 mdash mdash mdash mdash 1603 4 65524 7Hemophiliacoagulation disorder 43 0 5176 1 11 0 348 0 54 0 5524 1High-risk heterosexual contactc 2997 11 49610 6 4839 46 85186 44 7836 20 134796 14

Sex with injection drug user 330 1 11683 1 706 7 26073 14 1036 3 37756 4Sex with bisexual male mdash mdash mdash mdash 234 2 5162 3 234 1 5162 1Sex with person with hemophilia 1 0 84 0 11 0 502 0 12 0 586 0Sex with HIV-infected transfusion

recipient 22 0 553 0 21 0 793 0 43 0 1346 0Sex with HIV-infected person risk

factor not specified 2644 9 37290 5 3867 37 52656 27 6511 17 89946 9Receipt of blood transfusion blood

d components or tissue 63 0 5213 1 68 1 4176 2 131 0 9389 1Otherrisk factor not reported or

identifiede 6484 23 73136 9 3793 36 34311 18 10278 26 107450 11Subtotal 28378 100 791626 100 10537 100 191714 100 38916 100 983343 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 0 0 222 5 0 0 7 0 0 0 229 2Mother with documented HIV infection or

1 of the following risk factors 24 75 4315 89 50 93 4423 95 74 86 8738 92Injection drug use 4 13 1676 35 4 7 1665 36 8 9 3341 35Sex with injection drug user 4 13 789 16 4 7 750 16 8 9 1539 16Sex with bisexual male 1 3 101 2 2 4 110 2 3 3 211 2Sex with person with hemophilia 0 0 20 0 0 0 16 0 0 0 36 0Sex with HIV-infected transfusion

recipient 0 0 11 0 0 0 15 0 0 0 26 0Sex with HIV-infected person risk

factor not specified 6 19 742 15 17 31 790 17 23 27 1532 16Receipt of blood transfusion blood

components or tissue 0 0 70 1 0 0 82 2 0 0 152 2Has HIV infection risk factor not

specified 9 28 906 19 23 43 995 21 32 37 1901 20Receipt of blood transfusion blood

fcomponents or tissue 1 3 243 5 0 0 144 3 1 1 387 4Otherrisk factor not reported or

identifiedg 7 22 75 2 4 7 93 2 11 13 168 2Subtotal 32 100 4855 100 54 100 4667 100 86 100 9522 100

Total 28410 100 796481 100 10591 100 196381 100 39002 100 992865 100a From the beginning of the epidemic through 2006b From the beginning of the epidemic through 2006 Includes 3 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infectiond AIDS developed in 47 adultsadolescents after they received blood that had tested negative for HIV antibodies AIDS developed in 14 additional adults

after they received tissue organs or artificial insemination from HIV-infected donors Four of the 14 received tissue or organs from a donor who was negative for HIV antibody at the time of donation

e Includes 37 adultsadolescents who were exposed to HIV-infected blood body fluids or concentrated virus in health care laboratory or household settings as supported by seroconversion epidemiologic andor laboratory evidence One person was infected after intentional inoculation with HIV-infected blood Includes an additional 740 persons who acquired HIV infection perinatally but who were more than 12 years of age when AIDS was diagnosed These 740 persons are not counted in the values for the pediatric transmission category

f AIDS developed in 3 children after they received blood that had tested negative for HIV antibodiesg Includes 5 children who were exposed to HIV-infected blood as supported by seroconversion epidemiologic andor laboratory evidence 1 child was

infected after intentional inoculation with HIV-infected blood and 5 children were exposed to HIV-infected blood in a household setting Of the 168 children 26 had sexual contact with an adult with or at high risk for HIV infection

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 37

Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No

Adult or adolescentMale-to-male sexual contact 22912 59 103679 52 mdash mdash mdash mdash 22912 44 103679 37

Injection drug use 3503 9 24255 12 2124 16 13925 17 5627 11 38181 14

Male-to-male sexual contact and injection drug use 1946 5 10704 5 mdash mdash mdash mdash 1946 4 10704 4

Hemophiliacoagulation disorder 43 0 495 0 6 0 73 0 49 0 568 0

High-risk heterosexual contactc 2874 7 16830 8 5939 45 38315 47 8813 17 55145 20

Sex with injection drug user 308 1 2601 1 757 6 6791 8 1065 2 9392 3

Sex with bisexual male mdash mdash mdash mdash 328 2 2265 3 328 1 2265 1

Sex with person with hemophilia 4 0 31 0 16 0 201 0 20 0 232 0

Sex with HIV-infected transfusion recipient 13 0 131 0 28 0 223 0 41 0 354 0

Sex with HIV-infected person risk factor not specified 2549 7 14067 7 4810 36 28835 35 7359 14 42902 15

Receipt of blood transfusion blood components or tissue 61 0 489 0 50 0 536 1 111 0 1025 0

Otherrisk factor not reported or identified 7748 20 44021 22 5106 39 29312 36 12854 25 73338 26

Subtotal 39087 100 200473 100 13225 100 82161 100 52312 100 282640 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 8 3 106 4 0 0 1 0 8 1 107 2

Mother with documented HIV infection or 1 of the following risk factors 197 74 2195 85 254 85 2417 89 451 80 4612 87

Injection drug use 34 13 532 21 53 18 561 21 87 15 1093 21

Sex with injection drug user 12 5 208 8 21 7 213 8 33 6 421 8

Sex with bisexual male 5 2 37 1 4 1 32 1 9 2 69 1

Sex with person with hemophilia 0 0 3 0 1 0 7 0 1 0 10 0

Sex with HIV-infected transfusion recipient 0 0 4 0 0 0 4 0 0 0 8 0

Sex with HIV-infected person risk factor not specified 54 20 534 21 76 25 629 23 130 23 1163 22

Receipt of blood transfusion blood components or tissue 0 0 17 1 2 1 20 1 2 0 37 1

Has HIV infection risk factor not specified 92 35 860 33 97 32 951 35 189 33 1811 34

Receipt of blood transfusion blood components or tissue 6 2 28 1 3 1 24 1 9 2 52 1

Otherrisk factor not reported or identified 55 21 260 10 43 14 283 10 98 17 543 10

Subtotal 266 100 2589 100 300 100 2725 100 566 100 5314 100

Total 39353 100 203062 100 13525 100 84886 100 52878 100 287954 100

Note See Table 16 for the list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006b From the beginning of the epidemic through December 2006 Includes 6 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infection

38 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity

2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 6251 65 253927 73Injection drug use 733 8 31737 9Male-to-male sexual contact and injection drug use 732 8 31434 9Hemophiliacoagulation disorder 26 0 3989 1High-risk heterosexual contactb 416 4 7850 2

Sex with injection drug user 74 1 2310 1

Sex with person with hemophilia 0 0 36 0

Sex with HIV-infected transfusion recipient 2 0 176 0

Sex with HIV-infected person risk factor not specified 340 4 5328 2Receipt of blood transfusion blood components or tissue 20 0 3194 1Otherrisk factor not reported or identified 1400 15 16469 5

Total 9578 100 348600 100

Black not HispanicMale-to-male sexual contact 4309 36 103297 37Injection drug use 1635 14 83369 30Male-to-male sexual contact and injection drug use 526 4 22134 8Hemophiliacoagulation disorder 10 0 604 0High-risk heterosexual contactb 1875 16 29952 11

Sex with injection drug user 167 1 6823 2Sex with person with hemophilia 1 0 36 0Sex with HIV-infected transfusion recipient 15 0 237 0Sex with HIV-infected person risk factor not specified 1692 14 22856 8

Receipt of blood transfusion blood components or tissue 24 0 1218 0Otherrisk factor not reported or identified 3579 30 40268 14

Total 11958 100 280842 100

HispanicMale-to-male sexual contact 2816 47 64893 44Injection drug use 965 16 46337 31Male-to-male sexual contact and injection drug use 287 5 10884 7Hemophiliacoagulation disorder 6 0 466 0High-risk heterosexual contactb 638 11 10950 7

Sex with injection drug user 84 1 2409 2Sex with person with hemophilia 0 0 11 0Sex with HIV-infected transfusion recipient 5 0 125 0Sex with HIV-infected person risk factor not specified 549 9 8405 6

Receipt of blood transfusion blood components or tissue 17 0 657 0Otherrisk factor not reported or identified 1326 22 14832 10

Total 6055 100 149019 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 39

a

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulative

No No

AsianPacific IslanderMale-to-male sexual contact 225 54 4475 68Injection drug use 20 5 317 5Male-to-male sexual contact and injection drug use 17 4 284 4Hemophiliacoagulation disorder 1 0 70 1High-risk heterosexual contactb 34 8 376 6

Sex with injection drug user 1 0 54 1Sex with person with hemophilia 0 0 1 0Sex with HIV-infected transfusion recipient 0 0 8 0Sex with HIV-infected person risk factor not specified 33 8 313 5

Receipt of blood transfusion blood components or tissue 2 0 112 2Otherrisk factor not reported or identified 114 28 949 14

Total 413 100 6583 100

American IndianAlaska NativeMale-to-male sexual contact 61 49 1403 55Injection drug use 15 12 395 15Male-to-male sexual contact and injection drug use 23 19 457 18Hemophiliacoagulation disorder 0 0 27 1High-risk heterosexual contactb 9 7 118 5

Sex with injection drug user 1 1 33 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 8 6 82 3

Receipt of blood transfusion blood components or tissue 0 0 8 0Otherrisk factor not reported or identified 16 13 155 6

Total 124 100 2563 100

Total casesMale-to-male sexual contact 13775 49 429897 54Injection drug use 3413 12 163070 21Male-to-male sexual contact and injection drug use 1603 6 65524 8Hemophiliacoagulation disorder 43 0 5176 1High-risk heterosexual contactb 2997 11 49610 6

Sex with injection drug user 330 1 11683 1Sex with person with hemophilia 1 0 84 0Sex with HIV-infected transfusion recipient 22 0 553 0Sex with HIV-infected person risk factor not specified 2644 9 37290 5

Receipt of blood transfusion blood components or tissue 63 0 5213 1Otherrisk factor not reported or identified 6484 23 73136 9

Total 28378c 100 791626d 100a From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 4019 males of unknown race or multiple races

40 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 11963 73 55725 69Injection drug use 858 5 5512 7Male-to-male sexual contact and injection drug use 1092 7 5578 7Hemophiliacoagulation disorder 29 0 355 0High-risk heterosexual contactb 522 3 2658 3

Sex with injection drug user 65 0 544 1Sex with person with hemophilia 0 0 8 0Sex with HIV-infected transfusion recipient 3 0 33 0Sex with HIV-infected person risk factor not specified 454 3 2073 3

Receipt of blood transfusion blood components or tissue 14 0 197 0Otherrisk factor not reported or identified 1956 12 11147 14

Total 16434 100 81172 100

Black not HispanicMale-to-male sexual contact 6203 44 30148 37Injection drug use 1594 11 11997 15Male-to-male sexual contact and injection drug use 483 3 3489 4Hemophiliacoagulation disorder 10 0 109 0High-risk heterosexual contactb 1714 12 10905 13

Sex with injection drug user 169 1 1554 2Sex with person with hemophilia 4 0 17 0Sex with HIV-infected transfusion recipient 6 0 77 0Sex with HIV-infected person risk factor not specified 1535 11 9257 11

Receipt of blood transfusion blood components or tissue 32 0 223 0Otherrisk factor not reported or identified 4151 29 24632 30

Total 14187 100 81503 100

HispanicMale-to-male sexual contact 4094 55 15623 47Injection drug use 993 13 6407 19Male-to-male sexual contact and injection drug use 316 4 1402 4Hemophiliacoagulation disorder 3 0 26 0High-risk heterosexual contactb 582 8 2963 9

Sex with injection drug user 65 1 455 1Sex with person with hemophilia 0 0 6 0Sex with HIV-infected transfusion recipient 4 0 18 0Sex with HIV-infected person risk factor not specified 513 7 2484 7

Receipt of blood transfusion blood components or tissue 11 0 55 0Otherrisk factor not reported or identified 1475 20 6977 21

Total 7474 100 33453 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 41

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderMale-to-male sexual contact 402 70 1006 63Injection drug use 17 3 55 3Male-to-male sexual contact and injection drug use 15 3 38 2Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 25 4 96 6

Sex with injection drug user 3 1 10 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 22 4 83 5

Receipt of blood transfusion blood components or tissue 4 1 7 0Otherrisk factor not reported or identified 109 19 397 25

Total 572 100 1600 100

American IndianAlaska NativeMale-to-male sexual contact 104 61 516 57Injection drug use 13 8 101 11Male-to-male sexual contact and injection drug use 19 11 110 12Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 10 6 53 6

Sex with injection drug user 2 1 14 2Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 8 5 39 4

Receipt of blood transfusion blood components or tissue 0 0 2 0Otherrisk factor not reported or identified 24 14 125 14

Total 170 100 907 100

Total casesMale-to-male sexual contact 22912 59 103679 52Injection drug use 3503 9 24255 12Male-to-male sexual contact and injection drug use 1946 5 10704 5Hemophiliacoagulation disorder 43 0 495 0High-risk heterosexual contactb 2874 7 16830 8

Sex with injection drug user 308 1 2601 1Sex with person with hemophilia 4 0 31 0Sex with HIV-infected transfusion recipient 13 0 131 0Sex with HIV-infected person risk factor not specified 2549 7 14067 7

Receipt of blood transfusion blood components or tissue 61 0 489 0Otherrisk factor not reported or identified 7748 20 44021 22

Total 39087c 100 200473d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 1838 males of unknown race or multiple races

42 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race

ethnicity 2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 482 28 14981 40Hemophiliacoagulation disorder 4 0 123 0High-risk heterosexual contactb 725 42 15799 42

Sex with injection drug user 153 9 5650 15Sex with bisexual male 63 4 1859 5Sex with person with hemophilia 5 0 329 1Sex with HIV-infected transfusion recipient 5 0 338 1Sex with HIV-infected person risk factor not specified 499 29 7623 20

Receipt of blood transfusion blood components or tissue 15 1 1870 5Otherrisk factor not reported or identified 499 29 4801 13

Total 1725 100 37574 100

Black not HispanicInjection drug use 982 15 38914 34Hemophiliacoagulation disorder 3 0 145 0High-risk heterosexual contactb 3103 46 49876 44

Sex with injection drug user 373 6 13530 12Sex with bisexual male 136 2 2352 2Sex with person with hemophilia 4 0 121 0Sex with HIV-infected transfusion recipient 8 0 277 0Sex with HIV-infected person risk factor not specified 2582 38 33596 29

Receipt of blood transfusion blood components or tissue 39 1 1546 1Otherrisk factor not reported or identified 2612 39 23894 21

Total 6739 100 114375 100

HispanicInjection drug use 322 18 12892 35Hemophiliacoagulation disorder 4 0 67 0High-risk heterosexual contactb 894 49 17995 49

Sex with injection drug user 166 9 6522 18Sex with bisexual male 32 2 818 2Sex with person with hemophilia 1 0 45 0Sex with HIV-infected transfusion recipient 7 0 141 0Sex with HIV-infected person risk factor not specified 688 38 10469 29

Receipt of blood transfusion blood components or tissue 12 1 619 2Otherrisk factor not reported or identified 592 32 5023 14

Total 1824 100 36596 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 43

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 8 8 125 12Hemophiliacoagulation disorder 0 0 7 1High-risk heterosexual contactb 49 47 574 53

Sex with injection drug user 4 4 114 11Sex with bisexual male 2 2 80 7Sex with person with hemophilia 0 0 4 0Sex with HIV-infected transfusion recipient 1 1 25 2Sex with HIV-infected person risk factor not specified 42 40 351 33

Receipt of blood transfusion blood components or tissue 1 1 93 9Otherrisk factor not reported or identified 46 44 279 26

Total 104 100 1078 100

American IndianAlaska NativeInjection drug use 13 32 280 42Hemophiliacoagulation disorder 0 0 3 0High-risk heterosexual contactb 15 37 277 41

Sex with injection drug user 4 10 107 16Sex with bisexual male 1 2 27 4Sex with person with hemophilia 0 0 2 0Sex with HIV-infected transfusion recipient 0 0 6 1Sex with HIV-infected person risk factor not specified 10 24 135 20

Receipt of blood transfusion blood components or tissue 1 2 17 3Otherrisk factor not reported or identified 12 29 95 14

Total 41 100 672 100

Total casesInjection drug use 1826 17 67693 35Hemophiliacoagulation disorder 11 0 348 0High-risk heterosexual contactb 4839 46 85186 44

Sex with injection drug user 706 7 26073 14Sex with bisexual male 234 2 5162 3Sex with person with hemophilia 11 0 502 0Sex with HIV-infected transfusion recipient 21 0 793 0Sex with HIV-infected person risk factor not specified 3867 37 52656 27

Receipt of blood transfusion blood components or tissue 68 1 4176 2Otherrisk factor not reported or identified 3793 36 34311 18

Total 10537c 100 191714d 100a From the beginning of the epidemic through 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 104 females of unknown race or multiple racesd Includes 1419 females of unknown race or multiple races

44 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 690 26 4260 26Hemophiliacoagulation disorder 3 0 24 0

bHigh-risk heterosexual contact 1132 42 7593 46Sex with injection drug user 205 8 1876 11Sex with bisexual male 98 4 659 4Sex with person with hemophilia 10 0 115 1Sex with HIV-infected transfusion recipient 7 0 64 0Sex with HIV-infected person risk factor not specified 812 30 4879 29

Receipt of blood transfusion blood components or tissue 12 0 146 1Otherrisk factor not reported or identified 850 32 4567 28

Total 2687 100 16590 100

Black not HispanicInjection drug use 1034 13 7105 14Hemophiliacoagulation disorder 1 0 35 0

bHigh-risk heterosexual contact 3451 44 23732 46Sex with injection drug user 313 4 3473 7Sex with bisexual male 155 2 1294 3Sex with person with hemophilia 5 0 71 0Sex with HIV-infected transfusion recipient 14 0 120 0Sex with HIV-infected person risk factor not specified 2964 38 18774 36

Receipt of blood transfusion blood components or tissue 26 0 324 1Otherrisk factor not reported or identified 3370 43 20244 39

Total 7882 100 51440 100

HispanicInjection drug use 339 15 2280 18Hemophiliacoagulation disorder 2 0 11 0

bHigh-risk heterosexual contact 1198 52 6264 50Sex with injection drug user 218 9 1324 11Sex with bisexual male 62 3 266 2Sex with person with hemophilia 1 0 11 0Sex with HIV-infected transfusion recipient 7 0 39 0Sex with HIV-infected person risk factor not specified 910 39 4624 37

Receipt of blood transfusion blood components or tissue 12 1 58 0Otherrisk factor not reported or identified 767 33 3843 31

Total 2318 100 12456 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 45

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 25: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age categorymdashUnited States and dependent areas (cont)

Area of residence

Living with HIV infection (not AIDS)a Living with AIDS

Adults or adolescents

Children (lt13 years) Total

Adults or adolescents

Children (lt13 years) Total

US dependent areasAmerican Samoa 2 0 2 1 0 1Guam 63 0 63 36 0 36Northern Mariana Islands 7 0 7 3 0 3Puerto Rico 6269 31 6300 10971 26 10997US Virgin Islands 228 2 230 312 2 314Otherc mdash mdash mdash 1 0 1

Totald 230872 2207 233079 447724 1147 448871

Note These numbers do not represent reported case counts Rather these numbers are point estimates which result from adjustments of reported case counts The reported case counts have been adjusted for reporting delays but not for incomplete reporting a See Technical Notes for the list of areas that have had laws or regulations requiring confidential name-based HIV infection reporting since at

least 2003b Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterc Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasd Total number of persons living with HIV infection (not AIDS) includes persons reported from areas with confidential name-based HIV

infection reporting who were residents of other states or whose area of residence is unknown Total number of persons living with AIDS includes persons whose area of residence is unknown Because column totals were calculated independently of the values for the subpopulations the values in each column may not sum to the column total

Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS) 25

Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristicsmdashUnited States and dependent areas

No of persons

Survival in months

gt12 gt24 gt36Data for 50 states and the District of Columbia

Age at diagnosis (yrs)lt13 101 096 094 09413ndash14 60 098 098 09515ndash19 305 098 096 09520ndash24 1351 096 093 09225ndash29 3034 095 092 09130ndash34 5499 094 091 08935ndash39 7888 093 090 08740ndash44 7085 092 088 08545ndash49 5090 089 085 08250ndash54 3067 086 081 07855ndash59 1505 083 078 07460ndash64 806 080 073 069gt65 614 073 068 065

RaceethnicityWhite not Hispanic 10706 092 089 087Black not Hispanic 18406 090 086 082Hispanic 6398 092 090 088AsianPacific Islander 404 094 092 090American IndianAlaska Native 167 084 081 075

Transmission categoryMale adult or adolescentMale-to-male sexual contact 12830 093 090 088Injection drug use 4048 089 084 081Male-to-male sexual contact and injection drug use 1701 093 089 086High-risk heterosexual contacta 3170 091 088 085Otherb 5019 086 083 080Subtotal 26768 091 088 085

Female adult or adolescentInjection drug use 2101 089 083 078High-risk heterosexual contacta 4686 093 089 086Otherb 2749 090 085 083Subtotal 9536 091 087 083

Child (lt13 yrs at diagnosis)Perinatal 98 096 095 095Otherc 3 100 067 067Subtotal 101 096 094 094

Subtotal for 50 states and the District of Columbia 36405 091 087 085

Data for US dependent areas 891 083 078 075

Total 37352d 091 087 084Note Excludes persons whose date of death was before or in the same month as date of diagnosis Excludes persons whose month of diagnosis or month of death is unknowna Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes 325 persons of unknown race or multiple races

26 Survival after AIDS Diagnosis

Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by year of diagnosismdashUnited States and dependent areas

Months after AIDS diagnosis

Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by age groupmdashUnited States and dependent areas

Months after AIDS diagnosis

Survival after AIDS Diagnosis 27

Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by raceethnicitymdashUnited States and dependent areas

Months after AIDS diagnosis

28 Survival after AIDS Diagnosis

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006

and cumulativemdashUnited States and dependent areas

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Alabama 510 112 462 100 8626 76 8702Alaska 24 36 38 57 648 7 655Arizona 626 105 539 87 10396 46 10442Arkansas 237 85 252 90 3891 36 3927California 4069 113 3960 109 142254 664 142918Colorado 351 75 322 68 8742 31 8773Connecticut 658 188 422 120 14716 183 14899Delaware 177 210 116 136 3547 26 3573District of Columbia 672 1155 853 1467 17372 189 17561Florida 4921 277 4932 273 104084 1530 105614Georgia 2325 255 1605 171 31734 231 31965Hawaii 105 82 93 72 2927 17 2944Idaho 24 17 26 18 604 2 606Illinois 1886 148 1382 108 33620 282 33902Indiana 407 65 346 55 8239 56 8295Iowa 93 31 86 29 1727 13 1740Kansas 105 38 120 43 2781 14 2795Kentucky 249 60 207 49 4600 32 4632Louisiana 936 208 824 192 17612 128 17740Maine 21 16 68 51 1110 8 1118Maryland 1558 279 1626 290 30252 319 30571Massachusetts 666 104 533 83 19181 214 19395Michigan 821 81 672 67 14941 113 15054Minnesota 226 44 212 41 4817 28 4845Mississippi 368 127 365 125 6642 56 6698Missouri 385 66 469 80 11016 61 11077Montana 21 22 7 07 373 3 376Nebraska 53 30 118 67 1479 11 1490Nevada 293 121 294 118 5733 29 5762New Hampshire 33 25 55 42 1074 10 1084New Jersey 1262 145 1065 122 48750 778 49528New Mexico 134 70 93 48 2603 7 2610New York 6201 321 5495 285 174908 2354 177262North Carolina 916 106 1229 139 15954 118 16072North Dakota 10 16 6 09 144 1 145Ohio 753 66 767 67 14957 138 15095Oklahoma 281 79 205 57 4836 26 4862Oregon 217 60 281 76 5995 20 6015Pennsylvania 1486 120 1893 152 33417 365 33782Rhode Island 87 81 111 104 2580 28 2608South Carolina 682 161 705 163 13301 105 13406South Dakota 18 23 18 23 255 5 260Tennessee 818 137 680 113 12457 59 12516Texas 3045 133 2998 128 69735 392 70127Utah 63 25 57 22 2295 20 2315Vermont 5 08 18 29 461 6 467Virginia 638 84 605 79 16802 177 16979Washington 485 77 389 61 11792 34 11826West Virginia 74 41 67 37 1500 11 1511Wisconsin 122 22 217 39 4513 33 4546Wyoming 6 12 8 16 228 2 230

Subtotal 40123 135 37911 127 952221 9094 961315

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 29

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulativemdashUnited States and dependent areas (cont)

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

US dependent areasAmerican Samoa 0 0 0 0 1 0 1Guam 0 0 0 0 68 1 69Northern Mariana Islands 0 0 0 0 3 0 3Puerto Rico 1029 263 850 216 29511 400 29911US Virgin Islands 17 156 32 295 629 18 647Otherb 0 0 0 0 3 0 3

Totalc 41357 138 39002 129 983343 9522 992865d

a From the beginning of the epidemic through 2006b Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasc Includes persons whose state or area of residence is unknownd Includes 916 persons whose state or area of residence is unknown

30 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

MSA (population gt 500000)

Akron Ohio 66 94 32 46 762 1 763

AlbanyndashSchenectadyndashTroy NY 97 114 105 123 2253 24 2277

Albuquerque N Mex 70 88 50 61 1404 2 1406

AllentownndashBethlehemndashEaston PandashNJ 72 91 119 149 1352 17 1369

AtlantandashSandy SpringsndashMarietta Ga 1586 319 1006 196 21896 128 22024

AugustandashRichmond County GandashSC 106 205 32 61 1851 24 1875

AustinndashRound Rock Tex 227 156 186 123 4830 26 4856

Bakersfield Calif 76 100 122 156 1528 8 1536

BaltimorendashTowson Md 1064 401 1001 377 20352 218 20570

Baton Rouge La 222 304 231 301 3732 20 3752

BirminghamndashHoover Ala 151 139 110 100 2614 25 2639

Boise CityndashNampa Idaho 14 26 14 25 281 0 281

Boston MassndashNHa 441 99 355 80 13476 147 13623

Boston Division 269 146 185 101 8451 91 8542

Cambridge Division 108 74 102 70 3126 35 3161

Essex Division 52 71 51 69 1577 20 1597

BridgeportndashStamfordndashNorwalk Conn 181 201 135 150 3733 57 3790

BuffalondashNiagara Falls NY 117 102 96 84 2476 20 2496

Cape CoralndashFort Myers Fla 44 81 91 159 1692 24 1716

CharlestonndashNorth Charleston SC 92 155 91 151 2034 18 2052

CharlottendashGastoniandashConcord NCndashSC 214 141 285 180 3242 22 3264

Chicago IllndashIndndashWis 1716 182 1159 122 30118 261 30379

Chicago Division 1604 203 1073 135 28300 248 28548

Gary Division 61 88 50 71 1038 8 1046

Lake Division 51 59 36 41 780 5 785

CincinnatindashMiddletown OhiondashKyndashInd 111 53 199 95 2735 17 2752

ClevelandndashElyriandashMentor Ohio 228 107 170 80 4226 48 4274

Colorado Springs Colo 19 32 21 35 576 5 581

Columbia SC 177 256 197 280 3274 24 3298

Columbus Ohio 166 97 165 96 3112 15 3127

Dallas Tex 874 150 929 155 20238 63 20301

Dallas Division 681 175 714 178 16038 37 16075

Fort Worth Division 193 100 215 108 4200 26 4226

Dayton Ohio 58 69 54 64 1217 15 1232

DenverndashAurora Colo 274 116 236 98 6899 22 6921

Des Moines Iowa 30 57 23 43 530 4 534

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 31

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Detroit Mich 570 127 445 100 10373 73 10446

Detroit Division 443 223 330 167 8268 57 8325

Warren Division 127 51 115 46 2105 16 2121

El Paso Tex 56 78 40 54 1476 10 1486

Fresno Calif 52 59 64 72 1430 11 1441

Grand RapidsndashWyoming Mich 46 60 51 66 816 6 822

GreensborondashHigh Point NC 52 77 66 96 1265 14 1279

Greenville SC 70 119 67 111 1292 4 1296

HarrisburgndashCarlisle Pa 23 44 67 128 1224 8 1232

HartfordndashWest HartfordndashEast Hartford Conn 256 216 135 114 5126 46 5172

Honolulu Hawaii 54 60 69 76 2121 14 2135

HoustonndashBaytownndashSugar Land Tex 1017 190 1092 197 25821 172 25993

Indianapolis Ind 191 116 150 90 3824 25 3849

Jackson Miss 134 257 117 221 2419 30 2449

Jacksonville Fla 309 248 315 246 6020 75 6095

Kansas City MondashKans 183 94 160 81 4669 15 4684

Knoxville Tenn 47 72 35 52 882 5 887

Lakeland Fla 103 190 112 199 1811 21 1832

Las VegasndashParadise Nev 245 143 258 145 4616 28 4644

Little RockndashNorth Little Rock Ark 87 135 75 115 1383 14 1397

Los Angeles Calif 1529 118 1684 130 57953 293 58246

Los Angeles Division 1339 135 1435 144 51098 250 51348

Santa Anna Division 190 63 249 83 6855 43 6898

Louisville KyndashInd 123 102 97 79 2286 22 2308

Madison Wis 10 19 29 53 520 4 524

McAllenndashEdinburgndashPharr Tex 57 84 45 64 630 11 641

Memphis TennndashMissndashArk 402 320 346 271 5128 19 5147

Miami Fla 2420 446 2289 419 55807 997 56804

Fort Lauderdale Division 810 455 769 430 16412 262 16674

Miami Division 1243 523 1165 485 29703 512 30215

West Palm Beach Division 367 290 355 279 9692 223 9915

MilwaukeendashWaukeshandashWest Allis Wis 68 45 109 72 2507 18 2525

MinneapolisndashSt PaulndashBloomington MinnndashWis 186 59 184 58 4259 22 4281

Modesto Calif 36 71 22 43 671 6 677

NashvillendashDavidsonndashMurfreesboro Tenn 224 158 172 118 3848 20 3868

New HavenndashMilford Conn 169 200 107 127 4573 73 4646

New OrleansndashMetairiendashKenner La 393 299 271 264 8835 67 8902

32 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

New York NYndashNJndashPa 6215 330 5500 292 195177 2906 198083

Edison Division 191 83 130 56 6709 139 6848

Nassau Division 262 93 246 88 8141 110 8251

New York Division 5266 456 4716 408 160408 2323 162731

Newark Division 496 231 408 190 19919 334 20253

Oklahoma City Okla 125 108 88 75 2255 5 2260

OmahandashCouncil Bluffs NebndashIowa 37 46 80 97 1035 3 1038

Orlando Fla 544 282 517 260 8653 92 8745

OxnardndashThousand OaksndashVentura Calif 49 62 21 26 1008 3 1011

Palm BayndashMelbournendashTitusville Fla 68 129 61 114 1512 11 1523

Philadelphia PandashNJndashDelndashMd 1261 217 1348 231 28221 313 28534

Camden Division 108 87 111 89 3118 42 3160

Philadelphia Division 1022 263 1144 294 22112 250 22362

Wilmington Division 131 191 93 134 2991 21 3012

PhoenixndashMesandashScottsdale Ariz 460 119 376 93 7459 31 7490

Pittsburgh Pa 143 60 135 57 3182 19 3201

PortlandndashSouth Portland Maine 9 18 34 66 562 1 563

PortlandndashVancouverndashBeaverton OrendashWash 170 81 215 101 4825 10 4835

PoughkeepsiendashNewburghndashMiddletown NY 136 204 113 168 3162 24 3186

ProvidencendashNew BedfordndashFall River RIndashMass 132 82 155 96 3900 44 3944

RaleighndashCary NC 138 145 201 202 1987 13 2000

Richmond Va 119 101 122 102 3371 35 3406

RiversidendashSan BernardinondashOntario Calif 361 92 306 76 8568 60 8628

Rochester NY 165 159 124 120 3134 13 3147

SacramentondashArden-ArcadendashRoseville Calif 154 75 169 82 4000 26 4026

St Louis MondashIll 192 69 366 131 5965 40 6005

Salt Lake City Utah 46 44 40 37 1743 10 1753

San Antonio Tex 215 114 247 127 4987 30 5017

San DiegondashCarlsbadndashSan Marcos Calif 491 167 384 131 12934 61 12995

San Francisco Calif 867 209 690 165 40152 96 40248

Oakland Division 312 126 246 99 9546 48 9594

San Francisco Division 555 329 444 261 30606 48 30654

San JosendashSunnyvalendashSanta Clara Calif 88 50 145 81 3747 15 3762

San JuanndashCaguasndashGuaynabo PR 745 289 578 223 21402 277 21679

SarasotandashBradentonndashVenice Fla 82 122 104 152 1978 27 2005

ScrantonndashWilkes-Barre Pa 27 49 47 85 572 6 578

Seattle Wash 353 110 280 86 9172 27 9199

Seattle Division 316 129 255 102 8161 18 8179

Tacoma Division 37 49 25 33 1011 9 1020

Springfield Mass 88 128 45 66 2075 26 2101

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 33

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Stockton Calif 52 78 52 77 1076 15 1091

Syracuse NY 52 80 49 75 1317 8 1325

TampandashSt PetersburgndashClearwater Fla 559 211 605 224 11174 112 11286

Toledo Ohio 25 38 66 101 812 14 826

Tucson Ariz 103 111 100 106 2010 10 2020

Tulsa Okla 83 94 65 72 1494 10 1504

Virginia BeachndashNorfolkndashNewport News VandashNC 183 111 132 80 4711 63 4774

Washington DCndashVandashMdndashWV 1322 252 1684 318 31130 315 31445

Bethesda Division 135 118 173 150 2774 23 2797

Washington Division 1187 289 1511 365 28356 292 28648

Wichita Kans 35 60 38 64 851 2 853

Worcester Mass 76 97 79 101 1783 20 1803

YoungstownndashWarrenndashBoardman OhiondashPa 27 46 26 44 519 0 519

Subtotal for MSAs (population gt500000) 33602 173 31274 159 829633 8171 837804

Metropolitan areas (population of 50000 to 499999) 4477 80 4466 79 94829 847 95676

Nonmetropolitan areas 2666 54 2732 55 52063 445 52508

Totalb 41144 137 38749 128 981708 9494 991202

Note Because of the lack of census information for all US dependent areas includes data for only the 50 states the District of Columbia and Puerto RicoMSA metropolitan statistical areaMSA definitions for this report can be found at httpwwwcensusgovpopulationwwwestimatesmetrodefhtmla Reported case counts for the metropolitan divisions do not sum to the MSA total MSA total includes data from 1 metropolitan division with

population of lt500000b Includes persons whose county of residence is unknown

34 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Alabama (January 1988) 502 6041 48 6089

Alaska (February 1999) 38 285 2 287

Arizona (January 1987) 617 5877 80 5957

Arkansas (July 1989) 206 2349 20 2369

California (April 2006) 6581 7056 92 7148

Colorado (November 1985) 319 6084 31 6115

Connecticut (January 2005)b 826 2500 101 2601

Delaware (February 2006) 788 801 18 819

Florida (July 1997)c 4163 36386 397 36783

Georgia (December 2003) 2245 8197 194 8391

Idaho (June 1986) 35 340 4 344

Illinois (January 2006) 6241 6661 162 6823

Indiana (July 1988) 399 4027 43 4070

Iowa (July 1998) 69 586 5 591

Kansas (July 1999) 142 1225 15 1240

Kentucky (October 2004) 333 1303 13 1316

Louisiana (February 1993) 728 8149 166 8315

Maine (January 2006) 386 393 3 396

Michigan (April 1992) 635 6702 134 6836

Minnesota (October 1985) 309 3356 40 3396

Mississippi (August 1988) 352 4549 59 4608

Missouri (October 1987) 502 5086 55 5141

Nebraska (September 1995) 91 672 14 686

Nevada (February 1992) 339 3532 24 3556

New Hampshire (January 2005) 59 466 9 475

New Jersey (January 1992) 1477 17513 325 17838

New Mexico (January 1998) 114 949 4 953

New York (June 2000) 5326 42345 1820 44165

North Carolina (February 1990) 1615 13879 143 14022

North Dakota (January 1988) 4 82 1 83

Ohio (June 1990) 867 8222 101 8323

Oklahoma (June 1988) 229 2401 30 2431

Oregon (April 2006) 49 95 19 114

Pennsylvania (October 2002)d 4269 9537 179 9716

Rhode Island (July 2006) 14 21 0 21

South Carolina (February 1986) 493 6970 93 7063

South Dakota (January 1988) 18 215 6 221

Tennessee (January 1992) 732 7115 90 7205

Texas (January 1999)e 3370 24282 417 24699

Utah (April 1989) 106 893 14 907

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 35

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Virginia (July 1989) 864 10257 95 10352

Washington (March 2006) 4048 4157 40 4197

West Virginia (January 1989) 66 673 8 681

Wisconsin (November 1985) 261 2500 31 2531

Wyoming (June 1989) 7 93 1 94

Subtotal 50834 274822 5146 279968

US dependent areas

American Samoa (August 2001) 0 1 0 1

Guam (March 2000) 2 66 0 66

Northern Mariana Islands (October 2001) 2 7 0 7

Puerto Rico (January 2003) 1471 5610 91 5701

US Virgin Islands (December 1998) 22 247 6 253

Persons reported from areas with confidential name-based HIV infection reporting but who were residents of other areas 132 685 21 706

Totalf 52878 282640 5314 287954

Note Includes data from 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through 2006b Beginning in 1992 Connecticut had name-based HIV reporting for cases in children only From January 2002 through December 2004

Connecticut had name- or code-based HIV reporting for cases in adolescents and adults As of January 2005 Connecticut has name-based reporting of all cases of HIV infection

c Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterd On October 18 2002 Pennsylvania initiated confidential name-based HIV infection reporting in all areas except Philadelphia Code-based

reporting was implemented in Philadelphia in March 2004 and the switch to name-based reporting was made in October 2005e From February 1994 through December 1998 Texas reported HIV infection in children onlyf Includes 1252 persons reported from areas with confidential name-based HIV infection reporting but whose area of residence is unknown

36 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulativemdashUnited States and dependent areas

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No Adult or adolescentMale-to-male sexual contact 13775 49 429897 54 mdash mdash mdash mdash 13775 35 429897 44Injection drug use 3413 12 163070 21 1826 17 67693 35 5239 13 230763 23Male-to-male sexual contact and

injection drug use 1603 6 65524 8 mdash mdash mdash mdash 1603 4 65524 7Hemophiliacoagulation disorder 43 0 5176 1 11 0 348 0 54 0 5524 1High-risk heterosexual contactc 2997 11 49610 6 4839 46 85186 44 7836 20 134796 14

Sex with injection drug user 330 1 11683 1 706 7 26073 14 1036 3 37756 4Sex with bisexual male mdash mdash mdash mdash 234 2 5162 3 234 1 5162 1Sex with person with hemophilia 1 0 84 0 11 0 502 0 12 0 586 0Sex with HIV-infected transfusion

recipient 22 0 553 0 21 0 793 0 43 0 1346 0Sex with HIV-infected person risk

factor not specified 2644 9 37290 5 3867 37 52656 27 6511 17 89946 9Receipt of blood transfusion blood

d components or tissue 63 0 5213 1 68 1 4176 2 131 0 9389 1Otherrisk factor not reported or

identifiede 6484 23 73136 9 3793 36 34311 18 10278 26 107450 11Subtotal 28378 100 791626 100 10537 100 191714 100 38916 100 983343 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 0 0 222 5 0 0 7 0 0 0 229 2Mother with documented HIV infection or

1 of the following risk factors 24 75 4315 89 50 93 4423 95 74 86 8738 92Injection drug use 4 13 1676 35 4 7 1665 36 8 9 3341 35Sex with injection drug user 4 13 789 16 4 7 750 16 8 9 1539 16Sex with bisexual male 1 3 101 2 2 4 110 2 3 3 211 2Sex with person with hemophilia 0 0 20 0 0 0 16 0 0 0 36 0Sex with HIV-infected transfusion

recipient 0 0 11 0 0 0 15 0 0 0 26 0Sex with HIV-infected person risk

factor not specified 6 19 742 15 17 31 790 17 23 27 1532 16Receipt of blood transfusion blood

components or tissue 0 0 70 1 0 0 82 2 0 0 152 2Has HIV infection risk factor not

specified 9 28 906 19 23 43 995 21 32 37 1901 20Receipt of blood transfusion blood

fcomponents or tissue 1 3 243 5 0 0 144 3 1 1 387 4Otherrisk factor not reported or

identifiedg 7 22 75 2 4 7 93 2 11 13 168 2Subtotal 32 100 4855 100 54 100 4667 100 86 100 9522 100

Total 28410 100 796481 100 10591 100 196381 100 39002 100 992865 100a From the beginning of the epidemic through 2006b From the beginning of the epidemic through 2006 Includes 3 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infectiond AIDS developed in 47 adultsadolescents after they received blood that had tested negative for HIV antibodies AIDS developed in 14 additional adults

after they received tissue organs or artificial insemination from HIV-infected donors Four of the 14 received tissue or organs from a donor who was negative for HIV antibody at the time of donation

e Includes 37 adultsadolescents who were exposed to HIV-infected blood body fluids or concentrated virus in health care laboratory or household settings as supported by seroconversion epidemiologic andor laboratory evidence One person was infected after intentional inoculation with HIV-infected blood Includes an additional 740 persons who acquired HIV infection perinatally but who were more than 12 years of age when AIDS was diagnosed These 740 persons are not counted in the values for the pediatric transmission category

f AIDS developed in 3 children after they received blood that had tested negative for HIV antibodiesg Includes 5 children who were exposed to HIV-infected blood as supported by seroconversion epidemiologic andor laboratory evidence 1 child was

infected after intentional inoculation with HIV-infected blood and 5 children were exposed to HIV-infected blood in a household setting Of the 168 children 26 had sexual contact with an adult with or at high risk for HIV infection

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 37

Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No

Adult or adolescentMale-to-male sexual contact 22912 59 103679 52 mdash mdash mdash mdash 22912 44 103679 37

Injection drug use 3503 9 24255 12 2124 16 13925 17 5627 11 38181 14

Male-to-male sexual contact and injection drug use 1946 5 10704 5 mdash mdash mdash mdash 1946 4 10704 4

Hemophiliacoagulation disorder 43 0 495 0 6 0 73 0 49 0 568 0

High-risk heterosexual contactc 2874 7 16830 8 5939 45 38315 47 8813 17 55145 20

Sex with injection drug user 308 1 2601 1 757 6 6791 8 1065 2 9392 3

Sex with bisexual male mdash mdash mdash mdash 328 2 2265 3 328 1 2265 1

Sex with person with hemophilia 4 0 31 0 16 0 201 0 20 0 232 0

Sex with HIV-infected transfusion recipient 13 0 131 0 28 0 223 0 41 0 354 0

Sex with HIV-infected person risk factor not specified 2549 7 14067 7 4810 36 28835 35 7359 14 42902 15

Receipt of blood transfusion blood components or tissue 61 0 489 0 50 0 536 1 111 0 1025 0

Otherrisk factor not reported or identified 7748 20 44021 22 5106 39 29312 36 12854 25 73338 26

Subtotal 39087 100 200473 100 13225 100 82161 100 52312 100 282640 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 8 3 106 4 0 0 1 0 8 1 107 2

Mother with documented HIV infection or 1 of the following risk factors 197 74 2195 85 254 85 2417 89 451 80 4612 87

Injection drug use 34 13 532 21 53 18 561 21 87 15 1093 21

Sex with injection drug user 12 5 208 8 21 7 213 8 33 6 421 8

Sex with bisexual male 5 2 37 1 4 1 32 1 9 2 69 1

Sex with person with hemophilia 0 0 3 0 1 0 7 0 1 0 10 0

Sex with HIV-infected transfusion recipient 0 0 4 0 0 0 4 0 0 0 8 0

Sex with HIV-infected person risk factor not specified 54 20 534 21 76 25 629 23 130 23 1163 22

Receipt of blood transfusion blood components or tissue 0 0 17 1 2 1 20 1 2 0 37 1

Has HIV infection risk factor not specified 92 35 860 33 97 32 951 35 189 33 1811 34

Receipt of blood transfusion blood components or tissue 6 2 28 1 3 1 24 1 9 2 52 1

Otherrisk factor not reported or identified 55 21 260 10 43 14 283 10 98 17 543 10

Subtotal 266 100 2589 100 300 100 2725 100 566 100 5314 100

Total 39353 100 203062 100 13525 100 84886 100 52878 100 287954 100

Note See Table 16 for the list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006b From the beginning of the epidemic through December 2006 Includes 6 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infection

38 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity

2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 6251 65 253927 73Injection drug use 733 8 31737 9Male-to-male sexual contact and injection drug use 732 8 31434 9Hemophiliacoagulation disorder 26 0 3989 1High-risk heterosexual contactb 416 4 7850 2

Sex with injection drug user 74 1 2310 1

Sex with person with hemophilia 0 0 36 0

Sex with HIV-infected transfusion recipient 2 0 176 0

Sex with HIV-infected person risk factor not specified 340 4 5328 2Receipt of blood transfusion blood components or tissue 20 0 3194 1Otherrisk factor not reported or identified 1400 15 16469 5

Total 9578 100 348600 100

Black not HispanicMale-to-male sexual contact 4309 36 103297 37Injection drug use 1635 14 83369 30Male-to-male sexual contact and injection drug use 526 4 22134 8Hemophiliacoagulation disorder 10 0 604 0High-risk heterosexual contactb 1875 16 29952 11

Sex with injection drug user 167 1 6823 2Sex with person with hemophilia 1 0 36 0Sex with HIV-infected transfusion recipient 15 0 237 0Sex with HIV-infected person risk factor not specified 1692 14 22856 8

Receipt of blood transfusion blood components or tissue 24 0 1218 0Otherrisk factor not reported or identified 3579 30 40268 14

Total 11958 100 280842 100

HispanicMale-to-male sexual contact 2816 47 64893 44Injection drug use 965 16 46337 31Male-to-male sexual contact and injection drug use 287 5 10884 7Hemophiliacoagulation disorder 6 0 466 0High-risk heterosexual contactb 638 11 10950 7

Sex with injection drug user 84 1 2409 2Sex with person with hemophilia 0 0 11 0Sex with HIV-infected transfusion recipient 5 0 125 0Sex with HIV-infected person risk factor not specified 549 9 8405 6

Receipt of blood transfusion blood components or tissue 17 0 657 0Otherrisk factor not reported or identified 1326 22 14832 10

Total 6055 100 149019 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 39

a

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulative

No No

AsianPacific IslanderMale-to-male sexual contact 225 54 4475 68Injection drug use 20 5 317 5Male-to-male sexual contact and injection drug use 17 4 284 4Hemophiliacoagulation disorder 1 0 70 1High-risk heterosexual contactb 34 8 376 6

Sex with injection drug user 1 0 54 1Sex with person with hemophilia 0 0 1 0Sex with HIV-infected transfusion recipient 0 0 8 0Sex with HIV-infected person risk factor not specified 33 8 313 5

Receipt of blood transfusion blood components or tissue 2 0 112 2Otherrisk factor not reported or identified 114 28 949 14

Total 413 100 6583 100

American IndianAlaska NativeMale-to-male sexual contact 61 49 1403 55Injection drug use 15 12 395 15Male-to-male sexual contact and injection drug use 23 19 457 18Hemophiliacoagulation disorder 0 0 27 1High-risk heterosexual contactb 9 7 118 5

Sex with injection drug user 1 1 33 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 8 6 82 3

Receipt of blood transfusion blood components or tissue 0 0 8 0Otherrisk factor not reported or identified 16 13 155 6

Total 124 100 2563 100

Total casesMale-to-male sexual contact 13775 49 429897 54Injection drug use 3413 12 163070 21Male-to-male sexual contact and injection drug use 1603 6 65524 8Hemophiliacoagulation disorder 43 0 5176 1High-risk heterosexual contactb 2997 11 49610 6

Sex with injection drug user 330 1 11683 1Sex with person with hemophilia 1 0 84 0Sex with HIV-infected transfusion recipient 22 0 553 0Sex with HIV-infected person risk factor not specified 2644 9 37290 5

Receipt of blood transfusion blood components or tissue 63 0 5213 1Otherrisk factor not reported or identified 6484 23 73136 9

Total 28378c 100 791626d 100a From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 4019 males of unknown race or multiple races

40 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 11963 73 55725 69Injection drug use 858 5 5512 7Male-to-male sexual contact and injection drug use 1092 7 5578 7Hemophiliacoagulation disorder 29 0 355 0High-risk heterosexual contactb 522 3 2658 3

Sex with injection drug user 65 0 544 1Sex with person with hemophilia 0 0 8 0Sex with HIV-infected transfusion recipient 3 0 33 0Sex with HIV-infected person risk factor not specified 454 3 2073 3

Receipt of blood transfusion blood components or tissue 14 0 197 0Otherrisk factor not reported or identified 1956 12 11147 14

Total 16434 100 81172 100

Black not HispanicMale-to-male sexual contact 6203 44 30148 37Injection drug use 1594 11 11997 15Male-to-male sexual contact and injection drug use 483 3 3489 4Hemophiliacoagulation disorder 10 0 109 0High-risk heterosexual contactb 1714 12 10905 13

Sex with injection drug user 169 1 1554 2Sex with person with hemophilia 4 0 17 0Sex with HIV-infected transfusion recipient 6 0 77 0Sex with HIV-infected person risk factor not specified 1535 11 9257 11

Receipt of blood transfusion blood components or tissue 32 0 223 0Otherrisk factor not reported or identified 4151 29 24632 30

Total 14187 100 81503 100

HispanicMale-to-male sexual contact 4094 55 15623 47Injection drug use 993 13 6407 19Male-to-male sexual contact and injection drug use 316 4 1402 4Hemophiliacoagulation disorder 3 0 26 0High-risk heterosexual contactb 582 8 2963 9

Sex with injection drug user 65 1 455 1Sex with person with hemophilia 0 0 6 0Sex with HIV-infected transfusion recipient 4 0 18 0Sex with HIV-infected person risk factor not specified 513 7 2484 7

Receipt of blood transfusion blood components or tissue 11 0 55 0Otherrisk factor not reported or identified 1475 20 6977 21

Total 7474 100 33453 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 41

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderMale-to-male sexual contact 402 70 1006 63Injection drug use 17 3 55 3Male-to-male sexual contact and injection drug use 15 3 38 2Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 25 4 96 6

Sex with injection drug user 3 1 10 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 22 4 83 5

Receipt of blood transfusion blood components or tissue 4 1 7 0Otherrisk factor not reported or identified 109 19 397 25

Total 572 100 1600 100

American IndianAlaska NativeMale-to-male sexual contact 104 61 516 57Injection drug use 13 8 101 11Male-to-male sexual contact and injection drug use 19 11 110 12Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 10 6 53 6

Sex with injection drug user 2 1 14 2Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 8 5 39 4

Receipt of blood transfusion blood components or tissue 0 0 2 0Otherrisk factor not reported or identified 24 14 125 14

Total 170 100 907 100

Total casesMale-to-male sexual contact 22912 59 103679 52Injection drug use 3503 9 24255 12Male-to-male sexual contact and injection drug use 1946 5 10704 5Hemophiliacoagulation disorder 43 0 495 0High-risk heterosexual contactb 2874 7 16830 8

Sex with injection drug user 308 1 2601 1Sex with person with hemophilia 4 0 31 0Sex with HIV-infected transfusion recipient 13 0 131 0Sex with HIV-infected person risk factor not specified 2549 7 14067 7

Receipt of blood transfusion blood components or tissue 61 0 489 0Otherrisk factor not reported or identified 7748 20 44021 22

Total 39087c 100 200473d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 1838 males of unknown race or multiple races

42 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race

ethnicity 2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 482 28 14981 40Hemophiliacoagulation disorder 4 0 123 0High-risk heterosexual contactb 725 42 15799 42

Sex with injection drug user 153 9 5650 15Sex with bisexual male 63 4 1859 5Sex with person with hemophilia 5 0 329 1Sex with HIV-infected transfusion recipient 5 0 338 1Sex with HIV-infected person risk factor not specified 499 29 7623 20

Receipt of blood transfusion blood components or tissue 15 1 1870 5Otherrisk factor not reported or identified 499 29 4801 13

Total 1725 100 37574 100

Black not HispanicInjection drug use 982 15 38914 34Hemophiliacoagulation disorder 3 0 145 0High-risk heterosexual contactb 3103 46 49876 44

Sex with injection drug user 373 6 13530 12Sex with bisexual male 136 2 2352 2Sex with person with hemophilia 4 0 121 0Sex with HIV-infected transfusion recipient 8 0 277 0Sex with HIV-infected person risk factor not specified 2582 38 33596 29

Receipt of blood transfusion blood components or tissue 39 1 1546 1Otherrisk factor not reported or identified 2612 39 23894 21

Total 6739 100 114375 100

HispanicInjection drug use 322 18 12892 35Hemophiliacoagulation disorder 4 0 67 0High-risk heterosexual contactb 894 49 17995 49

Sex with injection drug user 166 9 6522 18Sex with bisexual male 32 2 818 2Sex with person with hemophilia 1 0 45 0Sex with HIV-infected transfusion recipient 7 0 141 0Sex with HIV-infected person risk factor not specified 688 38 10469 29

Receipt of blood transfusion blood components or tissue 12 1 619 2Otherrisk factor not reported or identified 592 32 5023 14

Total 1824 100 36596 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 43

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 8 8 125 12Hemophiliacoagulation disorder 0 0 7 1High-risk heterosexual contactb 49 47 574 53

Sex with injection drug user 4 4 114 11Sex with bisexual male 2 2 80 7Sex with person with hemophilia 0 0 4 0Sex with HIV-infected transfusion recipient 1 1 25 2Sex with HIV-infected person risk factor not specified 42 40 351 33

Receipt of blood transfusion blood components or tissue 1 1 93 9Otherrisk factor not reported or identified 46 44 279 26

Total 104 100 1078 100

American IndianAlaska NativeInjection drug use 13 32 280 42Hemophiliacoagulation disorder 0 0 3 0High-risk heterosexual contactb 15 37 277 41

Sex with injection drug user 4 10 107 16Sex with bisexual male 1 2 27 4Sex with person with hemophilia 0 0 2 0Sex with HIV-infected transfusion recipient 0 0 6 1Sex with HIV-infected person risk factor not specified 10 24 135 20

Receipt of blood transfusion blood components or tissue 1 2 17 3Otherrisk factor not reported or identified 12 29 95 14

Total 41 100 672 100

Total casesInjection drug use 1826 17 67693 35Hemophiliacoagulation disorder 11 0 348 0High-risk heterosexual contactb 4839 46 85186 44

Sex with injection drug user 706 7 26073 14Sex with bisexual male 234 2 5162 3Sex with person with hemophilia 11 0 502 0Sex with HIV-infected transfusion recipient 21 0 793 0Sex with HIV-infected person risk factor not specified 3867 37 52656 27

Receipt of blood transfusion blood components or tissue 68 1 4176 2Otherrisk factor not reported or identified 3793 36 34311 18

Total 10537c 100 191714d 100a From the beginning of the epidemic through 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 104 females of unknown race or multiple racesd Includes 1419 females of unknown race or multiple races

44 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 690 26 4260 26Hemophiliacoagulation disorder 3 0 24 0

bHigh-risk heterosexual contact 1132 42 7593 46Sex with injection drug user 205 8 1876 11Sex with bisexual male 98 4 659 4Sex with person with hemophilia 10 0 115 1Sex with HIV-infected transfusion recipient 7 0 64 0Sex with HIV-infected person risk factor not specified 812 30 4879 29

Receipt of blood transfusion blood components or tissue 12 0 146 1Otherrisk factor not reported or identified 850 32 4567 28

Total 2687 100 16590 100

Black not HispanicInjection drug use 1034 13 7105 14Hemophiliacoagulation disorder 1 0 35 0

bHigh-risk heterosexual contact 3451 44 23732 46Sex with injection drug user 313 4 3473 7Sex with bisexual male 155 2 1294 3Sex with person with hemophilia 5 0 71 0Sex with HIV-infected transfusion recipient 14 0 120 0Sex with HIV-infected person risk factor not specified 2964 38 18774 36

Receipt of blood transfusion blood components or tissue 26 0 324 1Otherrisk factor not reported or identified 3370 43 20244 39

Total 7882 100 51440 100

HispanicInjection drug use 339 15 2280 18Hemophiliacoagulation disorder 2 0 11 0

bHigh-risk heterosexual contact 1198 52 6264 50Sex with injection drug user 218 9 1324 11Sex with bisexual male 62 3 266 2Sex with person with hemophilia 1 0 11 0Sex with HIV-infected transfusion recipient 7 0 39 0Sex with HIV-infected person risk factor not specified 910 39 4624 37

Receipt of blood transfusion blood components or tissue 12 1 58 0Otherrisk factor not reported or identified 767 33 3843 31

Total 2318 100 12456 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 45

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 26: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristicsmdashUnited States and dependent areas

No of persons

Survival in months

gt12 gt24 gt36Data for 50 states and the District of Columbia

Age at diagnosis (yrs)lt13 101 096 094 09413ndash14 60 098 098 09515ndash19 305 098 096 09520ndash24 1351 096 093 09225ndash29 3034 095 092 09130ndash34 5499 094 091 08935ndash39 7888 093 090 08740ndash44 7085 092 088 08545ndash49 5090 089 085 08250ndash54 3067 086 081 07855ndash59 1505 083 078 07460ndash64 806 080 073 069gt65 614 073 068 065

RaceethnicityWhite not Hispanic 10706 092 089 087Black not Hispanic 18406 090 086 082Hispanic 6398 092 090 088AsianPacific Islander 404 094 092 090American IndianAlaska Native 167 084 081 075

Transmission categoryMale adult or adolescentMale-to-male sexual contact 12830 093 090 088Injection drug use 4048 089 084 081Male-to-male sexual contact and injection drug use 1701 093 089 086High-risk heterosexual contacta 3170 091 088 085Otherb 5019 086 083 080Subtotal 26768 091 088 085

Female adult or adolescentInjection drug use 2101 089 083 078High-risk heterosexual contacta 4686 093 089 086Otherb 2749 090 085 083Subtotal 9536 091 087 083

Child (lt13 yrs at diagnosis)Perinatal 98 096 095 095Otherc 3 100 067 067Subtotal 101 096 094 094

Subtotal for 50 states and the District of Columbia 36405 091 087 085

Data for US dependent areas 891 083 078 075

Total 37352d 091 087 084Note Excludes persons whose date of death was before or in the same month as date of diagnosis Excludes persons whose month of diagnosis or month of death is unknowna Heterosexual contact with a person known to have or to be at high risk for HIV infectionb Includes hemophilia blood transfusion perinatal exposure and risk factor not reported or not identifiedc Includes hemophilia blood transfusion and risk factor not reported or not identifiedd Includes 325 persons of unknown race or multiple races

26 Survival after AIDS Diagnosis

Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by year of diagnosismdashUnited States and dependent areas

Months after AIDS diagnosis

Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by age groupmdashUnited States and dependent areas

Months after AIDS diagnosis

Survival after AIDS Diagnosis 27

Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by raceethnicitymdashUnited States and dependent areas

Months after AIDS diagnosis

28 Survival after AIDS Diagnosis

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006

and cumulativemdashUnited States and dependent areas

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Alabama 510 112 462 100 8626 76 8702Alaska 24 36 38 57 648 7 655Arizona 626 105 539 87 10396 46 10442Arkansas 237 85 252 90 3891 36 3927California 4069 113 3960 109 142254 664 142918Colorado 351 75 322 68 8742 31 8773Connecticut 658 188 422 120 14716 183 14899Delaware 177 210 116 136 3547 26 3573District of Columbia 672 1155 853 1467 17372 189 17561Florida 4921 277 4932 273 104084 1530 105614Georgia 2325 255 1605 171 31734 231 31965Hawaii 105 82 93 72 2927 17 2944Idaho 24 17 26 18 604 2 606Illinois 1886 148 1382 108 33620 282 33902Indiana 407 65 346 55 8239 56 8295Iowa 93 31 86 29 1727 13 1740Kansas 105 38 120 43 2781 14 2795Kentucky 249 60 207 49 4600 32 4632Louisiana 936 208 824 192 17612 128 17740Maine 21 16 68 51 1110 8 1118Maryland 1558 279 1626 290 30252 319 30571Massachusetts 666 104 533 83 19181 214 19395Michigan 821 81 672 67 14941 113 15054Minnesota 226 44 212 41 4817 28 4845Mississippi 368 127 365 125 6642 56 6698Missouri 385 66 469 80 11016 61 11077Montana 21 22 7 07 373 3 376Nebraska 53 30 118 67 1479 11 1490Nevada 293 121 294 118 5733 29 5762New Hampshire 33 25 55 42 1074 10 1084New Jersey 1262 145 1065 122 48750 778 49528New Mexico 134 70 93 48 2603 7 2610New York 6201 321 5495 285 174908 2354 177262North Carolina 916 106 1229 139 15954 118 16072North Dakota 10 16 6 09 144 1 145Ohio 753 66 767 67 14957 138 15095Oklahoma 281 79 205 57 4836 26 4862Oregon 217 60 281 76 5995 20 6015Pennsylvania 1486 120 1893 152 33417 365 33782Rhode Island 87 81 111 104 2580 28 2608South Carolina 682 161 705 163 13301 105 13406South Dakota 18 23 18 23 255 5 260Tennessee 818 137 680 113 12457 59 12516Texas 3045 133 2998 128 69735 392 70127Utah 63 25 57 22 2295 20 2315Vermont 5 08 18 29 461 6 467Virginia 638 84 605 79 16802 177 16979Washington 485 77 389 61 11792 34 11826West Virginia 74 41 67 37 1500 11 1511Wisconsin 122 22 217 39 4513 33 4546Wyoming 6 12 8 16 228 2 230

Subtotal 40123 135 37911 127 952221 9094 961315

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 29

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulativemdashUnited States and dependent areas (cont)

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

US dependent areasAmerican Samoa 0 0 0 0 1 0 1Guam 0 0 0 0 68 1 69Northern Mariana Islands 0 0 0 0 3 0 3Puerto Rico 1029 263 850 216 29511 400 29911US Virgin Islands 17 156 32 295 629 18 647Otherb 0 0 0 0 3 0 3

Totalc 41357 138 39002 129 983343 9522 992865d

a From the beginning of the epidemic through 2006b Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasc Includes persons whose state or area of residence is unknownd Includes 916 persons whose state or area of residence is unknown

30 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

MSA (population gt 500000)

Akron Ohio 66 94 32 46 762 1 763

AlbanyndashSchenectadyndashTroy NY 97 114 105 123 2253 24 2277

Albuquerque N Mex 70 88 50 61 1404 2 1406

AllentownndashBethlehemndashEaston PandashNJ 72 91 119 149 1352 17 1369

AtlantandashSandy SpringsndashMarietta Ga 1586 319 1006 196 21896 128 22024

AugustandashRichmond County GandashSC 106 205 32 61 1851 24 1875

AustinndashRound Rock Tex 227 156 186 123 4830 26 4856

Bakersfield Calif 76 100 122 156 1528 8 1536

BaltimorendashTowson Md 1064 401 1001 377 20352 218 20570

Baton Rouge La 222 304 231 301 3732 20 3752

BirminghamndashHoover Ala 151 139 110 100 2614 25 2639

Boise CityndashNampa Idaho 14 26 14 25 281 0 281

Boston MassndashNHa 441 99 355 80 13476 147 13623

Boston Division 269 146 185 101 8451 91 8542

Cambridge Division 108 74 102 70 3126 35 3161

Essex Division 52 71 51 69 1577 20 1597

BridgeportndashStamfordndashNorwalk Conn 181 201 135 150 3733 57 3790

BuffalondashNiagara Falls NY 117 102 96 84 2476 20 2496

Cape CoralndashFort Myers Fla 44 81 91 159 1692 24 1716

CharlestonndashNorth Charleston SC 92 155 91 151 2034 18 2052

CharlottendashGastoniandashConcord NCndashSC 214 141 285 180 3242 22 3264

Chicago IllndashIndndashWis 1716 182 1159 122 30118 261 30379

Chicago Division 1604 203 1073 135 28300 248 28548

Gary Division 61 88 50 71 1038 8 1046

Lake Division 51 59 36 41 780 5 785

CincinnatindashMiddletown OhiondashKyndashInd 111 53 199 95 2735 17 2752

ClevelandndashElyriandashMentor Ohio 228 107 170 80 4226 48 4274

Colorado Springs Colo 19 32 21 35 576 5 581

Columbia SC 177 256 197 280 3274 24 3298

Columbus Ohio 166 97 165 96 3112 15 3127

Dallas Tex 874 150 929 155 20238 63 20301

Dallas Division 681 175 714 178 16038 37 16075

Fort Worth Division 193 100 215 108 4200 26 4226

Dayton Ohio 58 69 54 64 1217 15 1232

DenverndashAurora Colo 274 116 236 98 6899 22 6921

Des Moines Iowa 30 57 23 43 530 4 534

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 31

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Detroit Mich 570 127 445 100 10373 73 10446

Detroit Division 443 223 330 167 8268 57 8325

Warren Division 127 51 115 46 2105 16 2121

El Paso Tex 56 78 40 54 1476 10 1486

Fresno Calif 52 59 64 72 1430 11 1441

Grand RapidsndashWyoming Mich 46 60 51 66 816 6 822

GreensborondashHigh Point NC 52 77 66 96 1265 14 1279

Greenville SC 70 119 67 111 1292 4 1296

HarrisburgndashCarlisle Pa 23 44 67 128 1224 8 1232

HartfordndashWest HartfordndashEast Hartford Conn 256 216 135 114 5126 46 5172

Honolulu Hawaii 54 60 69 76 2121 14 2135

HoustonndashBaytownndashSugar Land Tex 1017 190 1092 197 25821 172 25993

Indianapolis Ind 191 116 150 90 3824 25 3849

Jackson Miss 134 257 117 221 2419 30 2449

Jacksonville Fla 309 248 315 246 6020 75 6095

Kansas City MondashKans 183 94 160 81 4669 15 4684

Knoxville Tenn 47 72 35 52 882 5 887

Lakeland Fla 103 190 112 199 1811 21 1832

Las VegasndashParadise Nev 245 143 258 145 4616 28 4644

Little RockndashNorth Little Rock Ark 87 135 75 115 1383 14 1397

Los Angeles Calif 1529 118 1684 130 57953 293 58246

Los Angeles Division 1339 135 1435 144 51098 250 51348

Santa Anna Division 190 63 249 83 6855 43 6898

Louisville KyndashInd 123 102 97 79 2286 22 2308

Madison Wis 10 19 29 53 520 4 524

McAllenndashEdinburgndashPharr Tex 57 84 45 64 630 11 641

Memphis TennndashMissndashArk 402 320 346 271 5128 19 5147

Miami Fla 2420 446 2289 419 55807 997 56804

Fort Lauderdale Division 810 455 769 430 16412 262 16674

Miami Division 1243 523 1165 485 29703 512 30215

West Palm Beach Division 367 290 355 279 9692 223 9915

MilwaukeendashWaukeshandashWest Allis Wis 68 45 109 72 2507 18 2525

MinneapolisndashSt PaulndashBloomington MinnndashWis 186 59 184 58 4259 22 4281

Modesto Calif 36 71 22 43 671 6 677

NashvillendashDavidsonndashMurfreesboro Tenn 224 158 172 118 3848 20 3868

New HavenndashMilford Conn 169 200 107 127 4573 73 4646

New OrleansndashMetairiendashKenner La 393 299 271 264 8835 67 8902

32 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

New York NYndashNJndashPa 6215 330 5500 292 195177 2906 198083

Edison Division 191 83 130 56 6709 139 6848

Nassau Division 262 93 246 88 8141 110 8251

New York Division 5266 456 4716 408 160408 2323 162731

Newark Division 496 231 408 190 19919 334 20253

Oklahoma City Okla 125 108 88 75 2255 5 2260

OmahandashCouncil Bluffs NebndashIowa 37 46 80 97 1035 3 1038

Orlando Fla 544 282 517 260 8653 92 8745

OxnardndashThousand OaksndashVentura Calif 49 62 21 26 1008 3 1011

Palm BayndashMelbournendashTitusville Fla 68 129 61 114 1512 11 1523

Philadelphia PandashNJndashDelndashMd 1261 217 1348 231 28221 313 28534

Camden Division 108 87 111 89 3118 42 3160

Philadelphia Division 1022 263 1144 294 22112 250 22362

Wilmington Division 131 191 93 134 2991 21 3012

PhoenixndashMesandashScottsdale Ariz 460 119 376 93 7459 31 7490

Pittsburgh Pa 143 60 135 57 3182 19 3201

PortlandndashSouth Portland Maine 9 18 34 66 562 1 563

PortlandndashVancouverndashBeaverton OrendashWash 170 81 215 101 4825 10 4835

PoughkeepsiendashNewburghndashMiddletown NY 136 204 113 168 3162 24 3186

ProvidencendashNew BedfordndashFall River RIndashMass 132 82 155 96 3900 44 3944

RaleighndashCary NC 138 145 201 202 1987 13 2000

Richmond Va 119 101 122 102 3371 35 3406

RiversidendashSan BernardinondashOntario Calif 361 92 306 76 8568 60 8628

Rochester NY 165 159 124 120 3134 13 3147

SacramentondashArden-ArcadendashRoseville Calif 154 75 169 82 4000 26 4026

St Louis MondashIll 192 69 366 131 5965 40 6005

Salt Lake City Utah 46 44 40 37 1743 10 1753

San Antonio Tex 215 114 247 127 4987 30 5017

San DiegondashCarlsbadndashSan Marcos Calif 491 167 384 131 12934 61 12995

San Francisco Calif 867 209 690 165 40152 96 40248

Oakland Division 312 126 246 99 9546 48 9594

San Francisco Division 555 329 444 261 30606 48 30654

San JosendashSunnyvalendashSanta Clara Calif 88 50 145 81 3747 15 3762

San JuanndashCaguasndashGuaynabo PR 745 289 578 223 21402 277 21679

SarasotandashBradentonndashVenice Fla 82 122 104 152 1978 27 2005

ScrantonndashWilkes-Barre Pa 27 49 47 85 572 6 578

Seattle Wash 353 110 280 86 9172 27 9199

Seattle Division 316 129 255 102 8161 18 8179

Tacoma Division 37 49 25 33 1011 9 1020

Springfield Mass 88 128 45 66 2075 26 2101

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 33

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Stockton Calif 52 78 52 77 1076 15 1091

Syracuse NY 52 80 49 75 1317 8 1325

TampandashSt PetersburgndashClearwater Fla 559 211 605 224 11174 112 11286

Toledo Ohio 25 38 66 101 812 14 826

Tucson Ariz 103 111 100 106 2010 10 2020

Tulsa Okla 83 94 65 72 1494 10 1504

Virginia BeachndashNorfolkndashNewport News VandashNC 183 111 132 80 4711 63 4774

Washington DCndashVandashMdndashWV 1322 252 1684 318 31130 315 31445

Bethesda Division 135 118 173 150 2774 23 2797

Washington Division 1187 289 1511 365 28356 292 28648

Wichita Kans 35 60 38 64 851 2 853

Worcester Mass 76 97 79 101 1783 20 1803

YoungstownndashWarrenndashBoardman OhiondashPa 27 46 26 44 519 0 519

Subtotal for MSAs (population gt500000) 33602 173 31274 159 829633 8171 837804

Metropolitan areas (population of 50000 to 499999) 4477 80 4466 79 94829 847 95676

Nonmetropolitan areas 2666 54 2732 55 52063 445 52508

Totalb 41144 137 38749 128 981708 9494 991202

Note Because of the lack of census information for all US dependent areas includes data for only the 50 states the District of Columbia and Puerto RicoMSA metropolitan statistical areaMSA definitions for this report can be found at httpwwwcensusgovpopulationwwwestimatesmetrodefhtmla Reported case counts for the metropolitan divisions do not sum to the MSA total MSA total includes data from 1 metropolitan division with

population of lt500000b Includes persons whose county of residence is unknown

34 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Alabama (January 1988) 502 6041 48 6089

Alaska (February 1999) 38 285 2 287

Arizona (January 1987) 617 5877 80 5957

Arkansas (July 1989) 206 2349 20 2369

California (April 2006) 6581 7056 92 7148

Colorado (November 1985) 319 6084 31 6115

Connecticut (January 2005)b 826 2500 101 2601

Delaware (February 2006) 788 801 18 819

Florida (July 1997)c 4163 36386 397 36783

Georgia (December 2003) 2245 8197 194 8391

Idaho (June 1986) 35 340 4 344

Illinois (January 2006) 6241 6661 162 6823

Indiana (July 1988) 399 4027 43 4070

Iowa (July 1998) 69 586 5 591

Kansas (July 1999) 142 1225 15 1240

Kentucky (October 2004) 333 1303 13 1316

Louisiana (February 1993) 728 8149 166 8315

Maine (January 2006) 386 393 3 396

Michigan (April 1992) 635 6702 134 6836

Minnesota (October 1985) 309 3356 40 3396

Mississippi (August 1988) 352 4549 59 4608

Missouri (October 1987) 502 5086 55 5141

Nebraska (September 1995) 91 672 14 686

Nevada (February 1992) 339 3532 24 3556

New Hampshire (January 2005) 59 466 9 475

New Jersey (January 1992) 1477 17513 325 17838

New Mexico (January 1998) 114 949 4 953

New York (June 2000) 5326 42345 1820 44165

North Carolina (February 1990) 1615 13879 143 14022

North Dakota (January 1988) 4 82 1 83

Ohio (June 1990) 867 8222 101 8323

Oklahoma (June 1988) 229 2401 30 2431

Oregon (April 2006) 49 95 19 114

Pennsylvania (October 2002)d 4269 9537 179 9716

Rhode Island (July 2006) 14 21 0 21

South Carolina (February 1986) 493 6970 93 7063

South Dakota (January 1988) 18 215 6 221

Tennessee (January 1992) 732 7115 90 7205

Texas (January 1999)e 3370 24282 417 24699

Utah (April 1989) 106 893 14 907

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 35

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Virginia (July 1989) 864 10257 95 10352

Washington (March 2006) 4048 4157 40 4197

West Virginia (January 1989) 66 673 8 681

Wisconsin (November 1985) 261 2500 31 2531

Wyoming (June 1989) 7 93 1 94

Subtotal 50834 274822 5146 279968

US dependent areas

American Samoa (August 2001) 0 1 0 1

Guam (March 2000) 2 66 0 66

Northern Mariana Islands (October 2001) 2 7 0 7

Puerto Rico (January 2003) 1471 5610 91 5701

US Virgin Islands (December 1998) 22 247 6 253

Persons reported from areas with confidential name-based HIV infection reporting but who were residents of other areas 132 685 21 706

Totalf 52878 282640 5314 287954

Note Includes data from 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through 2006b Beginning in 1992 Connecticut had name-based HIV reporting for cases in children only From January 2002 through December 2004

Connecticut had name- or code-based HIV reporting for cases in adolescents and adults As of January 2005 Connecticut has name-based reporting of all cases of HIV infection

c Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterd On October 18 2002 Pennsylvania initiated confidential name-based HIV infection reporting in all areas except Philadelphia Code-based

reporting was implemented in Philadelphia in March 2004 and the switch to name-based reporting was made in October 2005e From February 1994 through December 1998 Texas reported HIV infection in children onlyf Includes 1252 persons reported from areas with confidential name-based HIV infection reporting but whose area of residence is unknown

36 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulativemdashUnited States and dependent areas

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No Adult or adolescentMale-to-male sexual contact 13775 49 429897 54 mdash mdash mdash mdash 13775 35 429897 44Injection drug use 3413 12 163070 21 1826 17 67693 35 5239 13 230763 23Male-to-male sexual contact and

injection drug use 1603 6 65524 8 mdash mdash mdash mdash 1603 4 65524 7Hemophiliacoagulation disorder 43 0 5176 1 11 0 348 0 54 0 5524 1High-risk heterosexual contactc 2997 11 49610 6 4839 46 85186 44 7836 20 134796 14

Sex with injection drug user 330 1 11683 1 706 7 26073 14 1036 3 37756 4Sex with bisexual male mdash mdash mdash mdash 234 2 5162 3 234 1 5162 1Sex with person with hemophilia 1 0 84 0 11 0 502 0 12 0 586 0Sex with HIV-infected transfusion

recipient 22 0 553 0 21 0 793 0 43 0 1346 0Sex with HIV-infected person risk

factor not specified 2644 9 37290 5 3867 37 52656 27 6511 17 89946 9Receipt of blood transfusion blood

d components or tissue 63 0 5213 1 68 1 4176 2 131 0 9389 1Otherrisk factor not reported or

identifiede 6484 23 73136 9 3793 36 34311 18 10278 26 107450 11Subtotal 28378 100 791626 100 10537 100 191714 100 38916 100 983343 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 0 0 222 5 0 0 7 0 0 0 229 2Mother with documented HIV infection or

1 of the following risk factors 24 75 4315 89 50 93 4423 95 74 86 8738 92Injection drug use 4 13 1676 35 4 7 1665 36 8 9 3341 35Sex with injection drug user 4 13 789 16 4 7 750 16 8 9 1539 16Sex with bisexual male 1 3 101 2 2 4 110 2 3 3 211 2Sex with person with hemophilia 0 0 20 0 0 0 16 0 0 0 36 0Sex with HIV-infected transfusion

recipient 0 0 11 0 0 0 15 0 0 0 26 0Sex with HIV-infected person risk

factor not specified 6 19 742 15 17 31 790 17 23 27 1532 16Receipt of blood transfusion blood

components or tissue 0 0 70 1 0 0 82 2 0 0 152 2Has HIV infection risk factor not

specified 9 28 906 19 23 43 995 21 32 37 1901 20Receipt of blood transfusion blood

fcomponents or tissue 1 3 243 5 0 0 144 3 1 1 387 4Otherrisk factor not reported or

identifiedg 7 22 75 2 4 7 93 2 11 13 168 2Subtotal 32 100 4855 100 54 100 4667 100 86 100 9522 100

Total 28410 100 796481 100 10591 100 196381 100 39002 100 992865 100a From the beginning of the epidemic through 2006b From the beginning of the epidemic through 2006 Includes 3 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infectiond AIDS developed in 47 adultsadolescents after they received blood that had tested negative for HIV antibodies AIDS developed in 14 additional adults

after they received tissue organs or artificial insemination from HIV-infected donors Four of the 14 received tissue or organs from a donor who was negative for HIV antibody at the time of donation

e Includes 37 adultsadolescents who were exposed to HIV-infected blood body fluids or concentrated virus in health care laboratory or household settings as supported by seroconversion epidemiologic andor laboratory evidence One person was infected after intentional inoculation with HIV-infected blood Includes an additional 740 persons who acquired HIV infection perinatally but who were more than 12 years of age when AIDS was diagnosed These 740 persons are not counted in the values for the pediatric transmission category

f AIDS developed in 3 children after they received blood that had tested negative for HIV antibodiesg Includes 5 children who were exposed to HIV-infected blood as supported by seroconversion epidemiologic andor laboratory evidence 1 child was

infected after intentional inoculation with HIV-infected blood and 5 children were exposed to HIV-infected blood in a household setting Of the 168 children 26 had sexual contact with an adult with or at high risk for HIV infection

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 37

Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No

Adult or adolescentMale-to-male sexual contact 22912 59 103679 52 mdash mdash mdash mdash 22912 44 103679 37

Injection drug use 3503 9 24255 12 2124 16 13925 17 5627 11 38181 14

Male-to-male sexual contact and injection drug use 1946 5 10704 5 mdash mdash mdash mdash 1946 4 10704 4

Hemophiliacoagulation disorder 43 0 495 0 6 0 73 0 49 0 568 0

High-risk heterosexual contactc 2874 7 16830 8 5939 45 38315 47 8813 17 55145 20

Sex with injection drug user 308 1 2601 1 757 6 6791 8 1065 2 9392 3

Sex with bisexual male mdash mdash mdash mdash 328 2 2265 3 328 1 2265 1

Sex with person with hemophilia 4 0 31 0 16 0 201 0 20 0 232 0

Sex with HIV-infected transfusion recipient 13 0 131 0 28 0 223 0 41 0 354 0

Sex with HIV-infected person risk factor not specified 2549 7 14067 7 4810 36 28835 35 7359 14 42902 15

Receipt of blood transfusion blood components or tissue 61 0 489 0 50 0 536 1 111 0 1025 0

Otherrisk factor not reported or identified 7748 20 44021 22 5106 39 29312 36 12854 25 73338 26

Subtotal 39087 100 200473 100 13225 100 82161 100 52312 100 282640 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 8 3 106 4 0 0 1 0 8 1 107 2

Mother with documented HIV infection or 1 of the following risk factors 197 74 2195 85 254 85 2417 89 451 80 4612 87

Injection drug use 34 13 532 21 53 18 561 21 87 15 1093 21

Sex with injection drug user 12 5 208 8 21 7 213 8 33 6 421 8

Sex with bisexual male 5 2 37 1 4 1 32 1 9 2 69 1

Sex with person with hemophilia 0 0 3 0 1 0 7 0 1 0 10 0

Sex with HIV-infected transfusion recipient 0 0 4 0 0 0 4 0 0 0 8 0

Sex with HIV-infected person risk factor not specified 54 20 534 21 76 25 629 23 130 23 1163 22

Receipt of blood transfusion blood components or tissue 0 0 17 1 2 1 20 1 2 0 37 1

Has HIV infection risk factor not specified 92 35 860 33 97 32 951 35 189 33 1811 34

Receipt of blood transfusion blood components or tissue 6 2 28 1 3 1 24 1 9 2 52 1

Otherrisk factor not reported or identified 55 21 260 10 43 14 283 10 98 17 543 10

Subtotal 266 100 2589 100 300 100 2725 100 566 100 5314 100

Total 39353 100 203062 100 13525 100 84886 100 52878 100 287954 100

Note See Table 16 for the list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006b From the beginning of the epidemic through December 2006 Includes 6 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infection

38 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity

2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 6251 65 253927 73Injection drug use 733 8 31737 9Male-to-male sexual contact and injection drug use 732 8 31434 9Hemophiliacoagulation disorder 26 0 3989 1High-risk heterosexual contactb 416 4 7850 2

Sex with injection drug user 74 1 2310 1

Sex with person with hemophilia 0 0 36 0

Sex with HIV-infected transfusion recipient 2 0 176 0

Sex with HIV-infected person risk factor not specified 340 4 5328 2Receipt of blood transfusion blood components or tissue 20 0 3194 1Otherrisk factor not reported or identified 1400 15 16469 5

Total 9578 100 348600 100

Black not HispanicMale-to-male sexual contact 4309 36 103297 37Injection drug use 1635 14 83369 30Male-to-male sexual contact and injection drug use 526 4 22134 8Hemophiliacoagulation disorder 10 0 604 0High-risk heterosexual contactb 1875 16 29952 11

Sex with injection drug user 167 1 6823 2Sex with person with hemophilia 1 0 36 0Sex with HIV-infected transfusion recipient 15 0 237 0Sex with HIV-infected person risk factor not specified 1692 14 22856 8

Receipt of blood transfusion blood components or tissue 24 0 1218 0Otherrisk factor not reported or identified 3579 30 40268 14

Total 11958 100 280842 100

HispanicMale-to-male sexual contact 2816 47 64893 44Injection drug use 965 16 46337 31Male-to-male sexual contact and injection drug use 287 5 10884 7Hemophiliacoagulation disorder 6 0 466 0High-risk heterosexual contactb 638 11 10950 7

Sex with injection drug user 84 1 2409 2Sex with person with hemophilia 0 0 11 0Sex with HIV-infected transfusion recipient 5 0 125 0Sex with HIV-infected person risk factor not specified 549 9 8405 6

Receipt of blood transfusion blood components or tissue 17 0 657 0Otherrisk factor not reported or identified 1326 22 14832 10

Total 6055 100 149019 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 39

a

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulative

No No

AsianPacific IslanderMale-to-male sexual contact 225 54 4475 68Injection drug use 20 5 317 5Male-to-male sexual contact and injection drug use 17 4 284 4Hemophiliacoagulation disorder 1 0 70 1High-risk heterosexual contactb 34 8 376 6

Sex with injection drug user 1 0 54 1Sex with person with hemophilia 0 0 1 0Sex with HIV-infected transfusion recipient 0 0 8 0Sex with HIV-infected person risk factor not specified 33 8 313 5

Receipt of blood transfusion blood components or tissue 2 0 112 2Otherrisk factor not reported or identified 114 28 949 14

Total 413 100 6583 100

American IndianAlaska NativeMale-to-male sexual contact 61 49 1403 55Injection drug use 15 12 395 15Male-to-male sexual contact and injection drug use 23 19 457 18Hemophiliacoagulation disorder 0 0 27 1High-risk heterosexual contactb 9 7 118 5

Sex with injection drug user 1 1 33 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 8 6 82 3

Receipt of blood transfusion blood components or tissue 0 0 8 0Otherrisk factor not reported or identified 16 13 155 6

Total 124 100 2563 100

Total casesMale-to-male sexual contact 13775 49 429897 54Injection drug use 3413 12 163070 21Male-to-male sexual contact and injection drug use 1603 6 65524 8Hemophiliacoagulation disorder 43 0 5176 1High-risk heterosexual contactb 2997 11 49610 6

Sex with injection drug user 330 1 11683 1Sex with person with hemophilia 1 0 84 0Sex with HIV-infected transfusion recipient 22 0 553 0Sex with HIV-infected person risk factor not specified 2644 9 37290 5

Receipt of blood transfusion blood components or tissue 63 0 5213 1Otherrisk factor not reported or identified 6484 23 73136 9

Total 28378c 100 791626d 100a From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 4019 males of unknown race or multiple races

40 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 11963 73 55725 69Injection drug use 858 5 5512 7Male-to-male sexual contact and injection drug use 1092 7 5578 7Hemophiliacoagulation disorder 29 0 355 0High-risk heterosexual contactb 522 3 2658 3

Sex with injection drug user 65 0 544 1Sex with person with hemophilia 0 0 8 0Sex with HIV-infected transfusion recipient 3 0 33 0Sex with HIV-infected person risk factor not specified 454 3 2073 3

Receipt of blood transfusion blood components or tissue 14 0 197 0Otherrisk factor not reported or identified 1956 12 11147 14

Total 16434 100 81172 100

Black not HispanicMale-to-male sexual contact 6203 44 30148 37Injection drug use 1594 11 11997 15Male-to-male sexual contact and injection drug use 483 3 3489 4Hemophiliacoagulation disorder 10 0 109 0High-risk heterosexual contactb 1714 12 10905 13

Sex with injection drug user 169 1 1554 2Sex with person with hemophilia 4 0 17 0Sex with HIV-infected transfusion recipient 6 0 77 0Sex with HIV-infected person risk factor not specified 1535 11 9257 11

Receipt of blood transfusion blood components or tissue 32 0 223 0Otherrisk factor not reported or identified 4151 29 24632 30

Total 14187 100 81503 100

HispanicMale-to-male sexual contact 4094 55 15623 47Injection drug use 993 13 6407 19Male-to-male sexual contact and injection drug use 316 4 1402 4Hemophiliacoagulation disorder 3 0 26 0High-risk heterosexual contactb 582 8 2963 9

Sex with injection drug user 65 1 455 1Sex with person with hemophilia 0 0 6 0Sex with HIV-infected transfusion recipient 4 0 18 0Sex with HIV-infected person risk factor not specified 513 7 2484 7

Receipt of blood transfusion blood components or tissue 11 0 55 0Otherrisk factor not reported or identified 1475 20 6977 21

Total 7474 100 33453 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 41

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderMale-to-male sexual contact 402 70 1006 63Injection drug use 17 3 55 3Male-to-male sexual contact and injection drug use 15 3 38 2Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 25 4 96 6

Sex with injection drug user 3 1 10 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 22 4 83 5

Receipt of blood transfusion blood components or tissue 4 1 7 0Otherrisk factor not reported or identified 109 19 397 25

Total 572 100 1600 100

American IndianAlaska NativeMale-to-male sexual contact 104 61 516 57Injection drug use 13 8 101 11Male-to-male sexual contact and injection drug use 19 11 110 12Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 10 6 53 6

Sex with injection drug user 2 1 14 2Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 8 5 39 4

Receipt of blood transfusion blood components or tissue 0 0 2 0Otherrisk factor not reported or identified 24 14 125 14

Total 170 100 907 100

Total casesMale-to-male sexual contact 22912 59 103679 52Injection drug use 3503 9 24255 12Male-to-male sexual contact and injection drug use 1946 5 10704 5Hemophiliacoagulation disorder 43 0 495 0High-risk heterosexual contactb 2874 7 16830 8

Sex with injection drug user 308 1 2601 1Sex with person with hemophilia 4 0 31 0Sex with HIV-infected transfusion recipient 13 0 131 0Sex with HIV-infected person risk factor not specified 2549 7 14067 7

Receipt of blood transfusion blood components or tissue 61 0 489 0Otherrisk factor not reported or identified 7748 20 44021 22

Total 39087c 100 200473d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 1838 males of unknown race or multiple races

42 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race

ethnicity 2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 482 28 14981 40Hemophiliacoagulation disorder 4 0 123 0High-risk heterosexual contactb 725 42 15799 42

Sex with injection drug user 153 9 5650 15Sex with bisexual male 63 4 1859 5Sex with person with hemophilia 5 0 329 1Sex with HIV-infected transfusion recipient 5 0 338 1Sex with HIV-infected person risk factor not specified 499 29 7623 20

Receipt of blood transfusion blood components or tissue 15 1 1870 5Otherrisk factor not reported or identified 499 29 4801 13

Total 1725 100 37574 100

Black not HispanicInjection drug use 982 15 38914 34Hemophiliacoagulation disorder 3 0 145 0High-risk heterosexual contactb 3103 46 49876 44

Sex with injection drug user 373 6 13530 12Sex with bisexual male 136 2 2352 2Sex with person with hemophilia 4 0 121 0Sex with HIV-infected transfusion recipient 8 0 277 0Sex with HIV-infected person risk factor not specified 2582 38 33596 29

Receipt of blood transfusion blood components or tissue 39 1 1546 1Otherrisk factor not reported or identified 2612 39 23894 21

Total 6739 100 114375 100

HispanicInjection drug use 322 18 12892 35Hemophiliacoagulation disorder 4 0 67 0High-risk heterosexual contactb 894 49 17995 49

Sex with injection drug user 166 9 6522 18Sex with bisexual male 32 2 818 2Sex with person with hemophilia 1 0 45 0Sex with HIV-infected transfusion recipient 7 0 141 0Sex with HIV-infected person risk factor not specified 688 38 10469 29

Receipt of blood transfusion blood components or tissue 12 1 619 2Otherrisk factor not reported or identified 592 32 5023 14

Total 1824 100 36596 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 43

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 8 8 125 12Hemophiliacoagulation disorder 0 0 7 1High-risk heterosexual contactb 49 47 574 53

Sex with injection drug user 4 4 114 11Sex with bisexual male 2 2 80 7Sex with person with hemophilia 0 0 4 0Sex with HIV-infected transfusion recipient 1 1 25 2Sex with HIV-infected person risk factor not specified 42 40 351 33

Receipt of blood transfusion blood components or tissue 1 1 93 9Otherrisk factor not reported or identified 46 44 279 26

Total 104 100 1078 100

American IndianAlaska NativeInjection drug use 13 32 280 42Hemophiliacoagulation disorder 0 0 3 0High-risk heterosexual contactb 15 37 277 41

Sex with injection drug user 4 10 107 16Sex with bisexual male 1 2 27 4Sex with person with hemophilia 0 0 2 0Sex with HIV-infected transfusion recipient 0 0 6 1Sex with HIV-infected person risk factor not specified 10 24 135 20

Receipt of blood transfusion blood components or tissue 1 2 17 3Otherrisk factor not reported or identified 12 29 95 14

Total 41 100 672 100

Total casesInjection drug use 1826 17 67693 35Hemophiliacoagulation disorder 11 0 348 0High-risk heterosexual contactb 4839 46 85186 44

Sex with injection drug user 706 7 26073 14Sex with bisexual male 234 2 5162 3Sex with person with hemophilia 11 0 502 0Sex with HIV-infected transfusion recipient 21 0 793 0Sex with HIV-infected person risk factor not specified 3867 37 52656 27

Receipt of blood transfusion blood components or tissue 68 1 4176 2Otherrisk factor not reported or identified 3793 36 34311 18

Total 10537c 100 191714d 100a From the beginning of the epidemic through 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 104 females of unknown race or multiple racesd Includes 1419 females of unknown race or multiple races

44 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 690 26 4260 26Hemophiliacoagulation disorder 3 0 24 0

bHigh-risk heterosexual contact 1132 42 7593 46Sex with injection drug user 205 8 1876 11Sex with bisexual male 98 4 659 4Sex with person with hemophilia 10 0 115 1Sex with HIV-infected transfusion recipient 7 0 64 0Sex with HIV-infected person risk factor not specified 812 30 4879 29

Receipt of blood transfusion blood components or tissue 12 0 146 1Otherrisk factor not reported or identified 850 32 4567 28

Total 2687 100 16590 100

Black not HispanicInjection drug use 1034 13 7105 14Hemophiliacoagulation disorder 1 0 35 0

bHigh-risk heterosexual contact 3451 44 23732 46Sex with injection drug user 313 4 3473 7Sex with bisexual male 155 2 1294 3Sex with person with hemophilia 5 0 71 0Sex with HIV-infected transfusion recipient 14 0 120 0Sex with HIV-infected person risk factor not specified 2964 38 18774 36

Receipt of blood transfusion blood components or tissue 26 0 324 1Otherrisk factor not reported or identified 3370 43 20244 39

Total 7882 100 51440 100

HispanicInjection drug use 339 15 2280 18Hemophiliacoagulation disorder 2 0 11 0

bHigh-risk heterosexual contact 1198 52 6264 50Sex with injection drug user 218 9 1324 11Sex with bisexual male 62 3 266 2Sex with person with hemophilia 1 0 11 0Sex with HIV-infected transfusion recipient 7 0 39 0Sex with HIV-infected person risk factor not specified 910 39 4624 37

Receipt of blood transfusion blood components or tissue 12 1 58 0Otherrisk factor not reported or identified 767 33 3843 31

Total 2318 100 12456 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 45

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 27: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by year of diagnosismdashUnited States and dependent areas

Months after AIDS diagnosis

Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by age groupmdashUnited States and dependent areas

Months after AIDS diagnosis

Survival after AIDS Diagnosis 27

Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by raceethnicitymdashUnited States and dependent areas

Months after AIDS diagnosis

28 Survival after AIDS Diagnosis

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006

and cumulativemdashUnited States and dependent areas

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Alabama 510 112 462 100 8626 76 8702Alaska 24 36 38 57 648 7 655Arizona 626 105 539 87 10396 46 10442Arkansas 237 85 252 90 3891 36 3927California 4069 113 3960 109 142254 664 142918Colorado 351 75 322 68 8742 31 8773Connecticut 658 188 422 120 14716 183 14899Delaware 177 210 116 136 3547 26 3573District of Columbia 672 1155 853 1467 17372 189 17561Florida 4921 277 4932 273 104084 1530 105614Georgia 2325 255 1605 171 31734 231 31965Hawaii 105 82 93 72 2927 17 2944Idaho 24 17 26 18 604 2 606Illinois 1886 148 1382 108 33620 282 33902Indiana 407 65 346 55 8239 56 8295Iowa 93 31 86 29 1727 13 1740Kansas 105 38 120 43 2781 14 2795Kentucky 249 60 207 49 4600 32 4632Louisiana 936 208 824 192 17612 128 17740Maine 21 16 68 51 1110 8 1118Maryland 1558 279 1626 290 30252 319 30571Massachusetts 666 104 533 83 19181 214 19395Michigan 821 81 672 67 14941 113 15054Minnesota 226 44 212 41 4817 28 4845Mississippi 368 127 365 125 6642 56 6698Missouri 385 66 469 80 11016 61 11077Montana 21 22 7 07 373 3 376Nebraska 53 30 118 67 1479 11 1490Nevada 293 121 294 118 5733 29 5762New Hampshire 33 25 55 42 1074 10 1084New Jersey 1262 145 1065 122 48750 778 49528New Mexico 134 70 93 48 2603 7 2610New York 6201 321 5495 285 174908 2354 177262North Carolina 916 106 1229 139 15954 118 16072North Dakota 10 16 6 09 144 1 145Ohio 753 66 767 67 14957 138 15095Oklahoma 281 79 205 57 4836 26 4862Oregon 217 60 281 76 5995 20 6015Pennsylvania 1486 120 1893 152 33417 365 33782Rhode Island 87 81 111 104 2580 28 2608South Carolina 682 161 705 163 13301 105 13406South Dakota 18 23 18 23 255 5 260Tennessee 818 137 680 113 12457 59 12516Texas 3045 133 2998 128 69735 392 70127Utah 63 25 57 22 2295 20 2315Vermont 5 08 18 29 461 6 467Virginia 638 84 605 79 16802 177 16979Washington 485 77 389 61 11792 34 11826West Virginia 74 41 67 37 1500 11 1511Wisconsin 122 22 217 39 4513 33 4546Wyoming 6 12 8 16 228 2 230

Subtotal 40123 135 37911 127 952221 9094 961315

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 29

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulativemdashUnited States and dependent areas (cont)

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

US dependent areasAmerican Samoa 0 0 0 0 1 0 1Guam 0 0 0 0 68 1 69Northern Mariana Islands 0 0 0 0 3 0 3Puerto Rico 1029 263 850 216 29511 400 29911US Virgin Islands 17 156 32 295 629 18 647Otherb 0 0 0 0 3 0 3

Totalc 41357 138 39002 129 983343 9522 992865d

a From the beginning of the epidemic through 2006b Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasc Includes persons whose state or area of residence is unknownd Includes 916 persons whose state or area of residence is unknown

30 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

MSA (population gt 500000)

Akron Ohio 66 94 32 46 762 1 763

AlbanyndashSchenectadyndashTroy NY 97 114 105 123 2253 24 2277

Albuquerque N Mex 70 88 50 61 1404 2 1406

AllentownndashBethlehemndashEaston PandashNJ 72 91 119 149 1352 17 1369

AtlantandashSandy SpringsndashMarietta Ga 1586 319 1006 196 21896 128 22024

AugustandashRichmond County GandashSC 106 205 32 61 1851 24 1875

AustinndashRound Rock Tex 227 156 186 123 4830 26 4856

Bakersfield Calif 76 100 122 156 1528 8 1536

BaltimorendashTowson Md 1064 401 1001 377 20352 218 20570

Baton Rouge La 222 304 231 301 3732 20 3752

BirminghamndashHoover Ala 151 139 110 100 2614 25 2639

Boise CityndashNampa Idaho 14 26 14 25 281 0 281

Boston MassndashNHa 441 99 355 80 13476 147 13623

Boston Division 269 146 185 101 8451 91 8542

Cambridge Division 108 74 102 70 3126 35 3161

Essex Division 52 71 51 69 1577 20 1597

BridgeportndashStamfordndashNorwalk Conn 181 201 135 150 3733 57 3790

BuffalondashNiagara Falls NY 117 102 96 84 2476 20 2496

Cape CoralndashFort Myers Fla 44 81 91 159 1692 24 1716

CharlestonndashNorth Charleston SC 92 155 91 151 2034 18 2052

CharlottendashGastoniandashConcord NCndashSC 214 141 285 180 3242 22 3264

Chicago IllndashIndndashWis 1716 182 1159 122 30118 261 30379

Chicago Division 1604 203 1073 135 28300 248 28548

Gary Division 61 88 50 71 1038 8 1046

Lake Division 51 59 36 41 780 5 785

CincinnatindashMiddletown OhiondashKyndashInd 111 53 199 95 2735 17 2752

ClevelandndashElyriandashMentor Ohio 228 107 170 80 4226 48 4274

Colorado Springs Colo 19 32 21 35 576 5 581

Columbia SC 177 256 197 280 3274 24 3298

Columbus Ohio 166 97 165 96 3112 15 3127

Dallas Tex 874 150 929 155 20238 63 20301

Dallas Division 681 175 714 178 16038 37 16075

Fort Worth Division 193 100 215 108 4200 26 4226

Dayton Ohio 58 69 54 64 1217 15 1232

DenverndashAurora Colo 274 116 236 98 6899 22 6921

Des Moines Iowa 30 57 23 43 530 4 534

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 31

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Detroit Mich 570 127 445 100 10373 73 10446

Detroit Division 443 223 330 167 8268 57 8325

Warren Division 127 51 115 46 2105 16 2121

El Paso Tex 56 78 40 54 1476 10 1486

Fresno Calif 52 59 64 72 1430 11 1441

Grand RapidsndashWyoming Mich 46 60 51 66 816 6 822

GreensborondashHigh Point NC 52 77 66 96 1265 14 1279

Greenville SC 70 119 67 111 1292 4 1296

HarrisburgndashCarlisle Pa 23 44 67 128 1224 8 1232

HartfordndashWest HartfordndashEast Hartford Conn 256 216 135 114 5126 46 5172

Honolulu Hawaii 54 60 69 76 2121 14 2135

HoustonndashBaytownndashSugar Land Tex 1017 190 1092 197 25821 172 25993

Indianapolis Ind 191 116 150 90 3824 25 3849

Jackson Miss 134 257 117 221 2419 30 2449

Jacksonville Fla 309 248 315 246 6020 75 6095

Kansas City MondashKans 183 94 160 81 4669 15 4684

Knoxville Tenn 47 72 35 52 882 5 887

Lakeland Fla 103 190 112 199 1811 21 1832

Las VegasndashParadise Nev 245 143 258 145 4616 28 4644

Little RockndashNorth Little Rock Ark 87 135 75 115 1383 14 1397

Los Angeles Calif 1529 118 1684 130 57953 293 58246

Los Angeles Division 1339 135 1435 144 51098 250 51348

Santa Anna Division 190 63 249 83 6855 43 6898

Louisville KyndashInd 123 102 97 79 2286 22 2308

Madison Wis 10 19 29 53 520 4 524

McAllenndashEdinburgndashPharr Tex 57 84 45 64 630 11 641

Memphis TennndashMissndashArk 402 320 346 271 5128 19 5147

Miami Fla 2420 446 2289 419 55807 997 56804

Fort Lauderdale Division 810 455 769 430 16412 262 16674

Miami Division 1243 523 1165 485 29703 512 30215

West Palm Beach Division 367 290 355 279 9692 223 9915

MilwaukeendashWaukeshandashWest Allis Wis 68 45 109 72 2507 18 2525

MinneapolisndashSt PaulndashBloomington MinnndashWis 186 59 184 58 4259 22 4281

Modesto Calif 36 71 22 43 671 6 677

NashvillendashDavidsonndashMurfreesboro Tenn 224 158 172 118 3848 20 3868

New HavenndashMilford Conn 169 200 107 127 4573 73 4646

New OrleansndashMetairiendashKenner La 393 299 271 264 8835 67 8902

32 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

New York NYndashNJndashPa 6215 330 5500 292 195177 2906 198083

Edison Division 191 83 130 56 6709 139 6848

Nassau Division 262 93 246 88 8141 110 8251

New York Division 5266 456 4716 408 160408 2323 162731

Newark Division 496 231 408 190 19919 334 20253

Oklahoma City Okla 125 108 88 75 2255 5 2260

OmahandashCouncil Bluffs NebndashIowa 37 46 80 97 1035 3 1038

Orlando Fla 544 282 517 260 8653 92 8745

OxnardndashThousand OaksndashVentura Calif 49 62 21 26 1008 3 1011

Palm BayndashMelbournendashTitusville Fla 68 129 61 114 1512 11 1523

Philadelphia PandashNJndashDelndashMd 1261 217 1348 231 28221 313 28534

Camden Division 108 87 111 89 3118 42 3160

Philadelphia Division 1022 263 1144 294 22112 250 22362

Wilmington Division 131 191 93 134 2991 21 3012

PhoenixndashMesandashScottsdale Ariz 460 119 376 93 7459 31 7490

Pittsburgh Pa 143 60 135 57 3182 19 3201

PortlandndashSouth Portland Maine 9 18 34 66 562 1 563

PortlandndashVancouverndashBeaverton OrendashWash 170 81 215 101 4825 10 4835

PoughkeepsiendashNewburghndashMiddletown NY 136 204 113 168 3162 24 3186

ProvidencendashNew BedfordndashFall River RIndashMass 132 82 155 96 3900 44 3944

RaleighndashCary NC 138 145 201 202 1987 13 2000

Richmond Va 119 101 122 102 3371 35 3406

RiversidendashSan BernardinondashOntario Calif 361 92 306 76 8568 60 8628

Rochester NY 165 159 124 120 3134 13 3147

SacramentondashArden-ArcadendashRoseville Calif 154 75 169 82 4000 26 4026

St Louis MondashIll 192 69 366 131 5965 40 6005

Salt Lake City Utah 46 44 40 37 1743 10 1753

San Antonio Tex 215 114 247 127 4987 30 5017

San DiegondashCarlsbadndashSan Marcos Calif 491 167 384 131 12934 61 12995

San Francisco Calif 867 209 690 165 40152 96 40248

Oakland Division 312 126 246 99 9546 48 9594

San Francisco Division 555 329 444 261 30606 48 30654

San JosendashSunnyvalendashSanta Clara Calif 88 50 145 81 3747 15 3762

San JuanndashCaguasndashGuaynabo PR 745 289 578 223 21402 277 21679

SarasotandashBradentonndashVenice Fla 82 122 104 152 1978 27 2005

ScrantonndashWilkes-Barre Pa 27 49 47 85 572 6 578

Seattle Wash 353 110 280 86 9172 27 9199

Seattle Division 316 129 255 102 8161 18 8179

Tacoma Division 37 49 25 33 1011 9 1020

Springfield Mass 88 128 45 66 2075 26 2101

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 33

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Stockton Calif 52 78 52 77 1076 15 1091

Syracuse NY 52 80 49 75 1317 8 1325

TampandashSt PetersburgndashClearwater Fla 559 211 605 224 11174 112 11286

Toledo Ohio 25 38 66 101 812 14 826

Tucson Ariz 103 111 100 106 2010 10 2020

Tulsa Okla 83 94 65 72 1494 10 1504

Virginia BeachndashNorfolkndashNewport News VandashNC 183 111 132 80 4711 63 4774

Washington DCndashVandashMdndashWV 1322 252 1684 318 31130 315 31445

Bethesda Division 135 118 173 150 2774 23 2797

Washington Division 1187 289 1511 365 28356 292 28648

Wichita Kans 35 60 38 64 851 2 853

Worcester Mass 76 97 79 101 1783 20 1803

YoungstownndashWarrenndashBoardman OhiondashPa 27 46 26 44 519 0 519

Subtotal for MSAs (population gt500000) 33602 173 31274 159 829633 8171 837804

Metropolitan areas (population of 50000 to 499999) 4477 80 4466 79 94829 847 95676

Nonmetropolitan areas 2666 54 2732 55 52063 445 52508

Totalb 41144 137 38749 128 981708 9494 991202

Note Because of the lack of census information for all US dependent areas includes data for only the 50 states the District of Columbia and Puerto RicoMSA metropolitan statistical areaMSA definitions for this report can be found at httpwwwcensusgovpopulationwwwestimatesmetrodefhtmla Reported case counts for the metropolitan divisions do not sum to the MSA total MSA total includes data from 1 metropolitan division with

population of lt500000b Includes persons whose county of residence is unknown

34 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Alabama (January 1988) 502 6041 48 6089

Alaska (February 1999) 38 285 2 287

Arizona (January 1987) 617 5877 80 5957

Arkansas (July 1989) 206 2349 20 2369

California (April 2006) 6581 7056 92 7148

Colorado (November 1985) 319 6084 31 6115

Connecticut (January 2005)b 826 2500 101 2601

Delaware (February 2006) 788 801 18 819

Florida (July 1997)c 4163 36386 397 36783

Georgia (December 2003) 2245 8197 194 8391

Idaho (June 1986) 35 340 4 344

Illinois (January 2006) 6241 6661 162 6823

Indiana (July 1988) 399 4027 43 4070

Iowa (July 1998) 69 586 5 591

Kansas (July 1999) 142 1225 15 1240

Kentucky (October 2004) 333 1303 13 1316

Louisiana (February 1993) 728 8149 166 8315

Maine (January 2006) 386 393 3 396

Michigan (April 1992) 635 6702 134 6836

Minnesota (October 1985) 309 3356 40 3396

Mississippi (August 1988) 352 4549 59 4608

Missouri (October 1987) 502 5086 55 5141

Nebraska (September 1995) 91 672 14 686

Nevada (February 1992) 339 3532 24 3556

New Hampshire (January 2005) 59 466 9 475

New Jersey (January 1992) 1477 17513 325 17838

New Mexico (January 1998) 114 949 4 953

New York (June 2000) 5326 42345 1820 44165

North Carolina (February 1990) 1615 13879 143 14022

North Dakota (January 1988) 4 82 1 83

Ohio (June 1990) 867 8222 101 8323

Oklahoma (June 1988) 229 2401 30 2431

Oregon (April 2006) 49 95 19 114

Pennsylvania (October 2002)d 4269 9537 179 9716

Rhode Island (July 2006) 14 21 0 21

South Carolina (February 1986) 493 6970 93 7063

South Dakota (January 1988) 18 215 6 221

Tennessee (January 1992) 732 7115 90 7205

Texas (January 1999)e 3370 24282 417 24699

Utah (April 1989) 106 893 14 907

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 35

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Virginia (July 1989) 864 10257 95 10352

Washington (March 2006) 4048 4157 40 4197

West Virginia (January 1989) 66 673 8 681

Wisconsin (November 1985) 261 2500 31 2531

Wyoming (June 1989) 7 93 1 94

Subtotal 50834 274822 5146 279968

US dependent areas

American Samoa (August 2001) 0 1 0 1

Guam (March 2000) 2 66 0 66

Northern Mariana Islands (October 2001) 2 7 0 7

Puerto Rico (January 2003) 1471 5610 91 5701

US Virgin Islands (December 1998) 22 247 6 253

Persons reported from areas with confidential name-based HIV infection reporting but who were residents of other areas 132 685 21 706

Totalf 52878 282640 5314 287954

Note Includes data from 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through 2006b Beginning in 1992 Connecticut had name-based HIV reporting for cases in children only From January 2002 through December 2004

Connecticut had name- or code-based HIV reporting for cases in adolescents and adults As of January 2005 Connecticut has name-based reporting of all cases of HIV infection

c Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterd On October 18 2002 Pennsylvania initiated confidential name-based HIV infection reporting in all areas except Philadelphia Code-based

reporting was implemented in Philadelphia in March 2004 and the switch to name-based reporting was made in October 2005e From February 1994 through December 1998 Texas reported HIV infection in children onlyf Includes 1252 persons reported from areas with confidential name-based HIV infection reporting but whose area of residence is unknown

36 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulativemdashUnited States and dependent areas

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No Adult or adolescentMale-to-male sexual contact 13775 49 429897 54 mdash mdash mdash mdash 13775 35 429897 44Injection drug use 3413 12 163070 21 1826 17 67693 35 5239 13 230763 23Male-to-male sexual contact and

injection drug use 1603 6 65524 8 mdash mdash mdash mdash 1603 4 65524 7Hemophiliacoagulation disorder 43 0 5176 1 11 0 348 0 54 0 5524 1High-risk heterosexual contactc 2997 11 49610 6 4839 46 85186 44 7836 20 134796 14

Sex with injection drug user 330 1 11683 1 706 7 26073 14 1036 3 37756 4Sex with bisexual male mdash mdash mdash mdash 234 2 5162 3 234 1 5162 1Sex with person with hemophilia 1 0 84 0 11 0 502 0 12 0 586 0Sex with HIV-infected transfusion

recipient 22 0 553 0 21 0 793 0 43 0 1346 0Sex with HIV-infected person risk

factor not specified 2644 9 37290 5 3867 37 52656 27 6511 17 89946 9Receipt of blood transfusion blood

d components or tissue 63 0 5213 1 68 1 4176 2 131 0 9389 1Otherrisk factor not reported or

identifiede 6484 23 73136 9 3793 36 34311 18 10278 26 107450 11Subtotal 28378 100 791626 100 10537 100 191714 100 38916 100 983343 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 0 0 222 5 0 0 7 0 0 0 229 2Mother with documented HIV infection or

1 of the following risk factors 24 75 4315 89 50 93 4423 95 74 86 8738 92Injection drug use 4 13 1676 35 4 7 1665 36 8 9 3341 35Sex with injection drug user 4 13 789 16 4 7 750 16 8 9 1539 16Sex with bisexual male 1 3 101 2 2 4 110 2 3 3 211 2Sex with person with hemophilia 0 0 20 0 0 0 16 0 0 0 36 0Sex with HIV-infected transfusion

recipient 0 0 11 0 0 0 15 0 0 0 26 0Sex with HIV-infected person risk

factor not specified 6 19 742 15 17 31 790 17 23 27 1532 16Receipt of blood transfusion blood

components or tissue 0 0 70 1 0 0 82 2 0 0 152 2Has HIV infection risk factor not

specified 9 28 906 19 23 43 995 21 32 37 1901 20Receipt of blood transfusion blood

fcomponents or tissue 1 3 243 5 0 0 144 3 1 1 387 4Otherrisk factor not reported or

identifiedg 7 22 75 2 4 7 93 2 11 13 168 2Subtotal 32 100 4855 100 54 100 4667 100 86 100 9522 100

Total 28410 100 796481 100 10591 100 196381 100 39002 100 992865 100a From the beginning of the epidemic through 2006b From the beginning of the epidemic through 2006 Includes 3 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infectiond AIDS developed in 47 adultsadolescents after they received blood that had tested negative for HIV antibodies AIDS developed in 14 additional adults

after they received tissue organs or artificial insemination from HIV-infected donors Four of the 14 received tissue or organs from a donor who was negative for HIV antibody at the time of donation

e Includes 37 adultsadolescents who were exposed to HIV-infected blood body fluids or concentrated virus in health care laboratory or household settings as supported by seroconversion epidemiologic andor laboratory evidence One person was infected after intentional inoculation with HIV-infected blood Includes an additional 740 persons who acquired HIV infection perinatally but who were more than 12 years of age when AIDS was diagnosed These 740 persons are not counted in the values for the pediatric transmission category

f AIDS developed in 3 children after they received blood that had tested negative for HIV antibodiesg Includes 5 children who were exposed to HIV-infected blood as supported by seroconversion epidemiologic andor laboratory evidence 1 child was

infected after intentional inoculation with HIV-infected blood and 5 children were exposed to HIV-infected blood in a household setting Of the 168 children 26 had sexual contact with an adult with or at high risk for HIV infection

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 37

Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No

Adult or adolescentMale-to-male sexual contact 22912 59 103679 52 mdash mdash mdash mdash 22912 44 103679 37

Injection drug use 3503 9 24255 12 2124 16 13925 17 5627 11 38181 14

Male-to-male sexual contact and injection drug use 1946 5 10704 5 mdash mdash mdash mdash 1946 4 10704 4

Hemophiliacoagulation disorder 43 0 495 0 6 0 73 0 49 0 568 0

High-risk heterosexual contactc 2874 7 16830 8 5939 45 38315 47 8813 17 55145 20

Sex with injection drug user 308 1 2601 1 757 6 6791 8 1065 2 9392 3

Sex with bisexual male mdash mdash mdash mdash 328 2 2265 3 328 1 2265 1

Sex with person with hemophilia 4 0 31 0 16 0 201 0 20 0 232 0

Sex with HIV-infected transfusion recipient 13 0 131 0 28 0 223 0 41 0 354 0

Sex with HIV-infected person risk factor not specified 2549 7 14067 7 4810 36 28835 35 7359 14 42902 15

Receipt of blood transfusion blood components or tissue 61 0 489 0 50 0 536 1 111 0 1025 0

Otherrisk factor not reported or identified 7748 20 44021 22 5106 39 29312 36 12854 25 73338 26

Subtotal 39087 100 200473 100 13225 100 82161 100 52312 100 282640 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 8 3 106 4 0 0 1 0 8 1 107 2

Mother with documented HIV infection or 1 of the following risk factors 197 74 2195 85 254 85 2417 89 451 80 4612 87

Injection drug use 34 13 532 21 53 18 561 21 87 15 1093 21

Sex with injection drug user 12 5 208 8 21 7 213 8 33 6 421 8

Sex with bisexual male 5 2 37 1 4 1 32 1 9 2 69 1

Sex with person with hemophilia 0 0 3 0 1 0 7 0 1 0 10 0

Sex with HIV-infected transfusion recipient 0 0 4 0 0 0 4 0 0 0 8 0

Sex with HIV-infected person risk factor not specified 54 20 534 21 76 25 629 23 130 23 1163 22

Receipt of blood transfusion blood components or tissue 0 0 17 1 2 1 20 1 2 0 37 1

Has HIV infection risk factor not specified 92 35 860 33 97 32 951 35 189 33 1811 34

Receipt of blood transfusion blood components or tissue 6 2 28 1 3 1 24 1 9 2 52 1

Otherrisk factor not reported or identified 55 21 260 10 43 14 283 10 98 17 543 10

Subtotal 266 100 2589 100 300 100 2725 100 566 100 5314 100

Total 39353 100 203062 100 13525 100 84886 100 52878 100 287954 100

Note See Table 16 for the list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006b From the beginning of the epidemic through December 2006 Includes 6 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infection

38 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity

2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 6251 65 253927 73Injection drug use 733 8 31737 9Male-to-male sexual contact and injection drug use 732 8 31434 9Hemophiliacoagulation disorder 26 0 3989 1High-risk heterosexual contactb 416 4 7850 2

Sex with injection drug user 74 1 2310 1

Sex with person with hemophilia 0 0 36 0

Sex with HIV-infected transfusion recipient 2 0 176 0

Sex with HIV-infected person risk factor not specified 340 4 5328 2Receipt of blood transfusion blood components or tissue 20 0 3194 1Otherrisk factor not reported or identified 1400 15 16469 5

Total 9578 100 348600 100

Black not HispanicMale-to-male sexual contact 4309 36 103297 37Injection drug use 1635 14 83369 30Male-to-male sexual contact and injection drug use 526 4 22134 8Hemophiliacoagulation disorder 10 0 604 0High-risk heterosexual contactb 1875 16 29952 11

Sex with injection drug user 167 1 6823 2Sex with person with hemophilia 1 0 36 0Sex with HIV-infected transfusion recipient 15 0 237 0Sex with HIV-infected person risk factor not specified 1692 14 22856 8

Receipt of blood transfusion blood components or tissue 24 0 1218 0Otherrisk factor not reported or identified 3579 30 40268 14

Total 11958 100 280842 100

HispanicMale-to-male sexual contact 2816 47 64893 44Injection drug use 965 16 46337 31Male-to-male sexual contact and injection drug use 287 5 10884 7Hemophiliacoagulation disorder 6 0 466 0High-risk heterosexual contactb 638 11 10950 7

Sex with injection drug user 84 1 2409 2Sex with person with hemophilia 0 0 11 0Sex with HIV-infected transfusion recipient 5 0 125 0Sex with HIV-infected person risk factor not specified 549 9 8405 6

Receipt of blood transfusion blood components or tissue 17 0 657 0Otherrisk factor not reported or identified 1326 22 14832 10

Total 6055 100 149019 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 39

a

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulative

No No

AsianPacific IslanderMale-to-male sexual contact 225 54 4475 68Injection drug use 20 5 317 5Male-to-male sexual contact and injection drug use 17 4 284 4Hemophiliacoagulation disorder 1 0 70 1High-risk heterosexual contactb 34 8 376 6

Sex with injection drug user 1 0 54 1Sex with person with hemophilia 0 0 1 0Sex with HIV-infected transfusion recipient 0 0 8 0Sex with HIV-infected person risk factor not specified 33 8 313 5

Receipt of blood transfusion blood components or tissue 2 0 112 2Otherrisk factor not reported or identified 114 28 949 14

Total 413 100 6583 100

American IndianAlaska NativeMale-to-male sexual contact 61 49 1403 55Injection drug use 15 12 395 15Male-to-male sexual contact and injection drug use 23 19 457 18Hemophiliacoagulation disorder 0 0 27 1High-risk heterosexual contactb 9 7 118 5

Sex with injection drug user 1 1 33 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 8 6 82 3

Receipt of blood transfusion blood components or tissue 0 0 8 0Otherrisk factor not reported or identified 16 13 155 6

Total 124 100 2563 100

Total casesMale-to-male sexual contact 13775 49 429897 54Injection drug use 3413 12 163070 21Male-to-male sexual contact and injection drug use 1603 6 65524 8Hemophiliacoagulation disorder 43 0 5176 1High-risk heterosexual contactb 2997 11 49610 6

Sex with injection drug user 330 1 11683 1Sex with person with hemophilia 1 0 84 0Sex with HIV-infected transfusion recipient 22 0 553 0Sex with HIV-infected person risk factor not specified 2644 9 37290 5

Receipt of blood transfusion blood components or tissue 63 0 5213 1Otherrisk factor not reported or identified 6484 23 73136 9

Total 28378c 100 791626d 100a From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 4019 males of unknown race or multiple races

40 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 11963 73 55725 69Injection drug use 858 5 5512 7Male-to-male sexual contact and injection drug use 1092 7 5578 7Hemophiliacoagulation disorder 29 0 355 0High-risk heterosexual contactb 522 3 2658 3

Sex with injection drug user 65 0 544 1Sex with person with hemophilia 0 0 8 0Sex with HIV-infected transfusion recipient 3 0 33 0Sex with HIV-infected person risk factor not specified 454 3 2073 3

Receipt of blood transfusion blood components or tissue 14 0 197 0Otherrisk factor not reported or identified 1956 12 11147 14

Total 16434 100 81172 100

Black not HispanicMale-to-male sexual contact 6203 44 30148 37Injection drug use 1594 11 11997 15Male-to-male sexual contact and injection drug use 483 3 3489 4Hemophiliacoagulation disorder 10 0 109 0High-risk heterosexual contactb 1714 12 10905 13

Sex with injection drug user 169 1 1554 2Sex with person with hemophilia 4 0 17 0Sex with HIV-infected transfusion recipient 6 0 77 0Sex with HIV-infected person risk factor not specified 1535 11 9257 11

Receipt of blood transfusion blood components or tissue 32 0 223 0Otherrisk factor not reported or identified 4151 29 24632 30

Total 14187 100 81503 100

HispanicMale-to-male sexual contact 4094 55 15623 47Injection drug use 993 13 6407 19Male-to-male sexual contact and injection drug use 316 4 1402 4Hemophiliacoagulation disorder 3 0 26 0High-risk heterosexual contactb 582 8 2963 9

Sex with injection drug user 65 1 455 1Sex with person with hemophilia 0 0 6 0Sex with HIV-infected transfusion recipient 4 0 18 0Sex with HIV-infected person risk factor not specified 513 7 2484 7

Receipt of blood transfusion blood components or tissue 11 0 55 0Otherrisk factor not reported or identified 1475 20 6977 21

Total 7474 100 33453 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 41

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderMale-to-male sexual contact 402 70 1006 63Injection drug use 17 3 55 3Male-to-male sexual contact and injection drug use 15 3 38 2Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 25 4 96 6

Sex with injection drug user 3 1 10 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 22 4 83 5

Receipt of blood transfusion blood components or tissue 4 1 7 0Otherrisk factor not reported or identified 109 19 397 25

Total 572 100 1600 100

American IndianAlaska NativeMale-to-male sexual contact 104 61 516 57Injection drug use 13 8 101 11Male-to-male sexual contact and injection drug use 19 11 110 12Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 10 6 53 6

Sex with injection drug user 2 1 14 2Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 8 5 39 4

Receipt of blood transfusion blood components or tissue 0 0 2 0Otherrisk factor not reported or identified 24 14 125 14

Total 170 100 907 100

Total casesMale-to-male sexual contact 22912 59 103679 52Injection drug use 3503 9 24255 12Male-to-male sexual contact and injection drug use 1946 5 10704 5Hemophiliacoagulation disorder 43 0 495 0High-risk heterosexual contactb 2874 7 16830 8

Sex with injection drug user 308 1 2601 1Sex with person with hemophilia 4 0 31 0Sex with HIV-infected transfusion recipient 13 0 131 0Sex with HIV-infected person risk factor not specified 2549 7 14067 7

Receipt of blood transfusion blood components or tissue 61 0 489 0Otherrisk factor not reported or identified 7748 20 44021 22

Total 39087c 100 200473d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 1838 males of unknown race or multiple races

42 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race

ethnicity 2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 482 28 14981 40Hemophiliacoagulation disorder 4 0 123 0High-risk heterosexual contactb 725 42 15799 42

Sex with injection drug user 153 9 5650 15Sex with bisexual male 63 4 1859 5Sex with person with hemophilia 5 0 329 1Sex with HIV-infected transfusion recipient 5 0 338 1Sex with HIV-infected person risk factor not specified 499 29 7623 20

Receipt of blood transfusion blood components or tissue 15 1 1870 5Otherrisk factor not reported or identified 499 29 4801 13

Total 1725 100 37574 100

Black not HispanicInjection drug use 982 15 38914 34Hemophiliacoagulation disorder 3 0 145 0High-risk heterosexual contactb 3103 46 49876 44

Sex with injection drug user 373 6 13530 12Sex with bisexual male 136 2 2352 2Sex with person with hemophilia 4 0 121 0Sex with HIV-infected transfusion recipient 8 0 277 0Sex with HIV-infected person risk factor not specified 2582 38 33596 29

Receipt of blood transfusion blood components or tissue 39 1 1546 1Otherrisk factor not reported or identified 2612 39 23894 21

Total 6739 100 114375 100

HispanicInjection drug use 322 18 12892 35Hemophiliacoagulation disorder 4 0 67 0High-risk heterosexual contactb 894 49 17995 49

Sex with injection drug user 166 9 6522 18Sex with bisexual male 32 2 818 2Sex with person with hemophilia 1 0 45 0Sex with HIV-infected transfusion recipient 7 0 141 0Sex with HIV-infected person risk factor not specified 688 38 10469 29

Receipt of blood transfusion blood components or tissue 12 1 619 2Otherrisk factor not reported or identified 592 32 5023 14

Total 1824 100 36596 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 43

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 8 8 125 12Hemophiliacoagulation disorder 0 0 7 1High-risk heterosexual contactb 49 47 574 53

Sex with injection drug user 4 4 114 11Sex with bisexual male 2 2 80 7Sex with person with hemophilia 0 0 4 0Sex with HIV-infected transfusion recipient 1 1 25 2Sex with HIV-infected person risk factor not specified 42 40 351 33

Receipt of blood transfusion blood components or tissue 1 1 93 9Otherrisk factor not reported or identified 46 44 279 26

Total 104 100 1078 100

American IndianAlaska NativeInjection drug use 13 32 280 42Hemophiliacoagulation disorder 0 0 3 0High-risk heterosexual contactb 15 37 277 41

Sex with injection drug user 4 10 107 16Sex with bisexual male 1 2 27 4Sex with person with hemophilia 0 0 2 0Sex with HIV-infected transfusion recipient 0 0 6 1Sex with HIV-infected person risk factor not specified 10 24 135 20

Receipt of blood transfusion blood components or tissue 1 2 17 3Otherrisk factor not reported or identified 12 29 95 14

Total 41 100 672 100

Total casesInjection drug use 1826 17 67693 35Hemophiliacoagulation disorder 11 0 348 0High-risk heterosexual contactb 4839 46 85186 44

Sex with injection drug user 706 7 26073 14Sex with bisexual male 234 2 5162 3Sex with person with hemophilia 11 0 502 0Sex with HIV-infected transfusion recipient 21 0 793 0Sex with HIV-infected person risk factor not specified 3867 37 52656 27

Receipt of blood transfusion blood components or tissue 68 1 4176 2Otherrisk factor not reported or identified 3793 36 34311 18

Total 10537c 100 191714d 100a From the beginning of the epidemic through 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 104 females of unknown race or multiple racesd Includes 1419 females of unknown race or multiple races

44 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 690 26 4260 26Hemophiliacoagulation disorder 3 0 24 0

bHigh-risk heterosexual contact 1132 42 7593 46Sex with injection drug user 205 8 1876 11Sex with bisexual male 98 4 659 4Sex with person with hemophilia 10 0 115 1Sex with HIV-infected transfusion recipient 7 0 64 0Sex with HIV-infected person risk factor not specified 812 30 4879 29

Receipt of blood transfusion blood components or tissue 12 0 146 1Otherrisk factor not reported or identified 850 32 4567 28

Total 2687 100 16590 100

Black not HispanicInjection drug use 1034 13 7105 14Hemophiliacoagulation disorder 1 0 35 0

bHigh-risk heterosexual contact 3451 44 23732 46Sex with injection drug user 313 4 3473 7Sex with bisexual male 155 2 1294 3Sex with person with hemophilia 5 0 71 0Sex with HIV-infected transfusion recipient 14 0 120 0Sex with HIV-infected person risk factor not specified 2964 38 18774 36

Receipt of blood transfusion blood components or tissue 26 0 324 1Otherrisk factor not reported or identified 3370 43 20244 39

Total 7882 100 51440 100

HispanicInjection drug use 339 15 2280 18Hemophiliacoagulation disorder 2 0 11 0

bHigh-risk heterosexual contact 1198 52 6264 50Sex with injection drug user 218 9 1324 11Sex with bisexual male 62 3 266 2Sex with person with hemophilia 1 0 11 0Sex with HIV-infected transfusion recipient 7 0 39 0Sex with HIV-infected person risk factor not specified 910 39 4624 37

Receipt of blood transfusion blood components or tissue 12 1 58 0Otherrisk factor not reported or identified 767 33 3843 31

Total 2318 100 12456 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 45

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 28: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998ndash2005 and by raceethnicitymdashUnited States and dependent areas

Months after AIDS diagnosis

28 Survival after AIDS Diagnosis

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006

and cumulativemdashUnited States and dependent areas

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Alabama 510 112 462 100 8626 76 8702Alaska 24 36 38 57 648 7 655Arizona 626 105 539 87 10396 46 10442Arkansas 237 85 252 90 3891 36 3927California 4069 113 3960 109 142254 664 142918Colorado 351 75 322 68 8742 31 8773Connecticut 658 188 422 120 14716 183 14899Delaware 177 210 116 136 3547 26 3573District of Columbia 672 1155 853 1467 17372 189 17561Florida 4921 277 4932 273 104084 1530 105614Georgia 2325 255 1605 171 31734 231 31965Hawaii 105 82 93 72 2927 17 2944Idaho 24 17 26 18 604 2 606Illinois 1886 148 1382 108 33620 282 33902Indiana 407 65 346 55 8239 56 8295Iowa 93 31 86 29 1727 13 1740Kansas 105 38 120 43 2781 14 2795Kentucky 249 60 207 49 4600 32 4632Louisiana 936 208 824 192 17612 128 17740Maine 21 16 68 51 1110 8 1118Maryland 1558 279 1626 290 30252 319 30571Massachusetts 666 104 533 83 19181 214 19395Michigan 821 81 672 67 14941 113 15054Minnesota 226 44 212 41 4817 28 4845Mississippi 368 127 365 125 6642 56 6698Missouri 385 66 469 80 11016 61 11077Montana 21 22 7 07 373 3 376Nebraska 53 30 118 67 1479 11 1490Nevada 293 121 294 118 5733 29 5762New Hampshire 33 25 55 42 1074 10 1084New Jersey 1262 145 1065 122 48750 778 49528New Mexico 134 70 93 48 2603 7 2610New York 6201 321 5495 285 174908 2354 177262North Carolina 916 106 1229 139 15954 118 16072North Dakota 10 16 6 09 144 1 145Ohio 753 66 767 67 14957 138 15095Oklahoma 281 79 205 57 4836 26 4862Oregon 217 60 281 76 5995 20 6015Pennsylvania 1486 120 1893 152 33417 365 33782Rhode Island 87 81 111 104 2580 28 2608South Carolina 682 161 705 163 13301 105 13406South Dakota 18 23 18 23 255 5 260Tennessee 818 137 680 113 12457 59 12516Texas 3045 133 2998 128 69735 392 70127Utah 63 25 57 22 2295 20 2315Vermont 5 08 18 29 461 6 467Virginia 638 84 605 79 16802 177 16979Washington 485 77 389 61 11792 34 11826West Virginia 74 41 67 37 1500 11 1511Wisconsin 122 22 217 39 4513 33 4546Wyoming 6 12 8 16 228 2 230

Subtotal 40123 135 37911 127 952221 9094 961315

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 29

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulativemdashUnited States and dependent areas (cont)

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

US dependent areasAmerican Samoa 0 0 0 0 1 0 1Guam 0 0 0 0 68 1 69Northern Mariana Islands 0 0 0 0 3 0 3Puerto Rico 1029 263 850 216 29511 400 29911US Virgin Islands 17 156 32 295 629 18 647Otherb 0 0 0 0 3 0 3

Totalc 41357 138 39002 129 983343 9522 992865d

a From the beginning of the epidemic through 2006b Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasc Includes persons whose state or area of residence is unknownd Includes 916 persons whose state or area of residence is unknown

30 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

MSA (population gt 500000)

Akron Ohio 66 94 32 46 762 1 763

AlbanyndashSchenectadyndashTroy NY 97 114 105 123 2253 24 2277

Albuquerque N Mex 70 88 50 61 1404 2 1406

AllentownndashBethlehemndashEaston PandashNJ 72 91 119 149 1352 17 1369

AtlantandashSandy SpringsndashMarietta Ga 1586 319 1006 196 21896 128 22024

AugustandashRichmond County GandashSC 106 205 32 61 1851 24 1875

AustinndashRound Rock Tex 227 156 186 123 4830 26 4856

Bakersfield Calif 76 100 122 156 1528 8 1536

BaltimorendashTowson Md 1064 401 1001 377 20352 218 20570

Baton Rouge La 222 304 231 301 3732 20 3752

BirminghamndashHoover Ala 151 139 110 100 2614 25 2639

Boise CityndashNampa Idaho 14 26 14 25 281 0 281

Boston MassndashNHa 441 99 355 80 13476 147 13623

Boston Division 269 146 185 101 8451 91 8542

Cambridge Division 108 74 102 70 3126 35 3161

Essex Division 52 71 51 69 1577 20 1597

BridgeportndashStamfordndashNorwalk Conn 181 201 135 150 3733 57 3790

BuffalondashNiagara Falls NY 117 102 96 84 2476 20 2496

Cape CoralndashFort Myers Fla 44 81 91 159 1692 24 1716

CharlestonndashNorth Charleston SC 92 155 91 151 2034 18 2052

CharlottendashGastoniandashConcord NCndashSC 214 141 285 180 3242 22 3264

Chicago IllndashIndndashWis 1716 182 1159 122 30118 261 30379

Chicago Division 1604 203 1073 135 28300 248 28548

Gary Division 61 88 50 71 1038 8 1046

Lake Division 51 59 36 41 780 5 785

CincinnatindashMiddletown OhiondashKyndashInd 111 53 199 95 2735 17 2752

ClevelandndashElyriandashMentor Ohio 228 107 170 80 4226 48 4274

Colorado Springs Colo 19 32 21 35 576 5 581

Columbia SC 177 256 197 280 3274 24 3298

Columbus Ohio 166 97 165 96 3112 15 3127

Dallas Tex 874 150 929 155 20238 63 20301

Dallas Division 681 175 714 178 16038 37 16075

Fort Worth Division 193 100 215 108 4200 26 4226

Dayton Ohio 58 69 54 64 1217 15 1232

DenverndashAurora Colo 274 116 236 98 6899 22 6921

Des Moines Iowa 30 57 23 43 530 4 534

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 31

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Detroit Mich 570 127 445 100 10373 73 10446

Detroit Division 443 223 330 167 8268 57 8325

Warren Division 127 51 115 46 2105 16 2121

El Paso Tex 56 78 40 54 1476 10 1486

Fresno Calif 52 59 64 72 1430 11 1441

Grand RapidsndashWyoming Mich 46 60 51 66 816 6 822

GreensborondashHigh Point NC 52 77 66 96 1265 14 1279

Greenville SC 70 119 67 111 1292 4 1296

HarrisburgndashCarlisle Pa 23 44 67 128 1224 8 1232

HartfordndashWest HartfordndashEast Hartford Conn 256 216 135 114 5126 46 5172

Honolulu Hawaii 54 60 69 76 2121 14 2135

HoustonndashBaytownndashSugar Land Tex 1017 190 1092 197 25821 172 25993

Indianapolis Ind 191 116 150 90 3824 25 3849

Jackson Miss 134 257 117 221 2419 30 2449

Jacksonville Fla 309 248 315 246 6020 75 6095

Kansas City MondashKans 183 94 160 81 4669 15 4684

Knoxville Tenn 47 72 35 52 882 5 887

Lakeland Fla 103 190 112 199 1811 21 1832

Las VegasndashParadise Nev 245 143 258 145 4616 28 4644

Little RockndashNorth Little Rock Ark 87 135 75 115 1383 14 1397

Los Angeles Calif 1529 118 1684 130 57953 293 58246

Los Angeles Division 1339 135 1435 144 51098 250 51348

Santa Anna Division 190 63 249 83 6855 43 6898

Louisville KyndashInd 123 102 97 79 2286 22 2308

Madison Wis 10 19 29 53 520 4 524

McAllenndashEdinburgndashPharr Tex 57 84 45 64 630 11 641

Memphis TennndashMissndashArk 402 320 346 271 5128 19 5147

Miami Fla 2420 446 2289 419 55807 997 56804

Fort Lauderdale Division 810 455 769 430 16412 262 16674

Miami Division 1243 523 1165 485 29703 512 30215

West Palm Beach Division 367 290 355 279 9692 223 9915

MilwaukeendashWaukeshandashWest Allis Wis 68 45 109 72 2507 18 2525

MinneapolisndashSt PaulndashBloomington MinnndashWis 186 59 184 58 4259 22 4281

Modesto Calif 36 71 22 43 671 6 677

NashvillendashDavidsonndashMurfreesboro Tenn 224 158 172 118 3848 20 3868

New HavenndashMilford Conn 169 200 107 127 4573 73 4646

New OrleansndashMetairiendashKenner La 393 299 271 264 8835 67 8902

32 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

New York NYndashNJndashPa 6215 330 5500 292 195177 2906 198083

Edison Division 191 83 130 56 6709 139 6848

Nassau Division 262 93 246 88 8141 110 8251

New York Division 5266 456 4716 408 160408 2323 162731

Newark Division 496 231 408 190 19919 334 20253

Oklahoma City Okla 125 108 88 75 2255 5 2260

OmahandashCouncil Bluffs NebndashIowa 37 46 80 97 1035 3 1038

Orlando Fla 544 282 517 260 8653 92 8745

OxnardndashThousand OaksndashVentura Calif 49 62 21 26 1008 3 1011

Palm BayndashMelbournendashTitusville Fla 68 129 61 114 1512 11 1523

Philadelphia PandashNJndashDelndashMd 1261 217 1348 231 28221 313 28534

Camden Division 108 87 111 89 3118 42 3160

Philadelphia Division 1022 263 1144 294 22112 250 22362

Wilmington Division 131 191 93 134 2991 21 3012

PhoenixndashMesandashScottsdale Ariz 460 119 376 93 7459 31 7490

Pittsburgh Pa 143 60 135 57 3182 19 3201

PortlandndashSouth Portland Maine 9 18 34 66 562 1 563

PortlandndashVancouverndashBeaverton OrendashWash 170 81 215 101 4825 10 4835

PoughkeepsiendashNewburghndashMiddletown NY 136 204 113 168 3162 24 3186

ProvidencendashNew BedfordndashFall River RIndashMass 132 82 155 96 3900 44 3944

RaleighndashCary NC 138 145 201 202 1987 13 2000

Richmond Va 119 101 122 102 3371 35 3406

RiversidendashSan BernardinondashOntario Calif 361 92 306 76 8568 60 8628

Rochester NY 165 159 124 120 3134 13 3147

SacramentondashArden-ArcadendashRoseville Calif 154 75 169 82 4000 26 4026

St Louis MondashIll 192 69 366 131 5965 40 6005

Salt Lake City Utah 46 44 40 37 1743 10 1753

San Antonio Tex 215 114 247 127 4987 30 5017

San DiegondashCarlsbadndashSan Marcos Calif 491 167 384 131 12934 61 12995

San Francisco Calif 867 209 690 165 40152 96 40248

Oakland Division 312 126 246 99 9546 48 9594

San Francisco Division 555 329 444 261 30606 48 30654

San JosendashSunnyvalendashSanta Clara Calif 88 50 145 81 3747 15 3762

San JuanndashCaguasndashGuaynabo PR 745 289 578 223 21402 277 21679

SarasotandashBradentonndashVenice Fla 82 122 104 152 1978 27 2005

ScrantonndashWilkes-Barre Pa 27 49 47 85 572 6 578

Seattle Wash 353 110 280 86 9172 27 9199

Seattle Division 316 129 255 102 8161 18 8179

Tacoma Division 37 49 25 33 1011 9 1020

Springfield Mass 88 128 45 66 2075 26 2101

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 33

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Stockton Calif 52 78 52 77 1076 15 1091

Syracuse NY 52 80 49 75 1317 8 1325

TampandashSt PetersburgndashClearwater Fla 559 211 605 224 11174 112 11286

Toledo Ohio 25 38 66 101 812 14 826

Tucson Ariz 103 111 100 106 2010 10 2020

Tulsa Okla 83 94 65 72 1494 10 1504

Virginia BeachndashNorfolkndashNewport News VandashNC 183 111 132 80 4711 63 4774

Washington DCndashVandashMdndashWV 1322 252 1684 318 31130 315 31445

Bethesda Division 135 118 173 150 2774 23 2797

Washington Division 1187 289 1511 365 28356 292 28648

Wichita Kans 35 60 38 64 851 2 853

Worcester Mass 76 97 79 101 1783 20 1803

YoungstownndashWarrenndashBoardman OhiondashPa 27 46 26 44 519 0 519

Subtotal for MSAs (population gt500000) 33602 173 31274 159 829633 8171 837804

Metropolitan areas (population of 50000 to 499999) 4477 80 4466 79 94829 847 95676

Nonmetropolitan areas 2666 54 2732 55 52063 445 52508

Totalb 41144 137 38749 128 981708 9494 991202

Note Because of the lack of census information for all US dependent areas includes data for only the 50 states the District of Columbia and Puerto RicoMSA metropolitan statistical areaMSA definitions for this report can be found at httpwwwcensusgovpopulationwwwestimatesmetrodefhtmla Reported case counts for the metropolitan divisions do not sum to the MSA total MSA total includes data from 1 metropolitan division with

population of lt500000b Includes persons whose county of residence is unknown

34 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Alabama (January 1988) 502 6041 48 6089

Alaska (February 1999) 38 285 2 287

Arizona (January 1987) 617 5877 80 5957

Arkansas (July 1989) 206 2349 20 2369

California (April 2006) 6581 7056 92 7148

Colorado (November 1985) 319 6084 31 6115

Connecticut (January 2005)b 826 2500 101 2601

Delaware (February 2006) 788 801 18 819

Florida (July 1997)c 4163 36386 397 36783

Georgia (December 2003) 2245 8197 194 8391

Idaho (June 1986) 35 340 4 344

Illinois (January 2006) 6241 6661 162 6823

Indiana (July 1988) 399 4027 43 4070

Iowa (July 1998) 69 586 5 591

Kansas (July 1999) 142 1225 15 1240

Kentucky (October 2004) 333 1303 13 1316

Louisiana (February 1993) 728 8149 166 8315

Maine (January 2006) 386 393 3 396

Michigan (April 1992) 635 6702 134 6836

Minnesota (October 1985) 309 3356 40 3396

Mississippi (August 1988) 352 4549 59 4608

Missouri (October 1987) 502 5086 55 5141

Nebraska (September 1995) 91 672 14 686

Nevada (February 1992) 339 3532 24 3556

New Hampshire (January 2005) 59 466 9 475

New Jersey (January 1992) 1477 17513 325 17838

New Mexico (January 1998) 114 949 4 953

New York (June 2000) 5326 42345 1820 44165

North Carolina (February 1990) 1615 13879 143 14022

North Dakota (January 1988) 4 82 1 83

Ohio (June 1990) 867 8222 101 8323

Oklahoma (June 1988) 229 2401 30 2431

Oregon (April 2006) 49 95 19 114

Pennsylvania (October 2002)d 4269 9537 179 9716

Rhode Island (July 2006) 14 21 0 21

South Carolina (February 1986) 493 6970 93 7063

South Dakota (January 1988) 18 215 6 221

Tennessee (January 1992) 732 7115 90 7205

Texas (January 1999)e 3370 24282 417 24699

Utah (April 1989) 106 893 14 907

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 35

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Virginia (July 1989) 864 10257 95 10352

Washington (March 2006) 4048 4157 40 4197

West Virginia (January 1989) 66 673 8 681

Wisconsin (November 1985) 261 2500 31 2531

Wyoming (June 1989) 7 93 1 94

Subtotal 50834 274822 5146 279968

US dependent areas

American Samoa (August 2001) 0 1 0 1

Guam (March 2000) 2 66 0 66

Northern Mariana Islands (October 2001) 2 7 0 7

Puerto Rico (January 2003) 1471 5610 91 5701

US Virgin Islands (December 1998) 22 247 6 253

Persons reported from areas with confidential name-based HIV infection reporting but who were residents of other areas 132 685 21 706

Totalf 52878 282640 5314 287954

Note Includes data from 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through 2006b Beginning in 1992 Connecticut had name-based HIV reporting for cases in children only From January 2002 through December 2004

Connecticut had name- or code-based HIV reporting for cases in adolescents and adults As of January 2005 Connecticut has name-based reporting of all cases of HIV infection

c Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterd On October 18 2002 Pennsylvania initiated confidential name-based HIV infection reporting in all areas except Philadelphia Code-based

reporting was implemented in Philadelphia in March 2004 and the switch to name-based reporting was made in October 2005e From February 1994 through December 1998 Texas reported HIV infection in children onlyf Includes 1252 persons reported from areas with confidential name-based HIV infection reporting but whose area of residence is unknown

36 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulativemdashUnited States and dependent areas

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No Adult or adolescentMale-to-male sexual contact 13775 49 429897 54 mdash mdash mdash mdash 13775 35 429897 44Injection drug use 3413 12 163070 21 1826 17 67693 35 5239 13 230763 23Male-to-male sexual contact and

injection drug use 1603 6 65524 8 mdash mdash mdash mdash 1603 4 65524 7Hemophiliacoagulation disorder 43 0 5176 1 11 0 348 0 54 0 5524 1High-risk heterosexual contactc 2997 11 49610 6 4839 46 85186 44 7836 20 134796 14

Sex with injection drug user 330 1 11683 1 706 7 26073 14 1036 3 37756 4Sex with bisexual male mdash mdash mdash mdash 234 2 5162 3 234 1 5162 1Sex with person with hemophilia 1 0 84 0 11 0 502 0 12 0 586 0Sex with HIV-infected transfusion

recipient 22 0 553 0 21 0 793 0 43 0 1346 0Sex with HIV-infected person risk

factor not specified 2644 9 37290 5 3867 37 52656 27 6511 17 89946 9Receipt of blood transfusion blood

d components or tissue 63 0 5213 1 68 1 4176 2 131 0 9389 1Otherrisk factor not reported or

identifiede 6484 23 73136 9 3793 36 34311 18 10278 26 107450 11Subtotal 28378 100 791626 100 10537 100 191714 100 38916 100 983343 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 0 0 222 5 0 0 7 0 0 0 229 2Mother with documented HIV infection or

1 of the following risk factors 24 75 4315 89 50 93 4423 95 74 86 8738 92Injection drug use 4 13 1676 35 4 7 1665 36 8 9 3341 35Sex with injection drug user 4 13 789 16 4 7 750 16 8 9 1539 16Sex with bisexual male 1 3 101 2 2 4 110 2 3 3 211 2Sex with person with hemophilia 0 0 20 0 0 0 16 0 0 0 36 0Sex with HIV-infected transfusion

recipient 0 0 11 0 0 0 15 0 0 0 26 0Sex with HIV-infected person risk

factor not specified 6 19 742 15 17 31 790 17 23 27 1532 16Receipt of blood transfusion blood

components or tissue 0 0 70 1 0 0 82 2 0 0 152 2Has HIV infection risk factor not

specified 9 28 906 19 23 43 995 21 32 37 1901 20Receipt of blood transfusion blood

fcomponents or tissue 1 3 243 5 0 0 144 3 1 1 387 4Otherrisk factor not reported or

identifiedg 7 22 75 2 4 7 93 2 11 13 168 2Subtotal 32 100 4855 100 54 100 4667 100 86 100 9522 100

Total 28410 100 796481 100 10591 100 196381 100 39002 100 992865 100a From the beginning of the epidemic through 2006b From the beginning of the epidemic through 2006 Includes 3 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infectiond AIDS developed in 47 adultsadolescents after they received blood that had tested negative for HIV antibodies AIDS developed in 14 additional adults

after they received tissue organs or artificial insemination from HIV-infected donors Four of the 14 received tissue or organs from a donor who was negative for HIV antibody at the time of donation

e Includes 37 adultsadolescents who were exposed to HIV-infected blood body fluids or concentrated virus in health care laboratory or household settings as supported by seroconversion epidemiologic andor laboratory evidence One person was infected after intentional inoculation with HIV-infected blood Includes an additional 740 persons who acquired HIV infection perinatally but who were more than 12 years of age when AIDS was diagnosed These 740 persons are not counted in the values for the pediatric transmission category

f AIDS developed in 3 children after they received blood that had tested negative for HIV antibodiesg Includes 5 children who were exposed to HIV-infected blood as supported by seroconversion epidemiologic andor laboratory evidence 1 child was

infected after intentional inoculation with HIV-infected blood and 5 children were exposed to HIV-infected blood in a household setting Of the 168 children 26 had sexual contact with an adult with or at high risk for HIV infection

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 37

Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No

Adult or adolescentMale-to-male sexual contact 22912 59 103679 52 mdash mdash mdash mdash 22912 44 103679 37

Injection drug use 3503 9 24255 12 2124 16 13925 17 5627 11 38181 14

Male-to-male sexual contact and injection drug use 1946 5 10704 5 mdash mdash mdash mdash 1946 4 10704 4

Hemophiliacoagulation disorder 43 0 495 0 6 0 73 0 49 0 568 0

High-risk heterosexual contactc 2874 7 16830 8 5939 45 38315 47 8813 17 55145 20

Sex with injection drug user 308 1 2601 1 757 6 6791 8 1065 2 9392 3

Sex with bisexual male mdash mdash mdash mdash 328 2 2265 3 328 1 2265 1

Sex with person with hemophilia 4 0 31 0 16 0 201 0 20 0 232 0

Sex with HIV-infected transfusion recipient 13 0 131 0 28 0 223 0 41 0 354 0

Sex with HIV-infected person risk factor not specified 2549 7 14067 7 4810 36 28835 35 7359 14 42902 15

Receipt of blood transfusion blood components or tissue 61 0 489 0 50 0 536 1 111 0 1025 0

Otherrisk factor not reported or identified 7748 20 44021 22 5106 39 29312 36 12854 25 73338 26

Subtotal 39087 100 200473 100 13225 100 82161 100 52312 100 282640 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 8 3 106 4 0 0 1 0 8 1 107 2

Mother with documented HIV infection or 1 of the following risk factors 197 74 2195 85 254 85 2417 89 451 80 4612 87

Injection drug use 34 13 532 21 53 18 561 21 87 15 1093 21

Sex with injection drug user 12 5 208 8 21 7 213 8 33 6 421 8

Sex with bisexual male 5 2 37 1 4 1 32 1 9 2 69 1

Sex with person with hemophilia 0 0 3 0 1 0 7 0 1 0 10 0

Sex with HIV-infected transfusion recipient 0 0 4 0 0 0 4 0 0 0 8 0

Sex with HIV-infected person risk factor not specified 54 20 534 21 76 25 629 23 130 23 1163 22

Receipt of blood transfusion blood components or tissue 0 0 17 1 2 1 20 1 2 0 37 1

Has HIV infection risk factor not specified 92 35 860 33 97 32 951 35 189 33 1811 34

Receipt of blood transfusion blood components or tissue 6 2 28 1 3 1 24 1 9 2 52 1

Otherrisk factor not reported or identified 55 21 260 10 43 14 283 10 98 17 543 10

Subtotal 266 100 2589 100 300 100 2725 100 566 100 5314 100

Total 39353 100 203062 100 13525 100 84886 100 52878 100 287954 100

Note See Table 16 for the list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006b From the beginning of the epidemic through December 2006 Includes 6 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infection

38 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity

2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 6251 65 253927 73Injection drug use 733 8 31737 9Male-to-male sexual contact and injection drug use 732 8 31434 9Hemophiliacoagulation disorder 26 0 3989 1High-risk heterosexual contactb 416 4 7850 2

Sex with injection drug user 74 1 2310 1

Sex with person with hemophilia 0 0 36 0

Sex with HIV-infected transfusion recipient 2 0 176 0

Sex with HIV-infected person risk factor not specified 340 4 5328 2Receipt of blood transfusion blood components or tissue 20 0 3194 1Otherrisk factor not reported or identified 1400 15 16469 5

Total 9578 100 348600 100

Black not HispanicMale-to-male sexual contact 4309 36 103297 37Injection drug use 1635 14 83369 30Male-to-male sexual contact and injection drug use 526 4 22134 8Hemophiliacoagulation disorder 10 0 604 0High-risk heterosexual contactb 1875 16 29952 11

Sex with injection drug user 167 1 6823 2Sex with person with hemophilia 1 0 36 0Sex with HIV-infected transfusion recipient 15 0 237 0Sex with HIV-infected person risk factor not specified 1692 14 22856 8

Receipt of blood transfusion blood components or tissue 24 0 1218 0Otherrisk factor not reported or identified 3579 30 40268 14

Total 11958 100 280842 100

HispanicMale-to-male sexual contact 2816 47 64893 44Injection drug use 965 16 46337 31Male-to-male sexual contact and injection drug use 287 5 10884 7Hemophiliacoagulation disorder 6 0 466 0High-risk heterosexual contactb 638 11 10950 7

Sex with injection drug user 84 1 2409 2Sex with person with hemophilia 0 0 11 0Sex with HIV-infected transfusion recipient 5 0 125 0Sex with HIV-infected person risk factor not specified 549 9 8405 6

Receipt of blood transfusion blood components or tissue 17 0 657 0Otherrisk factor not reported or identified 1326 22 14832 10

Total 6055 100 149019 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 39

a

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulative

No No

AsianPacific IslanderMale-to-male sexual contact 225 54 4475 68Injection drug use 20 5 317 5Male-to-male sexual contact and injection drug use 17 4 284 4Hemophiliacoagulation disorder 1 0 70 1High-risk heterosexual contactb 34 8 376 6

Sex with injection drug user 1 0 54 1Sex with person with hemophilia 0 0 1 0Sex with HIV-infected transfusion recipient 0 0 8 0Sex with HIV-infected person risk factor not specified 33 8 313 5

Receipt of blood transfusion blood components or tissue 2 0 112 2Otherrisk factor not reported or identified 114 28 949 14

Total 413 100 6583 100

American IndianAlaska NativeMale-to-male sexual contact 61 49 1403 55Injection drug use 15 12 395 15Male-to-male sexual contact and injection drug use 23 19 457 18Hemophiliacoagulation disorder 0 0 27 1High-risk heterosexual contactb 9 7 118 5

Sex with injection drug user 1 1 33 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 8 6 82 3

Receipt of blood transfusion blood components or tissue 0 0 8 0Otherrisk factor not reported or identified 16 13 155 6

Total 124 100 2563 100

Total casesMale-to-male sexual contact 13775 49 429897 54Injection drug use 3413 12 163070 21Male-to-male sexual contact and injection drug use 1603 6 65524 8Hemophiliacoagulation disorder 43 0 5176 1High-risk heterosexual contactb 2997 11 49610 6

Sex with injection drug user 330 1 11683 1Sex with person with hemophilia 1 0 84 0Sex with HIV-infected transfusion recipient 22 0 553 0Sex with HIV-infected person risk factor not specified 2644 9 37290 5

Receipt of blood transfusion blood components or tissue 63 0 5213 1Otherrisk factor not reported or identified 6484 23 73136 9

Total 28378c 100 791626d 100a From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 4019 males of unknown race or multiple races

40 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 11963 73 55725 69Injection drug use 858 5 5512 7Male-to-male sexual contact and injection drug use 1092 7 5578 7Hemophiliacoagulation disorder 29 0 355 0High-risk heterosexual contactb 522 3 2658 3

Sex with injection drug user 65 0 544 1Sex with person with hemophilia 0 0 8 0Sex with HIV-infected transfusion recipient 3 0 33 0Sex with HIV-infected person risk factor not specified 454 3 2073 3

Receipt of blood transfusion blood components or tissue 14 0 197 0Otherrisk factor not reported or identified 1956 12 11147 14

Total 16434 100 81172 100

Black not HispanicMale-to-male sexual contact 6203 44 30148 37Injection drug use 1594 11 11997 15Male-to-male sexual contact and injection drug use 483 3 3489 4Hemophiliacoagulation disorder 10 0 109 0High-risk heterosexual contactb 1714 12 10905 13

Sex with injection drug user 169 1 1554 2Sex with person with hemophilia 4 0 17 0Sex with HIV-infected transfusion recipient 6 0 77 0Sex with HIV-infected person risk factor not specified 1535 11 9257 11

Receipt of blood transfusion blood components or tissue 32 0 223 0Otherrisk factor not reported or identified 4151 29 24632 30

Total 14187 100 81503 100

HispanicMale-to-male sexual contact 4094 55 15623 47Injection drug use 993 13 6407 19Male-to-male sexual contact and injection drug use 316 4 1402 4Hemophiliacoagulation disorder 3 0 26 0High-risk heterosexual contactb 582 8 2963 9

Sex with injection drug user 65 1 455 1Sex with person with hemophilia 0 0 6 0Sex with HIV-infected transfusion recipient 4 0 18 0Sex with HIV-infected person risk factor not specified 513 7 2484 7

Receipt of blood transfusion blood components or tissue 11 0 55 0Otherrisk factor not reported or identified 1475 20 6977 21

Total 7474 100 33453 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 41

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderMale-to-male sexual contact 402 70 1006 63Injection drug use 17 3 55 3Male-to-male sexual contact and injection drug use 15 3 38 2Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 25 4 96 6

Sex with injection drug user 3 1 10 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 22 4 83 5

Receipt of blood transfusion blood components or tissue 4 1 7 0Otherrisk factor not reported or identified 109 19 397 25

Total 572 100 1600 100

American IndianAlaska NativeMale-to-male sexual contact 104 61 516 57Injection drug use 13 8 101 11Male-to-male sexual contact and injection drug use 19 11 110 12Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 10 6 53 6

Sex with injection drug user 2 1 14 2Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 8 5 39 4

Receipt of blood transfusion blood components or tissue 0 0 2 0Otherrisk factor not reported or identified 24 14 125 14

Total 170 100 907 100

Total casesMale-to-male sexual contact 22912 59 103679 52Injection drug use 3503 9 24255 12Male-to-male sexual contact and injection drug use 1946 5 10704 5Hemophiliacoagulation disorder 43 0 495 0High-risk heterosexual contactb 2874 7 16830 8

Sex with injection drug user 308 1 2601 1Sex with person with hemophilia 4 0 31 0Sex with HIV-infected transfusion recipient 13 0 131 0Sex with HIV-infected person risk factor not specified 2549 7 14067 7

Receipt of blood transfusion blood components or tissue 61 0 489 0Otherrisk factor not reported or identified 7748 20 44021 22

Total 39087c 100 200473d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 1838 males of unknown race or multiple races

42 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race

ethnicity 2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 482 28 14981 40Hemophiliacoagulation disorder 4 0 123 0High-risk heterosexual contactb 725 42 15799 42

Sex with injection drug user 153 9 5650 15Sex with bisexual male 63 4 1859 5Sex with person with hemophilia 5 0 329 1Sex with HIV-infected transfusion recipient 5 0 338 1Sex with HIV-infected person risk factor not specified 499 29 7623 20

Receipt of blood transfusion blood components or tissue 15 1 1870 5Otherrisk factor not reported or identified 499 29 4801 13

Total 1725 100 37574 100

Black not HispanicInjection drug use 982 15 38914 34Hemophiliacoagulation disorder 3 0 145 0High-risk heterosexual contactb 3103 46 49876 44

Sex with injection drug user 373 6 13530 12Sex with bisexual male 136 2 2352 2Sex with person with hemophilia 4 0 121 0Sex with HIV-infected transfusion recipient 8 0 277 0Sex with HIV-infected person risk factor not specified 2582 38 33596 29

Receipt of blood transfusion blood components or tissue 39 1 1546 1Otherrisk factor not reported or identified 2612 39 23894 21

Total 6739 100 114375 100

HispanicInjection drug use 322 18 12892 35Hemophiliacoagulation disorder 4 0 67 0High-risk heterosexual contactb 894 49 17995 49

Sex with injection drug user 166 9 6522 18Sex with bisexual male 32 2 818 2Sex with person with hemophilia 1 0 45 0Sex with HIV-infected transfusion recipient 7 0 141 0Sex with HIV-infected person risk factor not specified 688 38 10469 29

Receipt of blood transfusion blood components or tissue 12 1 619 2Otherrisk factor not reported or identified 592 32 5023 14

Total 1824 100 36596 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 43

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 8 8 125 12Hemophiliacoagulation disorder 0 0 7 1High-risk heterosexual contactb 49 47 574 53

Sex with injection drug user 4 4 114 11Sex with bisexual male 2 2 80 7Sex with person with hemophilia 0 0 4 0Sex with HIV-infected transfusion recipient 1 1 25 2Sex with HIV-infected person risk factor not specified 42 40 351 33

Receipt of blood transfusion blood components or tissue 1 1 93 9Otherrisk factor not reported or identified 46 44 279 26

Total 104 100 1078 100

American IndianAlaska NativeInjection drug use 13 32 280 42Hemophiliacoagulation disorder 0 0 3 0High-risk heterosexual contactb 15 37 277 41

Sex with injection drug user 4 10 107 16Sex with bisexual male 1 2 27 4Sex with person with hemophilia 0 0 2 0Sex with HIV-infected transfusion recipient 0 0 6 1Sex with HIV-infected person risk factor not specified 10 24 135 20

Receipt of blood transfusion blood components or tissue 1 2 17 3Otherrisk factor not reported or identified 12 29 95 14

Total 41 100 672 100

Total casesInjection drug use 1826 17 67693 35Hemophiliacoagulation disorder 11 0 348 0High-risk heterosexual contactb 4839 46 85186 44

Sex with injection drug user 706 7 26073 14Sex with bisexual male 234 2 5162 3Sex with person with hemophilia 11 0 502 0Sex with HIV-infected transfusion recipient 21 0 793 0Sex with HIV-infected person risk factor not specified 3867 37 52656 27

Receipt of blood transfusion blood components or tissue 68 1 4176 2Otherrisk factor not reported or identified 3793 36 34311 18

Total 10537c 100 191714d 100a From the beginning of the epidemic through 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 104 females of unknown race or multiple racesd Includes 1419 females of unknown race or multiple races

44 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 690 26 4260 26Hemophiliacoagulation disorder 3 0 24 0

bHigh-risk heterosexual contact 1132 42 7593 46Sex with injection drug user 205 8 1876 11Sex with bisexual male 98 4 659 4Sex with person with hemophilia 10 0 115 1Sex with HIV-infected transfusion recipient 7 0 64 0Sex with HIV-infected person risk factor not specified 812 30 4879 29

Receipt of blood transfusion blood components or tissue 12 0 146 1Otherrisk factor not reported or identified 850 32 4567 28

Total 2687 100 16590 100

Black not HispanicInjection drug use 1034 13 7105 14Hemophiliacoagulation disorder 1 0 35 0

bHigh-risk heterosexual contact 3451 44 23732 46Sex with injection drug user 313 4 3473 7Sex with bisexual male 155 2 1294 3Sex with person with hemophilia 5 0 71 0Sex with HIV-infected transfusion recipient 14 0 120 0Sex with HIV-infected person risk factor not specified 2964 38 18774 36

Receipt of blood transfusion blood components or tissue 26 0 324 1Otherrisk factor not reported or identified 3370 43 20244 39

Total 7882 100 51440 100

HispanicInjection drug use 339 15 2280 18Hemophiliacoagulation disorder 2 0 11 0

bHigh-risk heterosexual contact 1198 52 6264 50Sex with injection drug user 218 9 1324 11Sex with bisexual male 62 3 266 2Sex with person with hemophilia 1 0 11 0Sex with HIV-infected transfusion recipient 7 0 39 0Sex with HIV-infected person risk factor not specified 910 39 4624 37

Receipt of blood transfusion blood components or tissue 12 1 58 0Otherrisk factor not reported or identified 767 33 3843 31

Total 2318 100 12456 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 45

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 29: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006

and cumulativemdashUnited States and dependent areas

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Alabama 510 112 462 100 8626 76 8702Alaska 24 36 38 57 648 7 655Arizona 626 105 539 87 10396 46 10442Arkansas 237 85 252 90 3891 36 3927California 4069 113 3960 109 142254 664 142918Colorado 351 75 322 68 8742 31 8773Connecticut 658 188 422 120 14716 183 14899Delaware 177 210 116 136 3547 26 3573District of Columbia 672 1155 853 1467 17372 189 17561Florida 4921 277 4932 273 104084 1530 105614Georgia 2325 255 1605 171 31734 231 31965Hawaii 105 82 93 72 2927 17 2944Idaho 24 17 26 18 604 2 606Illinois 1886 148 1382 108 33620 282 33902Indiana 407 65 346 55 8239 56 8295Iowa 93 31 86 29 1727 13 1740Kansas 105 38 120 43 2781 14 2795Kentucky 249 60 207 49 4600 32 4632Louisiana 936 208 824 192 17612 128 17740Maine 21 16 68 51 1110 8 1118Maryland 1558 279 1626 290 30252 319 30571Massachusetts 666 104 533 83 19181 214 19395Michigan 821 81 672 67 14941 113 15054Minnesota 226 44 212 41 4817 28 4845Mississippi 368 127 365 125 6642 56 6698Missouri 385 66 469 80 11016 61 11077Montana 21 22 7 07 373 3 376Nebraska 53 30 118 67 1479 11 1490Nevada 293 121 294 118 5733 29 5762New Hampshire 33 25 55 42 1074 10 1084New Jersey 1262 145 1065 122 48750 778 49528New Mexico 134 70 93 48 2603 7 2610New York 6201 321 5495 285 174908 2354 177262North Carolina 916 106 1229 139 15954 118 16072North Dakota 10 16 6 09 144 1 145Ohio 753 66 767 67 14957 138 15095Oklahoma 281 79 205 57 4836 26 4862Oregon 217 60 281 76 5995 20 6015Pennsylvania 1486 120 1893 152 33417 365 33782Rhode Island 87 81 111 104 2580 28 2608South Carolina 682 161 705 163 13301 105 13406South Dakota 18 23 18 23 255 5 260Tennessee 818 137 680 113 12457 59 12516Texas 3045 133 2998 128 69735 392 70127Utah 63 25 57 22 2295 20 2315Vermont 5 08 18 29 461 6 467Virginia 638 84 605 79 16802 177 16979Washington 485 77 389 61 11792 34 11826West Virginia 74 41 67 37 1500 11 1511Wisconsin 122 22 217 39 4513 33 4546Wyoming 6 12 8 16 228 2 230

Subtotal 40123 135 37911 127 952221 9094 961315

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 29

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulativemdashUnited States and dependent areas (cont)

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

US dependent areasAmerican Samoa 0 0 0 0 1 0 1Guam 0 0 0 0 68 1 69Northern Mariana Islands 0 0 0 0 3 0 3Puerto Rico 1029 263 850 216 29511 400 29911US Virgin Islands 17 156 32 295 629 18 647Otherb 0 0 0 0 3 0 3

Totalc 41357 138 39002 129 983343 9522 992865d

a From the beginning of the epidemic through 2006b Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasc Includes persons whose state or area of residence is unknownd Includes 916 persons whose state or area of residence is unknown

30 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

MSA (population gt 500000)

Akron Ohio 66 94 32 46 762 1 763

AlbanyndashSchenectadyndashTroy NY 97 114 105 123 2253 24 2277

Albuquerque N Mex 70 88 50 61 1404 2 1406

AllentownndashBethlehemndashEaston PandashNJ 72 91 119 149 1352 17 1369

AtlantandashSandy SpringsndashMarietta Ga 1586 319 1006 196 21896 128 22024

AugustandashRichmond County GandashSC 106 205 32 61 1851 24 1875

AustinndashRound Rock Tex 227 156 186 123 4830 26 4856

Bakersfield Calif 76 100 122 156 1528 8 1536

BaltimorendashTowson Md 1064 401 1001 377 20352 218 20570

Baton Rouge La 222 304 231 301 3732 20 3752

BirminghamndashHoover Ala 151 139 110 100 2614 25 2639

Boise CityndashNampa Idaho 14 26 14 25 281 0 281

Boston MassndashNHa 441 99 355 80 13476 147 13623

Boston Division 269 146 185 101 8451 91 8542

Cambridge Division 108 74 102 70 3126 35 3161

Essex Division 52 71 51 69 1577 20 1597

BridgeportndashStamfordndashNorwalk Conn 181 201 135 150 3733 57 3790

BuffalondashNiagara Falls NY 117 102 96 84 2476 20 2496

Cape CoralndashFort Myers Fla 44 81 91 159 1692 24 1716

CharlestonndashNorth Charleston SC 92 155 91 151 2034 18 2052

CharlottendashGastoniandashConcord NCndashSC 214 141 285 180 3242 22 3264

Chicago IllndashIndndashWis 1716 182 1159 122 30118 261 30379

Chicago Division 1604 203 1073 135 28300 248 28548

Gary Division 61 88 50 71 1038 8 1046

Lake Division 51 59 36 41 780 5 785

CincinnatindashMiddletown OhiondashKyndashInd 111 53 199 95 2735 17 2752

ClevelandndashElyriandashMentor Ohio 228 107 170 80 4226 48 4274

Colorado Springs Colo 19 32 21 35 576 5 581

Columbia SC 177 256 197 280 3274 24 3298

Columbus Ohio 166 97 165 96 3112 15 3127

Dallas Tex 874 150 929 155 20238 63 20301

Dallas Division 681 175 714 178 16038 37 16075

Fort Worth Division 193 100 215 108 4200 26 4226

Dayton Ohio 58 69 54 64 1217 15 1232

DenverndashAurora Colo 274 116 236 98 6899 22 6921

Des Moines Iowa 30 57 23 43 530 4 534

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 31

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Detroit Mich 570 127 445 100 10373 73 10446

Detroit Division 443 223 330 167 8268 57 8325

Warren Division 127 51 115 46 2105 16 2121

El Paso Tex 56 78 40 54 1476 10 1486

Fresno Calif 52 59 64 72 1430 11 1441

Grand RapidsndashWyoming Mich 46 60 51 66 816 6 822

GreensborondashHigh Point NC 52 77 66 96 1265 14 1279

Greenville SC 70 119 67 111 1292 4 1296

HarrisburgndashCarlisle Pa 23 44 67 128 1224 8 1232

HartfordndashWest HartfordndashEast Hartford Conn 256 216 135 114 5126 46 5172

Honolulu Hawaii 54 60 69 76 2121 14 2135

HoustonndashBaytownndashSugar Land Tex 1017 190 1092 197 25821 172 25993

Indianapolis Ind 191 116 150 90 3824 25 3849

Jackson Miss 134 257 117 221 2419 30 2449

Jacksonville Fla 309 248 315 246 6020 75 6095

Kansas City MondashKans 183 94 160 81 4669 15 4684

Knoxville Tenn 47 72 35 52 882 5 887

Lakeland Fla 103 190 112 199 1811 21 1832

Las VegasndashParadise Nev 245 143 258 145 4616 28 4644

Little RockndashNorth Little Rock Ark 87 135 75 115 1383 14 1397

Los Angeles Calif 1529 118 1684 130 57953 293 58246

Los Angeles Division 1339 135 1435 144 51098 250 51348

Santa Anna Division 190 63 249 83 6855 43 6898

Louisville KyndashInd 123 102 97 79 2286 22 2308

Madison Wis 10 19 29 53 520 4 524

McAllenndashEdinburgndashPharr Tex 57 84 45 64 630 11 641

Memphis TennndashMissndashArk 402 320 346 271 5128 19 5147

Miami Fla 2420 446 2289 419 55807 997 56804

Fort Lauderdale Division 810 455 769 430 16412 262 16674

Miami Division 1243 523 1165 485 29703 512 30215

West Palm Beach Division 367 290 355 279 9692 223 9915

MilwaukeendashWaukeshandashWest Allis Wis 68 45 109 72 2507 18 2525

MinneapolisndashSt PaulndashBloomington MinnndashWis 186 59 184 58 4259 22 4281

Modesto Calif 36 71 22 43 671 6 677

NashvillendashDavidsonndashMurfreesboro Tenn 224 158 172 118 3848 20 3868

New HavenndashMilford Conn 169 200 107 127 4573 73 4646

New OrleansndashMetairiendashKenner La 393 299 271 264 8835 67 8902

32 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

New York NYndashNJndashPa 6215 330 5500 292 195177 2906 198083

Edison Division 191 83 130 56 6709 139 6848

Nassau Division 262 93 246 88 8141 110 8251

New York Division 5266 456 4716 408 160408 2323 162731

Newark Division 496 231 408 190 19919 334 20253

Oklahoma City Okla 125 108 88 75 2255 5 2260

OmahandashCouncil Bluffs NebndashIowa 37 46 80 97 1035 3 1038

Orlando Fla 544 282 517 260 8653 92 8745

OxnardndashThousand OaksndashVentura Calif 49 62 21 26 1008 3 1011

Palm BayndashMelbournendashTitusville Fla 68 129 61 114 1512 11 1523

Philadelphia PandashNJndashDelndashMd 1261 217 1348 231 28221 313 28534

Camden Division 108 87 111 89 3118 42 3160

Philadelphia Division 1022 263 1144 294 22112 250 22362

Wilmington Division 131 191 93 134 2991 21 3012

PhoenixndashMesandashScottsdale Ariz 460 119 376 93 7459 31 7490

Pittsburgh Pa 143 60 135 57 3182 19 3201

PortlandndashSouth Portland Maine 9 18 34 66 562 1 563

PortlandndashVancouverndashBeaverton OrendashWash 170 81 215 101 4825 10 4835

PoughkeepsiendashNewburghndashMiddletown NY 136 204 113 168 3162 24 3186

ProvidencendashNew BedfordndashFall River RIndashMass 132 82 155 96 3900 44 3944

RaleighndashCary NC 138 145 201 202 1987 13 2000

Richmond Va 119 101 122 102 3371 35 3406

RiversidendashSan BernardinondashOntario Calif 361 92 306 76 8568 60 8628

Rochester NY 165 159 124 120 3134 13 3147

SacramentondashArden-ArcadendashRoseville Calif 154 75 169 82 4000 26 4026

St Louis MondashIll 192 69 366 131 5965 40 6005

Salt Lake City Utah 46 44 40 37 1743 10 1753

San Antonio Tex 215 114 247 127 4987 30 5017

San DiegondashCarlsbadndashSan Marcos Calif 491 167 384 131 12934 61 12995

San Francisco Calif 867 209 690 165 40152 96 40248

Oakland Division 312 126 246 99 9546 48 9594

San Francisco Division 555 329 444 261 30606 48 30654

San JosendashSunnyvalendashSanta Clara Calif 88 50 145 81 3747 15 3762

San JuanndashCaguasndashGuaynabo PR 745 289 578 223 21402 277 21679

SarasotandashBradentonndashVenice Fla 82 122 104 152 1978 27 2005

ScrantonndashWilkes-Barre Pa 27 49 47 85 572 6 578

Seattle Wash 353 110 280 86 9172 27 9199

Seattle Division 316 129 255 102 8161 18 8179

Tacoma Division 37 49 25 33 1011 9 1020

Springfield Mass 88 128 45 66 2075 26 2101

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 33

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Stockton Calif 52 78 52 77 1076 15 1091

Syracuse NY 52 80 49 75 1317 8 1325

TampandashSt PetersburgndashClearwater Fla 559 211 605 224 11174 112 11286

Toledo Ohio 25 38 66 101 812 14 826

Tucson Ariz 103 111 100 106 2010 10 2020

Tulsa Okla 83 94 65 72 1494 10 1504

Virginia BeachndashNorfolkndashNewport News VandashNC 183 111 132 80 4711 63 4774

Washington DCndashVandashMdndashWV 1322 252 1684 318 31130 315 31445

Bethesda Division 135 118 173 150 2774 23 2797

Washington Division 1187 289 1511 365 28356 292 28648

Wichita Kans 35 60 38 64 851 2 853

Worcester Mass 76 97 79 101 1783 20 1803

YoungstownndashWarrenndashBoardman OhiondashPa 27 46 26 44 519 0 519

Subtotal for MSAs (population gt500000) 33602 173 31274 159 829633 8171 837804

Metropolitan areas (population of 50000 to 499999) 4477 80 4466 79 94829 847 95676

Nonmetropolitan areas 2666 54 2732 55 52063 445 52508

Totalb 41144 137 38749 128 981708 9494 991202

Note Because of the lack of census information for all US dependent areas includes data for only the 50 states the District of Columbia and Puerto RicoMSA metropolitan statistical areaMSA definitions for this report can be found at httpwwwcensusgovpopulationwwwestimatesmetrodefhtmla Reported case counts for the metropolitan divisions do not sum to the MSA total MSA total includes data from 1 metropolitan division with

population of lt500000b Includes persons whose county of residence is unknown

34 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Alabama (January 1988) 502 6041 48 6089

Alaska (February 1999) 38 285 2 287

Arizona (January 1987) 617 5877 80 5957

Arkansas (July 1989) 206 2349 20 2369

California (April 2006) 6581 7056 92 7148

Colorado (November 1985) 319 6084 31 6115

Connecticut (January 2005)b 826 2500 101 2601

Delaware (February 2006) 788 801 18 819

Florida (July 1997)c 4163 36386 397 36783

Georgia (December 2003) 2245 8197 194 8391

Idaho (June 1986) 35 340 4 344

Illinois (January 2006) 6241 6661 162 6823

Indiana (July 1988) 399 4027 43 4070

Iowa (July 1998) 69 586 5 591

Kansas (July 1999) 142 1225 15 1240

Kentucky (October 2004) 333 1303 13 1316

Louisiana (February 1993) 728 8149 166 8315

Maine (January 2006) 386 393 3 396

Michigan (April 1992) 635 6702 134 6836

Minnesota (October 1985) 309 3356 40 3396

Mississippi (August 1988) 352 4549 59 4608

Missouri (October 1987) 502 5086 55 5141

Nebraska (September 1995) 91 672 14 686

Nevada (February 1992) 339 3532 24 3556

New Hampshire (January 2005) 59 466 9 475

New Jersey (January 1992) 1477 17513 325 17838

New Mexico (January 1998) 114 949 4 953

New York (June 2000) 5326 42345 1820 44165

North Carolina (February 1990) 1615 13879 143 14022

North Dakota (January 1988) 4 82 1 83

Ohio (June 1990) 867 8222 101 8323

Oklahoma (June 1988) 229 2401 30 2431

Oregon (April 2006) 49 95 19 114

Pennsylvania (October 2002)d 4269 9537 179 9716

Rhode Island (July 2006) 14 21 0 21

South Carolina (February 1986) 493 6970 93 7063

South Dakota (January 1988) 18 215 6 221

Tennessee (January 1992) 732 7115 90 7205

Texas (January 1999)e 3370 24282 417 24699

Utah (April 1989) 106 893 14 907

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 35

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Virginia (July 1989) 864 10257 95 10352

Washington (March 2006) 4048 4157 40 4197

West Virginia (January 1989) 66 673 8 681

Wisconsin (November 1985) 261 2500 31 2531

Wyoming (June 1989) 7 93 1 94

Subtotal 50834 274822 5146 279968

US dependent areas

American Samoa (August 2001) 0 1 0 1

Guam (March 2000) 2 66 0 66

Northern Mariana Islands (October 2001) 2 7 0 7

Puerto Rico (January 2003) 1471 5610 91 5701

US Virgin Islands (December 1998) 22 247 6 253

Persons reported from areas with confidential name-based HIV infection reporting but who were residents of other areas 132 685 21 706

Totalf 52878 282640 5314 287954

Note Includes data from 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through 2006b Beginning in 1992 Connecticut had name-based HIV reporting for cases in children only From January 2002 through December 2004

Connecticut had name- or code-based HIV reporting for cases in adolescents and adults As of January 2005 Connecticut has name-based reporting of all cases of HIV infection

c Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterd On October 18 2002 Pennsylvania initiated confidential name-based HIV infection reporting in all areas except Philadelphia Code-based

reporting was implemented in Philadelphia in March 2004 and the switch to name-based reporting was made in October 2005e From February 1994 through December 1998 Texas reported HIV infection in children onlyf Includes 1252 persons reported from areas with confidential name-based HIV infection reporting but whose area of residence is unknown

36 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulativemdashUnited States and dependent areas

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No Adult or adolescentMale-to-male sexual contact 13775 49 429897 54 mdash mdash mdash mdash 13775 35 429897 44Injection drug use 3413 12 163070 21 1826 17 67693 35 5239 13 230763 23Male-to-male sexual contact and

injection drug use 1603 6 65524 8 mdash mdash mdash mdash 1603 4 65524 7Hemophiliacoagulation disorder 43 0 5176 1 11 0 348 0 54 0 5524 1High-risk heterosexual contactc 2997 11 49610 6 4839 46 85186 44 7836 20 134796 14

Sex with injection drug user 330 1 11683 1 706 7 26073 14 1036 3 37756 4Sex with bisexual male mdash mdash mdash mdash 234 2 5162 3 234 1 5162 1Sex with person with hemophilia 1 0 84 0 11 0 502 0 12 0 586 0Sex with HIV-infected transfusion

recipient 22 0 553 0 21 0 793 0 43 0 1346 0Sex with HIV-infected person risk

factor not specified 2644 9 37290 5 3867 37 52656 27 6511 17 89946 9Receipt of blood transfusion blood

d components or tissue 63 0 5213 1 68 1 4176 2 131 0 9389 1Otherrisk factor not reported or

identifiede 6484 23 73136 9 3793 36 34311 18 10278 26 107450 11Subtotal 28378 100 791626 100 10537 100 191714 100 38916 100 983343 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 0 0 222 5 0 0 7 0 0 0 229 2Mother with documented HIV infection or

1 of the following risk factors 24 75 4315 89 50 93 4423 95 74 86 8738 92Injection drug use 4 13 1676 35 4 7 1665 36 8 9 3341 35Sex with injection drug user 4 13 789 16 4 7 750 16 8 9 1539 16Sex with bisexual male 1 3 101 2 2 4 110 2 3 3 211 2Sex with person with hemophilia 0 0 20 0 0 0 16 0 0 0 36 0Sex with HIV-infected transfusion

recipient 0 0 11 0 0 0 15 0 0 0 26 0Sex with HIV-infected person risk

factor not specified 6 19 742 15 17 31 790 17 23 27 1532 16Receipt of blood transfusion blood

components or tissue 0 0 70 1 0 0 82 2 0 0 152 2Has HIV infection risk factor not

specified 9 28 906 19 23 43 995 21 32 37 1901 20Receipt of blood transfusion blood

fcomponents or tissue 1 3 243 5 0 0 144 3 1 1 387 4Otherrisk factor not reported or

identifiedg 7 22 75 2 4 7 93 2 11 13 168 2Subtotal 32 100 4855 100 54 100 4667 100 86 100 9522 100

Total 28410 100 796481 100 10591 100 196381 100 39002 100 992865 100a From the beginning of the epidemic through 2006b From the beginning of the epidemic through 2006 Includes 3 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infectiond AIDS developed in 47 adultsadolescents after they received blood that had tested negative for HIV antibodies AIDS developed in 14 additional adults

after they received tissue organs or artificial insemination from HIV-infected donors Four of the 14 received tissue or organs from a donor who was negative for HIV antibody at the time of donation

e Includes 37 adultsadolescents who were exposed to HIV-infected blood body fluids or concentrated virus in health care laboratory or household settings as supported by seroconversion epidemiologic andor laboratory evidence One person was infected after intentional inoculation with HIV-infected blood Includes an additional 740 persons who acquired HIV infection perinatally but who were more than 12 years of age when AIDS was diagnosed These 740 persons are not counted in the values for the pediatric transmission category

f AIDS developed in 3 children after they received blood that had tested negative for HIV antibodiesg Includes 5 children who were exposed to HIV-infected blood as supported by seroconversion epidemiologic andor laboratory evidence 1 child was

infected after intentional inoculation with HIV-infected blood and 5 children were exposed to HIV-infected blood in a household setting Of the 168 children 26 had sexual contact with an adult with or at high risk for HIV infection

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 37

Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No

Adult or adolescentMale-to-male sexual contact 22912 59 103679 52 mdash mdash mdash mdash 22912 44 103679 37

Injection drug use 3503 9 24255 12 2124 16 13925 17 5627 11 38181 14

Male-to-male sexual contact and injection drug use 1946 5 10704 5 mdash mdash mdash mdash 1946 4 10704 4

Hemophiliacoagulation disorder 43 0 495 0 6 0 73 0 49 0 568 0

High-risk heterosexual contactc 2874 7 16830 8 5939 45 38315 47 8813 17 55145 20

Sex with injection drug user 308 1 2601 1 757 6 6791 8 1065 2 9392 3

Sex with bisexual male mdash mdash mdash mdash 328 2 2265 3 328 1 2265 1

Sex with person with hemophilia 4 0 31 0 16 0 201 0 20 0 232 0

Sex with HIV-infected transfusion recipient 13 0 131 0 28 0 223 0 41 0 354 0

Sex with HIV-infected person risk factor not specified 2549 7 14067 7 4810 36 28835 35 7359 14 42902 15

Receipt of blood transfusion blood components or tissue 61 0 489 0 50 0 536 1 111 0 1025 0

Otherrisk factor not reported or identified 7748 20 44021 22 5106 39 29312 36 12854 25 73338 26

Subtotal 39087 100 200473 100 13225 100 82161 100 52312 100 282640 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 8 3 106 4 0 0 1 0 8 1 107 2

Mother with documented HIV infection or 1 of the following risk factors 197 74 2195 85 254 85 2417 89 451 80 4612 87

Injection drug use 34 13 532 21 53 18 561 21 87 15 1093 21

Sex with injection drug user 12 5 208 8 21 7 213 8 33 6 421 8

Sex with bisexual male 5 2 37 1 4 1 32 1 9 2 69 1

Sex with person with hemophilia 0 0 3 0 1 0 7 0 1 0 10 0

Sex with HIV-infected transfusion recipient 0 0 4 0 0 0 4 0 0 0 8 0

Sex with HIV-infected person risk factor not specified 54 20 534 21 76 25 629 23 130 23 1163 22

Receipt of blood transfusion blood components or tissue 0 0 17 1 2 1 20 1 2 0 37 1

Has HIV infection risk factor not specified 92 35 860 33 97 32 951 35 189 33 1811 34

Receipt of blood transfusion blood components or tissue 6 2 28 1 3 1 24 1 9 2 52 1

Otherrisk factor not reported or identified 55 21 260 10 43 14 283 10 98 17 543 10

Subtotal 266 100 2589 100 300 100 2725 100 566 100 5314 100

Total 39353 100 203062 100 13525 100 84886 100 52878 100 287954 100

Note See Table 16 for the list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006b From the beginning of the epidemic through December 2006 Includes 6 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infection

38 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity

2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 6251 65 253927 73Injection drug use 733 8 31737 9Male-to-male sexual contact and injection drug use 732 8 31434 9Hemophiliacoagulation disorder 26 0 3989 1High-risk heterosexual contactb 416 4 7850 2

Sex with injection drug user 74 1 2310 1

Sex with person with hemophilia 0 0 36 0

Sex with HIV-infected transfusion recipient 2 0 176 0

Sex with HIV-infected person risk factor not specified 340 4 5328 2Receipt of blood transfusion blood components or tissue 20 0 3194 1Otherrisk factor not reported or identified 1400 15 16469 5

Total 9578 100 348600 100

Black not HispanicMale-to-male sexual contact 4309 36 103297 37Injection drug use 1635 14 83369 30Male-to-male sexual contact and injection drug use 526 4 22134 8Hemophiliacoagulation disorder 10 0 604 0High-risk heterosexual contactb 1875 16 29952 11

Sex with injection drug user 167 1 6823 2Sex with person with hemophilia 1 0 36 0Sex with HIV-infected transfusion recipient 15 0 237 0Sex with HIV-infected person risk factor not specified 1692 14 22856 8

Receipt of blood transfusion blood components or tissue 24 0 1218 0Otherrisk factor not reported or identified 3579 30 40268 14

Total 11958 100 280842 100

HispanicMale-to-male sexual contact 2816 47 64893 44Injection drug use 965 16 46337 31Male-to-male sexual contact and injection drug use 287 5 10884 7Hemophiliacoagulation disorder 6 0 466 0High-risk heterosexual contactb 638 11 10950 7

Sex with injection drug user 84 1 2409 2Sex with person with hemophilia 0 0 11 0Sex with HIV-infected transfusion recipient 5 0 125 0Sex with HIV-infected person risk factor not specified 549 9 8405 6

Receipt of blood transfusion blood components or tissue 17 0 657 0Otherrisk factor not reported or identified 1326 22 14832 10

Total 6055 100 149019 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 39

a

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulative

No No

AsianPacific IslanderMale-to-male sexual contact 225 54 4475 68Injection drug use 20 5 317 5Male-to-male sexual contact and injection drug use 17 4 284 4Hemophiliacoagulation disorder 1 0 70 1High-risk heterosexual contactb 34 8 376 6

Sex with injection drug user 1 0 54 1Sex with person with hemophilia 0 0 1 0Sex with HIV-infected transfusion recipient 0 0 8 0Sex with HIV-infected person risk factor not specified 33 8 313 5

Receipt of blood transfusion blood components or tissue 2 0 112 2Otherrisk factor not reported or identified 114 28 949 14

Total 413 100 6583 100

American IndianAlaska NativeMale-to-male sexual contact 61 49 1403 55Injection drug use 15 12 395 15Male-to-male sexual contact and injection drug use 23 19 457 18Hemophiliacoagulation disorder 0 0 27 1High-risk heterosexual contactb 9 7 118 5

Sex with injection drug user 1 1 33 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 8 6 82 3

Receipt of blood transfusion blood components or tissue 0 0 8 0Otherrisk factor not reported or identified 16 13 155 6

Total 124 100 2563 100

Total casesMale-to-male sexual contact 13775 49 429897 54Injection drug use 3413 12 163070 21Male-to-male sexual contact and injection drug use 1603 6 65524 8Hemophiliacoagulation disorder 43 0 5176 1High-risk heterosexual contactb 2997 11 49610 6

Sex with injection drug user 330 1 11683 1Sex with person with hemophilia 1 0 84 0Sex with HIV-infected transfusion recipient 22 0 553 0Sex with HIV-infected person risk factor not specified 2644 9 37290 5

Receipt of blood transfusion blood components or tissue 63 0 5213 1Otherrisk factor not reported or identified 6484 23 73136 9

Total 28378c 100 791626d 100a From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 4019 males of unknown race or multiple races

40 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 11963 73 55725 69Injection drug use 858 5 5512 7Male-to-male sexual contact and injection drug use 1092 7 5578 7Hemophiliacoagulation disorder 29 0 355 0High-risk heterosexual contactb 522 3 2658 3

Sex with injection drug user 65 0 544 1Sex with person with hemophilia 0 0 8 0Sex with HIV-infected transfusion recipient 3 0 33 0Sex with HIV-infected person risk factor not specified 454 3 2073 3

Receipt of blood transfusion blood components or tissue 14 0 197 0Otherrisk factor not reported or identified 1956 12 11147 14

Total 16434 100 81172 100

Black not HispanicMale-to-male sexual contact 6203 44 30148 37Injection drug use 1594 11 11997 15Male-to-male sexual contact and injection drug use 483 3 3489 4Hemophiliacoagulation disorder 10 0 109 0High-risk heterosexual contactb 1714 12 10905 13

Sex with injection drug user 169 1 1554 2Sex with person with hemophilia 4 0 17 0Sex with HIV-infected transfusion recipient 6 0 77 0Sex with HIV-infected person risk factor not specified 1535 11 9257 11

Receipt of blood transfusion blood components or tissue 32 0 223 0Otherrisk factor not reported or identified 4151 29 24632 30

Total 14187 100 81503 100

HispanicMale-to-male sexual contact 4094 55 15623 47Injection drug use 993 13 6407 19Male-to-male sexual contact and injection drug use 316 4 1402 4Hemophiliacoagulation disorder 3 0 26 0High-risk heterosexual contactb 582 8 2963 9

Sex with injection drug user 65 1 455 1Sex with person with hemophilia 0 0 6 0Sex with HIV-infected transfusion recipient 4 0 18 0Sex with HIV-infected person risk factor not specified 513 7 2484 7

Receipt of blood transfusion blood components or tissue 11 0 55 0Otherrisk factor not reported or identified 1475 20 6977 21

Total 7474 100 33453 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 41

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderMale-to-male sexual contact 402 70 1006 63Injection drug use 17 3 55 3Male-to-male sexual contact and injection drug use 15 3 38 2Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 25 4 96 6

Sex with injection drug user 3 1 10 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 22 4 83 5

Receipt of blood transfusion blood components or tissue 4 1 7 0Otherrisk factor not reported or identified 109 19 397 25

Total 572 100 1600 100

American IndianAlaska NativeMale-to-male sexual contact 104 61 516 57Injection drug use 13 8 101 11Male-to-male sexual contact and injection drug use 19 11 110 12Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 10 6 53 6

Sex with injection drug user 2 1 14 2Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 8 5 39 4

Receipt of blood transfusion blood components or tissue 0 0 2 0Otherrisk factor not reported or identified 24 14 125 14

Total 170 100 907 100

Total casesMale-to-male sexual contact 22912 59 103679 52Injection drug use 3503 9 24255 12Male-to-male sexual contact and injection drug use 1946 5 10704 5Hemophiliacoagulation disorder 43 0 495 0High-risk heterosexual contactb 2874 7 16830 8

Sex with injection drug user 308 1 2601 1Sex with person with hemophilia 4 0 31 0Sex with HIV-infected transfusion recipient 13 0 131 0Sex with HIV-infected person risk factor not specified 2549 7 14067 7

Receipt of blood transfusion blood components or tissue 61 0 489 0Otherrisk factor not reported or identified 7748 20 44021 22

Total 39087c 100 200473d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 1838 males of unknown race or multiple races

42 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race

ethnicity 2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 482 28 14981 40Hemophiliacoagulation disorder 4 0 123 0High-risk heterosexual contactb 725 42 15799 42

Sex with injection drug user 153 9 5650 15Sex with bisexual male 63 4 1859 5Sex with person with hemophilia 5 0 329 1Sex with HIV-infected transfusion recipient 5 0 338 1Sex with HIV-infected person risk factor not specified 499 29 7623 20

Receipt of blood transfusion blood components or tissue 15 1 1870 5Otherrisk factor not reported or identified 499 29 4801 13

Total 1725 100 37574 100

Black not HispanicInjection drug use 982 15 38914 34Hemophiliacoagulation disorder 3 0 145 0High-risk heterosexual contactb 3103 46 49876 44

Sex with injection drug user 373 6 13530 12Sex with bisexual male 136 2 2352 2Sex with person with hemophilia 4 0 121 0Sex with HIV-infected transfusion recipient 8 0 277 0Sex with HIV-infected person risk factor not specified 2582 38 33596 29

Receipt of blood transfusion blood components or tissue 39 1 1546 1Otherrisk factor not reported or identified 2612 39 23894 21

Total 6739 100 114375 100

HispanicInjection drug use 322 18 12892 35Hemophiliacoagulation disorder 4 0 67 0High-risk heterosexual contactb 894 49 17995 49

Sex with injection drug user 166 9 6522 18Sex with bisexual male 32 2 818 2Sex with person with hemophilia 1 0 45 0Sex with HIV-infected transfusion recipient 7 0 141 0Sex with HIV-infected person risk factor not specified 688 38 10469 29

Receipt of blood transfusion blood components or tissue 12 1 619 2Otherrisk factor not reported or identified 592 32 5023 14

Total 1824 100 36596 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 43

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 8 8 125 12Hemophiliacoagulation disorder 0 0 7 1High-risk heterosexual contactb 49 47 574 53

Sex with injection drug user 4 4 114 11Sex with bisexual male 2 2 80 7Sex with person with hemophilia 0 0 4 0Sex with HIV-infected transfusion recipient 1 1 25 2Sex with HIV-infected person risk factor not specified 42 40 351 33

Receipt of blood transfusion blood components or tissue 1 1 93 9Otherrisk factor not reported or identified 46 44 279 26

Total 104 100 1078 100

American IndianAlaska NativeInjection drug use 13 32 280 42Hemophiliacoagulation disorder 0 0 3 0High-risk heterosexual contactb 15 37 277 41

Sex with injection drug user 4 10 107 16Sex with bisexual male 1 2 27 4Sex with person with hemophilia 0 0 2 0Sex with HIV-infected transfusion recipient 0 0 6 1Sex with HIV-infected person risk factor not specified 10 24 135 20

Receipt of blood transfusion blood components or tissue 1 2 17 3Otherrisk factor not reported or identified 12 29 95 14

Total 41 100 672 100

Total casesInjection drug use 1826 17 67693 35Hemophiliacoagulation disorder 11 0 348 0High-risk heterosexual contactb 4839 46 85186 44

Sex with injection drug user 706 7 26073 14Sex with bisexual male 234 2 5162 3Sex with person with hemophilia 11 0 502 0Sex with HIV-infected transfusion recipient 21 0 793 0Sex with HIV-infected person risk factor not specified 3867 37 52656 27

Receipt of blood transfusion blood components or tissue 68 1 4176 2Otherrisk factor not reported or identified 3793 36 34311 18

Total 10537c 100 191714d 100a From the beginning of the epidemic through 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 104 females of unknown race or multiple racesd Includes 1419 females of unknown race or multiple races

44 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 690 26 4260 26Hemophiliacoagulation disorder 3 0 24 0

bHigh-risk heterosexual contact 1132 42 7593 46Sex with injection drug user 205 8 1876 11Sex with bisexual male 98 4 659 4Sex with person with hemophilia 10 0 115 1Sex with HIV-infected transfusion recipient 7 0 64 0Sex with HIV-infected person risk factor not specified 812 30 4879 29

Receipt of blood transfusion blood components or tissue 12 0 146 1Otherrisk factor not reported or identified 850 32 4567 28

Total 2687 100 16590 100

Black not HispanicInjection drug use 1034 13 7105 14Hemophiliacoagulation disorder 1 0 35 0

bHigh-risk heterosexual contact 3451 44 23732 46Sex with injection drug user 313 4 3473 7Sex with bisexual male 155 2 1294 3Sex with person with hemophilia 5 0 71 0Sex with HIV-infected transfusion recipient 14 0 120 0Sex with HIV-infected person risk factor not specified 2964 38 18774 36

Receipt of blood transfusion blood components or tissue 26 0 324 1Otherrisk factor not reported or identified 3370 43 20244 39

Total 7882 100 51440 100

HispanicInjection drug use 339 15 2280 18Hemophiliacoagulation disorder 2 0 11 0

bHigh-risk heterosexual contact 1198 52 6264 50Sex with injection drug user 218 9 1324 11Sex with bisexual male 62 3 266 2Sex with person with hemophilia 1 0 11 0Sex with HIV-infected transfusion recipient 7 0 39 0Sex with HIV-infected person risk factor not specified 910 39 4624 37

Receipt of blood transfusion blood components or tissue 12 1 58 0Otherrisk factor not reported or identified 767 33 3843 31

Total 2318 100 12456 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 45

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 30: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulativemdashUnited States and dependent areas (cont)

Area of residence

2005 2006

Cumulativea

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

US dependent areasAmerican Samoa 0 0 0 0 1 0 1Guam 0 0 0 0 68 1 69Northern Mariana Islands 0 0 0 0 3 0 3Puerto Rico 1029 263 850 216 29511 400 29911US Virgin Islands 17 156 32 295 629 18 647Otherb 0 0 0 0 3 0 3

Totalc 41357 138 39002 129 983343 9522 992865d

a From the beginning of the epidemic through 2006b Persons reported from areas with confidential name-based AIDS reporting but who are residents of other areasc Includes persons whose state or area of residence is unknownd Includes 916 persons whose state or area of residence is unknown

30 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

MSA (population gt 500000)

Akron Ohio 66 94 32 46 762 1 763

AlbanyndashSchenectadyndashTroy NY 97 114 105 123 2253 24 2277

Albuquerque N Mex 70 88 50 61 1404 2 1406

AllentownndashBethlehemndashEaston PandashNJ 72 91 119 149 1352 17 1369

AtlantandashSandy SpringsndashMarietta Ga 1586 319 1006 196 21896 128 22024

AugustandashRichmond County GandashSC 106 205 32 61 1851 24 1875

AustinndashRound Rock Tex 227 156 186 123 4830 26 4856

Bakersfield Calif 76 100 122 156 1528 8 1536

BaltimorendashTowson Md 1064 401 1001 377 20352 218 20570

Baton Rouge La 222 304 231 301 3732 20 3752

BirminghamndashHoover Ala 151 139 110 100 2614 25 2639

Boise CityndashNampa Idaho 14 26 14 25 281 0 281

Boston MassndashNHa 441 99 355 80 13476 147 13623

Boston Division 269 146 185 101 8451 91 8542

Cambridge Division 108 74 102 70 3126 35 3161

Essex Division 52 71 51 69 1577 20 1597

BridgeportndashStamfordndashNorwalk Conn 181 201 135 150 3733 57 3790

BuffalondashNiagara Falls NY 117 102 96 84 2476 20 2496

Cape CoralndashFort Myers Fla 44 81 91 159 1692 24 1716

CharlestonndashNorth Charleston SC 92 155 91 151 2034 18 2052

CharlottendashGastoniandashConcord NCndashSC 214 141 285 180 3242 22 3264

Chicago IllndashIndndashWis 1716 182 1159 122 30118 261 30379

Chicago Division 1604 203 1073 135 28300 248 28548

Gary Division 61 88 50 71 1038 8 1046

Lake Division 51 59 36 41 780 5 785

CincinnatindashMiddletown OhiondashKyndashInd 111 53 199 95 2735 17 2752

ClevelandndashElyriandashMentor Ohio 228 107 170 80 4226 48 4274

Colorado Springs Colo 19 32 21 35 576 5 581

Columbia SC 177 256 197 280 3274 24 3298

Columbus Ohio 166 97 165 96 3112 15 3127

Dallas Tex 874 150 929 155 20238 63 20301

Dallas Division 681 175 714 178 16038 37 16075

Fort Worth Division 193 100 215 108 4200 26 4226

Dayton Ohio 58 69 54 64 1217 15 1232

DenverndashAurora Colo 274 116 236 98 6899 22 6921

Des Moines Iowa 30 57 23 43 530 4 534

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 31

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Detroit Mich 570 127 445 100 10373 73 10446

Detroit Division 443 223 330 167 8268 57 8325

Warren Division 127 51 115 46 2105 16 2121

El Paso Tex 56 78 40 54 1476 10 1486

Fresno Calif 52 59 64 72 1430 11 1441

Grand RapidsndashWyoming Mich 46 60 51 66 816 6 822

GreensborondashHigh Point NC 52 77 66 96 1265 14 1279

Greenville SC 70 119 67 111 1292 4 1296

HarrisburgndashCarlisle Pa 23 44 67 128 1224 8 1232

HartfordndashWest HartfordndashEast Hartford Conn 256 216 135 114 5126 46 5172

Honolulu Hawaii 54 60 69 76 2121 14 2135

HoustonndashBaytownndashSugar Land Tex 1017 190 1092 197 25821 172 25993

Indianapolis Ind 191 116 150 90 3824 25 3849

Jackson Miss 134 257 117 221 2419 30 2449

Jacksonville Fla 309 248 315 246 6020 75 6095

Kansas City MondashKans 183 94 160 81 4669 15 4684

Knoxville Tenn 47 72 35 52 882 5 887

Lakeland Fla 103 190 112 199 1811 21 1832

Las VegasndashParadise Nev 245 143 258 145 4616 28 4644

Little RockndashNorth Little Rock Ark 87 135 75 115 1383 14 1397

Los Angeles Calif 1529 118 1684 130 57953 293 58246

Los Angeles Division 1339 135 1435 144 51098 250 51348

Santa Anna Division 190 63 249 83 6855 43 6898

Louisville KyndashInd 123 102 97 79 2286 22 2308

Madison Wis 10 19 29 53 520 4 524

McAllenndashEdinburgndashPharr Tex 57 84 45 64 630 11 641

Memphis TennndashMissndashArk 402 320 346 271 5128 19 5147

Miami Fla 2420 446 2289 419 55807 997 56804

Fort Lauderdale Division 810 455 769 430 16412 262 16674

Miami Division 1243 523 1165 485 29703 512 30215

West Palm Beach Division 367 290 355 279 9692 223 9915

MilwaukeendashWaukeshandashWest Allis Wis 68 45 109 72 2507 18 2525

MinneapolisndashSt PaulndashBloomington MinnndashWis 186 59 184 58 4259 22 4281

Modesto Calif 36 71 22 43 671 6 677

NashvillendashDavidsonndashMurfreesboro Tenn 224 158 172 118 3848 20 3868

New HavenndashMilford Conn 169 200 107 127 4573 73 4646

New OrleansndashMetairiendashKenner La 393 299 271 264 8835 67 8902

32 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

New York NYndashNJndashPa 6215 330 5500 292 195177 2906 198083

Edison Division 191 83 130 56 6709 139 6848

Nassau Division 262 93 246 88 8141 110 8251

New York Division 5266 456 4716 408 160408 2323 162731

Newark Division 496 231 408 190 19919 334 20253

Oklahoma City Okla 125 108 88 75 2255 5 2260

OmahandashCouncil Bluffs NebndashIowa 37 46 80 97 1035 3 1038

Orlando Fla 544 282 517 260 8653 92 8745

OxnardndashThousand OaksndashVentura Calif 49 62 21 26 1008 3 1011

Palm BayndashMelbournendashTitusville Fla 68 129 61 114 1512 11 1523

Philadelphia PandashNJndashDelndashMd 1261 217 1348 231 28221 313 28534

Camden Division 108 87 111 89 3118 42 3160

Philadelphia Division 1022 263 1144 294 22112 250 22362

Wilmington Division 131 191 93 134 2991 21 3012

PhoenixndashMesandashScottsdale Ariz 460 119 376 93 7459 31 7490

Pittsburgh Pa 143 60 135 57 3182 19 3201

PortlandndashSouth Portland Maine 9 18 34 66 562 1 563

PortlandndashVancouverndashBeaverton OrendashWash 170 81 215 101 4825 10 4835

PoughkeepsiendashNewburghndashMiddletown NY 136 204 113 168 3162 24 3186

ProvidencendashNew BedfordndashFall River RIndashMass 132 82 155 96 3900 44 3944

RaleighndashCary NC 138 145 201 202 1987 13 2000

Richmond Va 119 101 122 102 3371 35 3406

RiversidendashSan BernardinondashOntario Calif 361 92 306 76 8568 60 8628

Rochester NY 165 159 124 120 3134 13 3147

SacramentondashArden-ArcadendashRoseville Calif 154 75 169 82 4000 26 4026

St Louis MondashIll 192 69 366 131 5965 40 6005

Salt Lake City Utah 46 44 40 37 1743 10 1753

San Antonio Tex 215 114 247 127 4987 30 5017

San DiegondashCarlsbadndashSan Marcos Calif 491 167 384 131 12934 61 12995

San Francisco Calif 867 209 690 165 40152 96 40248

Oakland Division 312 126 246 99 9546 48 9594

San Francisco Division 555 329 444 261 30606 48 30654

San JosendashSunnyvalendashSanta Clara Calif 88 50 145 81 3747 15 3762

San JuanndashCaguasndashGuaynabo PR 745 289 578 223 21402 277 21679

SarasotandashBradentonndashVenice Fla 82 122 104 152 1978 27 2005

ScrantonndashWilkes-Barre Pa 27 49 47 85 572 6 578

Seattle Wash 353 110 280 86 9172 27 9199

Seattle Division 316 129 255 102 8161 18 8179

Tacoma Division 37 49 25 33 1011 9 1020

Springfield Mass 88 128 45 66 2075 26 2101

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 33

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Stockton Calif 52 78 52 77 1076 15 1091

Syracuse NY 52 80 49 75 1317 8 1325

TampandashSt PetersburgndashClearwater Fla 559 211 605 224 11174 112 11286

Toledo Ohio 25 38 66 101 812 14 826

Tucson Ariz 103 111 100 106 2010 10 2020

Tulsa Okla 83 94 65 72 1494 10 1504

Virginia BeachndashNorfolkndashNewport News VandashNC 183 111 132 80 4711 63 4774

Washington DCndashVandashMdndashWV 1322 252 1684 318 31130 315 31445

Bethesda Division 135 118 173 150 2774 23 2797

Washington Division 1187 289 1511 365 28356 292 28648

Wichita Kans 35 60 38 64 851 2 853

Worcester Mass 76 97 79 101 1783 20 1803

YoungstownndashWarrenndashBoardman OhiondashPa 27 46 26 44 519 0 519

Subtotal for MSAs (population gt500000) 33602 173 31274 159 829633 8171 837804

Metropolitan areas (population of 50000 to 499999) 4477 80 4466 79 94829 847 95676

Nonmetropolitan areas 2666 54 2732 55 52063 445 52508

Totalb 41144 137 38749 128 981708 9494 991202

Note Because of the lack of census information for all US dependent areas includes data for only the 50 states the District of Columbia and Puerto RicoMSA metropolitan statistical areaMSA definitions for this report can be found at httpwwwcensusgovpopulationwwwestimatesmetrodefhtmla Reported case counts for the metropolitan divisions do not sum to the MSA total MSA total includes data from 1 metropolitan division with

population of lt500000b Includes persons whose county of residence is unknown

34 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Alabama (January 1988) 502 6041 48 6089

Alaska (February 1999) 38 285 2 287

Arizona (January 1987) 617 5877 80 5957

Arkansas (July 1989) 206 2349 20 2369

California (April 2006) 6581 7056 92 7148

Colorado (November 1985) 319 6084 31 6115

Connecticut (January 2005)b 826 2500 101 2601

Delaware (February 2006) 788 801 18 819

Florida (July 1997)c 4163 36386 397 36783

Georgia (December 2003) 2245 8197 194 8391

Idaho (June 1986) 35 340 4 344

Illinois (January 2006) 6241 6661 162 6823

Indiana (July 1988) 399 4027 43 4070

Iowa (July 1998) 69 586 5 591

Kansas (July 1999) 142 1225 15 1240

Kentucky (October 2004) 333 1303 13 1316

Louisiana (February 1993) 728 8149 166 8315

Maine (January 2006) 386 393 3 396

Michigan (April 1992) 635 6702 134 6836

Minnesota (October 1985) 309 3356 40 3396

Mississippi (August 1988) 352 4549 59 4608

Missouri (October 1987) 502 5086 55 5141

Nebraska (September 1995) 91 672 14 686

Nevada (February 1992) 339 3532 24 3556

New Hampshire (January 2005) 59 466 9 475

New Jersey (January 1992) 1477 17513 325 17838

New Mexico (January 1998) 114 949 4 953

New York (June 2000) 5326 42345 1820 44165

North Carolina (February 1990) 1615 13879 143 14022

North Dakota (January 1988) 4 82 1 83

Ohio (June 1990) 867 8222 101 8323

Oklahoma (June 1988) 229 2401 30 2431

Oregon (April 2006) 49 95 19 114

Pennsylvania (October 2002)d 4269 9537 179 9716

Rhode Island (July 2006) 14 21 0 21

South Carolina (February 1986) 493 6970 93 7063

South Dakota (January 1988) 18 215 6 221

Tennessee (January 1992) 732 7115 90 7205

Texas (January 1999)e 3370 24282 417 24699

Utah (April 1989) 106 893 14 907

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 35

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Virginia (July 1989) 864 10257 95 10352

Washington (March 2006) 4048 4157 40 4197

West Virginia (January 1989) 66 673 8 681

Wisconsin (November 1985) 261 2500 31 2531

Wyoming (June 1989) 7 93 1 94

Subtotal 50834 274822 5146 279968

US dependent areas

American Samoa (August 2001) 0 1 0 1

Guam (March 2000) 2 66 0 66

Northern Mariana Islands (October 2001) 2 7 0 7

Puerto Rico (January 2003) 1471 5610 91 5701

US Virgin Islands (December 1998) 22 247 6 253

Persons reported from areas with confidential name-based HIV infection reporting but who were residents of other areas 132 685 21 706

Totalf 52878 282640 5314 287954

Note Includes data from 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through 2006b Beginning in 1992 Connecticut had name-based HIV reporting for cases in children only From January 2002 through December 2004

Connecticut had name- or code-based HIV reporting for cases in adolescents and adults As of January 2005 Connecticut has name-based reporting of all cases of HIV infection

c Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterd On October 18 2002 Pennsylvania initiated confidential name-based HIV infection reporting in all areas except Philadelphia Code-based

reporting was implemented in Philadelphia in March 2004 and the switch to name-based reporting was made in October 2005e From February 1994 through December 1998 Texas reported HIV infection in children onlyf Includes 1252 persons reported from areas with confidential name-based HIV infection reporting but whose area of residence is unknown

36 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulativemdashUnited States and dependent areas

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No Adult or adolescentMale-to-male sexual contact 13775 49 429897 54 mdash mdash mdash mdash 13775 35 429897 44Injection drug use 3413 12 163070 21 1826 17 67693 35 5239 13 230763 23Male-to-male sexual contact and

injection drug use 1603 6 65524 8 mdash mdash mdash mdash 1603 4 65524 7Hemophiliacoagulation disorder 43 0 5176 1 11 0 348 0 54 0 5524 1High-risk heterosexual contactc 2997 11 49610 6 4839 46 85186 44 7836 20 134796 14

Sex with injection drug user 330 1 11683 1 706 7 26073 14 1036 3 37756 4Sex with bisexual male mdash mdash mdash mdash 234 2 5162 3 234 1 5162 1Sex with person with hemophilia 1 0 84 0 11 0 502 0 12 0 586 0Sex with HIV-infected transfusion

recipient 22 0 553 0 21 0 793 0 43 0 1346 0Sex with HIV-infected person risk

factor not specified 2644 9 37290 5 3867 37 52656 27 6511 17 89946 9Receipt of blood transfusion blood

d components or tissue 63 0 5213 1 68 1 4176 2 131 0 9389 1Otherrisk factor not reported or

identifiede 6484 23 73136 9 3793 36 34311 18 10278 26 107450 11Subtotal 28378 100 791626 100 10537 100 191714 100 38916 100 983343 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 0 0 222 5 0 0 7 0 0 0 229 2Mother with documented HIV infection or

1 of the following risk factors 24 75 4315 89 50 93 4423 95 74 86 8738 92Injection drug use 4 13 1676 35 4 7 1665 36 8 9 3341 35Sex with injection drug user 4 13 789 16 4 7 750 16 8 9 1539 16Sex with bisexual male 1 3 101 2 2 4 110 2 3 3 211 2Sex with person with hemophilia 0 0 20 0 0 0 16 0 0 0 36 0Sex with HIV-infected transfusion

recipient 0 0 11 0 0 0 15 0 0 0 26 0Sex with HIV-infected person risk

factor not specified 6 19 742 15 17 31 790 17 23 27 1532 16Receipt of blood transfusion blood

components or tissue 0 0 70 1 0 0 82 2 0 0 152 2Has HIV infection risk factor not

specified 9 28 906 19 23 43 995 21 32 37 1901 20Receipt of blood transfusion blood

fcomponents or tissue 1 3 243 5 0 0 144 3 1 1 387 4Otherrisk factor not reported or

identifiedg 7 22 75 2 4 7 93 2 11 13 168 2Subtotal 32 100 4855 100 54 100 4667 100 86 100 9522 100

Total 28410 100 796481 100 10591 100 196381 100 39002 100 992865 100a From the beginning of the epidemic through 2006b From the beginning of the epidemic through 2006 Includes 3 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infectiond AIDS developed in 47 adultsadolescents after they received blood that had tested negative for HIV antibodies AIDS developed in 14 additional adults

after they received tissue organs or artificial insemination from HIV-infected donors Four of the 14 received tissue or organs from a donor who was negative for HIV antibody at the time of donation

e Includes 37 adultsadolescents who were exposed to HIV-infected blood body fluids or concentrated virus in health care laboratory or household settings as supported by seroconversion epidemiologic andor laboratory evidence One person was infected after intentional inoculation with HIV-infected blood Includes an additional 740 persons who acquired HIV infection perinatally but who were more than 12 years of age when AIDS was diagnosed These 740 persons are not counted in the values for the pediatric transmission category

f AIDS developed in 3 children after they received blood that had tested negative for HIV antibodiesg Includes 5 children who were exposed to HIV-infected blood as supported by seroconversion epidemiologic andor laboratory evidence 1 child was

infected after intentional inoculation with HIV-infected blood and 5 children were exposed to HIV-infected blood in a household setting Of the 168 children 26 had sexual contact with an adult with or at high risk for HIV infection

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 37

Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No

Adult or adolescentMale-to-male sexual contact 22912 59 103679 52 mdash mdash mdash mdash 22912 44 103679 37

Injection drug use 3503 9 24255 12 2124 16 13925 17 5627 11 38181 14

Male-to-male sexual contact and injection drug use 1946 5 10704 5 mdash mdash mdash mdash 1946 4 10704 4

Hemophiliacoagulation disorder 43 0 495 0 6 0 73 0 49 0 568 0

High-risk heterosexual contactc 2874 7 16830 8 5939 45 38315 47 8813 17 55145 20

Sex with injection drug user 308 1 2601 1 757 6 6791 8 1065 2 9392 3

Sex with bisexual male mdash mdash mdash mdash 328 2 2265 3 328 1 2265 1

Sex with person with hemophilia 4 0 31 0 16 0 201 0 20 0 232 0

Sex with HIV-infected transfusion recipient 13 0 131 0 28 0 223 0 41 0 354 0

Sex with HIV-infected person risk factor not specified 2549 7 14067 7 4810 36 28835 35 7359 14 42902 15

Receipt of blood transfusion blood components or tissue 61 0 489 0 50 0 536 1 111 0 1025 0

Otherrisk factor not reported or identified 7748 20 44021 22 5106 39 29312 36 12854 25 73338 26

Subtotal 39087 100 200473 100 13225 100 82161 100 52312 100 282640 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 8 3 106 4 0 0 1 0 8 1 107 2

Mother with documented HIV infection or 1 of the following risk factors 197 74 2195 85 254 85 2417 89 451 80 4612 87

Injection drug use 34 13 532 21 53 18 561 21 87 15 1093 21

Sex with injection drug user 12 5 208 8 21 7 213 8 33 6 421 8

Sex with bisexual male 5 2 37 1 4 1 32 1 9 2 69 1

Sex with person with hemophilia 0 0 3 0 1 0 7 0 1 0 10 0

Sex with HIV-infected transfusion recipient 0 0 4 0 0 0 4 0 0 0 8 0

Sex with HIV-infected person risk factor not specified 54 20 534 21 76 25 629 23 130 23 1163 22

Receipt of blood transfusion blood components or tissue 0 0 17 1 2 1 20 1 2 0 37 1

Has HIV infection risk factor not specified 92 35 860 33 97 32 951 35 189 33 1811 34

Receipt of blood transfusion blood components or tissue 6 2 28 1 3 1 24 1 9 2 52 1

Otherrisk factor not reported or identified 55 21 260 10 43 14 283 10 98 17 543 10

Subtotal 266 100 2589 100 300 100 2725 100 566 100 5314 100

Total 39353 100 203062 100 13525 100 84886 100 52878 100 287954 100

Note See Table 16 for the list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006b From the beginning of the epidemic through December 2006 Includes 6 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infection

38 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity

2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 6251 65 253927 73Injection drug use 733 8 31737 9Male-to-male sexual contact and injection drug use 732 8 31434 9Hemophiliacoagulation disorder 26 0 3989 1High-risk heterosexual contactb 416 4 7850 2

Sex with injection drug user 74 1 2310 1

Sex with person with hemophilia 0 0 36 0

Sex with HIV-infected transfusion recipient 2 0 176 0

Sex with HIV-infected person risk factor not specified 340 4 5328 2Receipt of blood transfusion blood components or tissue 20 0 3194 1Otherrisk factor not reported or identified 1400 15 16469 5

Total 9578 100 348600 100

Black not HispanicMale-to-male sexual contact 4309 36 103297 37Injection drug use 1635 14 83369 30Male-to-male sexual contact and injection drug use 526 4 22134 8Hemophiliacoagulation disorder 10 0 604 0High-risk heterosexual contactb 1875 16 29952 11

Sex with injection drug user 167 1 6823 2Sex with person with hemophilia 1 0 36 0Sex with HIV-infected transfusion recipient 15 0 237 0Sex with HIV-infected person risk factor not specified 1692 14 22856 8

Receipt of blood transfusion blood components or tissue 24 0 1218 0Otherrisk factor not reported or identified 3579 30 40268 14

Total 11958 100 280842 100

HispanicMale-to-male sexual contact 2816 47 64893 44Injection drug use 965 16 46337 31Male-to-male sexual contact and injection drug use 287 5 10884 7Hemophiliacoagulation disorder 6 0 466 0High-risk heterosexual contactb 638 11 10950 7

Sex with injection drug user 84 1 2409 2Sex with person with hemophilia 0 0 11 0Sex with HIV-infected transfusion recipient 5 0 125 0Sex with HIV-infected person risk factor not specified 549 9 8405 6

Receipt of blood transfusion blood components or tissue 17 0 657 0Otherrisk factor not reported or identified 1326 22 14832 10

Total 6055 100 149019 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 39

a

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulative

No No

AsianPacific IslanderMale-to-male sexual contact 225 54 4475 68Injection drug use 20 5 317 5Male-to-male sexual contact and injection drug use 17 4 284 4Hemophiliacoagulation disorder 1 0 70 1High-risk heterosexual contactb 34 8 376 6

Sex with injection drug user 1 0 54 1Sex with person with hemophilia 0 0 1 0Sex with HIV-infected transfusion recipient 0 0 8 0Sex with HIV-infected person risk factor not specified 33 8 313 5

Receipt of blood transfusion blood components or tissue 2 0 112 2Otherrisk factor not reported or identified 114 28 949 14

Total 413 100 6583 100

American IndianAlaska NativeMale-to-male sexual contact 61 49 1403 55Injection drug use 15 12 395 15Male-to-male sexual contact and injection drug use 23 19 457 18Hemophiliacoagulation disorder 0 0 27 1High-risk heterosexual contactb 9 7 118 5

Sex with injection drug user 1 1 33 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 8 6 82 3

Receipt of blood transfusion blood components or tissue 0 0 8 0Otherrisk factor not reported or identified 16 13 155 6

Total 124 100 2563 100

Total casesMale-to-male sexual contact 13775 49 429897 54Injection drug use 3413 12 163070 21Male-to-male sexual contact and injection drug use 1603 6 65524 8Hemophiliacoagulation disorder 43 0 5176 1High-risk heterosexual contactb 2997 11 49610 6

Sex with injection drug user 330 1 11683 1Sex with person with hemophilia 1 0 84 0Sex with HIV-infected transfusion recipient 22 0 553 0Sex with HIV-infected person risk factor not specified 2644 9 37290 5

Receipt of blood transfusion blood components or tissue 63 0 5213 1Otherrisk factor not reported or identified 6484 23 73136 9

Total 28378c 100 791626d 100a From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 4019 males of unknown race or multiple races

40 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 11963 73 55725 69Injection drug use 858 5 5512 7Male-to-male sexual contact and injection drug use 1092 7 5578 7Hemophiliacoagulation disorder 29 0 355 0High-risk heterosexual contactb 522 3 2658 3

Sex with injection drug user 65 0 544 1Sex with person with hemophilia 0 0 8 0Sex with HIV-infected transfusion recipient 3 0 33 0Sex with HIV-infected person risk factor not specified 454 3 2073 3

Receipt of blood transfusion blood components or tissue 14 0 197 0Otherrisk factor not reported or identified 1956 12 11147 14

Total 16434 100 81172 100

Black not HispanicMale-to-male sexual contact 6203 44 30148 37Injection drug use 1594 11 11997 15Male-to-male sexual contact and injection drug use 483 3 3489 4Hemophiliacoagulation disorder 10 0 109 0High-risk heterosexual contactb 1714 12 10905 13

Sex with injection drug user 169 1 1554 2Sex with person with hemophilia 4 0 17 0Sex with HIV-infected transfusion recipient 6 0 77 0Sex with HIV-infected person risk factor not specified 1535 11 9257 11

Receipt of blood transfusion blood components or tissue 32 0 223 0Otherrisk factor not reported or identified 4151 29 24632 30

Total 14187 100 81503 100

HispanicMale-to-male sexual contact 4094 55 15623 47Injection drug use 993 13 6407 19Male-to-male sexual contact and injection drug use 316 4 1402 4Hemophiliacoagulation disorder 3 0 26 0High-risk heterosexual contactb 582 8 2963 9

Sex with injection drug user 65 1 455 1Sex with person with hemophilia 0 0 6 0Sex with HIV-infected transfusion recipient 4 0 18 0Sex with HIV-infected person risk factor not specified 513 7 2484 7

Receipt of blood transfusion blood components or tissue 11 0 55 0Otherrisk factor not reported or identified 1475 20 6977 21

Total 7474 100 33453 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 41

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderMale-to-male sexual contact 402 70 1006 63Injection drug use 17 3 55 3Male-to-male sexual contact and injection drug use 15 3 38 2Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 25 4 96 6

Sex with injection drug user 3 1 10 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 22 4 83 5

Receipt of blood transfusion blood components or tissue 4 1 7 0Otherrisk factor not reported or identified 109 19 397 25

Total 572 100 1600 100

American IndianAlaska NativeMale-to-male sexual contact 104 61 516 57Injection drug use 13 8 101 11Male-to-male sexual contact and injection drug use 19 11 110 12Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 10 6 53 6

Sex with injection drug user 2 1 14 2Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 8 5 39 4

Receipt of blood transfusion blood components or tissue 0 0 2 0Otherrisk factor not reported or identified 24 14 125 14

Total 170 100 907 100

Total casesMale-to-male sexual contact 22912 59 103679 52Injection drug use 3503 9 24255 12Male-to-male sexual contact and injection drug use 1946 5 10704 5Hemophiliacoagulation disorder 43 0 495 0High-risk heterosexual contactb 2874 7 16830 8

Sex with injection drug user 308 1 2601 1Sex with person with hemophilia 4 0 31 0Sex with HIV-infected transfusion recipient 13 0 131 0Sex with HIV-infected person risk factor not specified 2549 7 14067 7

Receipt of blood transfusion blood components or tissue 61 0 489 0Otherrisk factor not reported or identified 7748 20 44021 22

Total 39087c 100 200473d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 1838 males of unknown race or multiple races

42 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race

ethnicity 2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 482 28 14981 40Hemophiliacoagulation disorder 4 0 123 0High-risk heterosexual contactb 725 42 15799 42

Sex with injection drug user 153 9 5650 15Sex with bisexual male 63 4 1859 5Sex with person with hemophilia 5 0 329 1Sex with HIV-infected transfusion recipient 5 0 338 1Sex with HIV-infected person risk factor not specified 499 29 7623 20

Receipt of blood transfusion blood components or tissue 15 1 1870 5Otherrisk factor not reported or identified 499 29 4801 13

Total 1725 100 37574 100

Black not HispanicInjection drug use 982 15 38914 34Hemophiliacoagulation disorder 3 0 145 0High-risk heterosexual contactb 3103 46 49876 44

Sex with injection drug user 373 6 13530 12Sex with bisexual male 136 2 2352 2Sex with person with hemophilia 4 0 121 0Sex with HIV-infected transfusion recipient 8 0 277 0Sex with HIV-infected person risk factor not specified 2582 38 33596 29

Receipt of blood transfusion blood components or tissue 39 1 1546 1Otherrisk factor not reported or identified 2612 39 23894 21

Total 6739 100 114375 100

HispanicInjection drug use 322 18 12892 35Hemophiliacoagulation disorder 4 0 67 0High-risk heterosexual contactb 894 49 17995 49

Sex with injection drug user 166 9 6522 18Sex with bisexual male 32 2 818 2Sex with person with hemophilia 1 0 45 0Sex with HIV-infected transfusion recipient 7 0 141 0Sex with HIV-infected person risk factor not specified 688 38 10469 29

Receipt of blood transfusion blood components or tissue 12 1 619 2Otherrisk factor not reported or identified 592 32 5023 14

Total 1824 100 36596 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 43

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 8 8 125 12Hemophiliacoagulation disorder 0 0 7 1High-risk heterosexual contactb 49 47 574 53

Sex with injection drug user 4 4 114 11Sex with bisexual male 2 2 80 7Sex with person with hemophilia 0 0 4 0Sex with HIV-infected transfusion recipient 1 1 25 2Sex with HIV-infected person risk factor not specified 42 40 351 33

Receipt of blood transfusion blood components or tissue 1 1 93 9Otherrisk factor not reported or identified 46 44 279 26

Total 104 100 1078 100

American IndianAlaska NativeInjection drug use 13 32 280 42Hemophiliacoagulation disorder 0 0 3 0High-risk heterosexual contactb 15 37 277 41

Sex with injection drug user 4 10 107 16Sex with bisexual male 1 2 27 4Sex with person with hemophilia 0 0 2 0Sex with HIV-infected transfusion recipient 0 0 6 1Sex with HIV-infected person risk factor not specified 10 24 135 20

Receipt of blood transfusion blood components or tissue 1 2 17 3Otherrisk factor not reported or identified 12 29 95 14

Total 41 100 672 100

Total casesInjection drug use 1826 17 67693 35Hemophiliacoagulation disorder 11 0 348 0High-risk heterosexual contactb 4839 46 85186 44

Sex with injection drug user 706 7 26073 14Sex with bisexual male 234 2 5162 3Sex with person with hemophilia 11 0 502 0Sex with HIV-infected transfusion recipient 21 0 793 0Sex with HIV-infected person risk factor not specified 3867 37 52656 27

Receipt of blood transfusion blood components or tissue 68 1 4176 2Otherrisk factor not reported or identified 3793 36 34311 18

Total 10537c 100 191714d 100a From the beginning of the epidemic through 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 104 females of unknown race or multiple racesd Includes 1419 females of unknown race or multiple races

44 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 690 26 4260 26Hemophiliacoagulation disorder 3 0 24 0

bHigh-risk heterosexual contact 1132 42 7593 46Sex with injection drug user 205 8 1876 11Sex with bisexual male 98 4 659 4Sex with person with hemophilia 10 0 115 1Sex with HIV-infected transfusion recipient 7 0 64 0Sex with HIV-infected person risk factor not specified 812 30 4879 29

Receipt of blood transfusion blood components or tissue 12 0 146 1Otherrisk factor not reported or identified 850 32 4567 28

Total 2687 100 16590 100

Black not HispanicInjection drug use 1034 13 7105 14Hemophiliacoagulation disorder 1 0 35 0

bHigh-risk heterosexual contact 3451 44 23732 46Sex with injection drug user 313 4 3473 7Sex with bisexual male 155 2 1294 3Sex with person with hemophilia 5 0 71 0Sex with HIV-infected transfusion recipient 14 0 120 0Sex with HIV-infected person risk factor not specified 2964 38 18774 36

Receipt of blood transfusion blood components or tissue 26 0 324 1Otherrisk factor not reported or identified 3370 43 20244 39

Total 7882 100 51440 100

HispanicInjection drug use 339 15 2280 18Hemophiliacoagulation disorder 2 0 11 0

bHigh-risk heterosexual contact 1198 52 6264 50Sex with injection drug user 218 9 1324 11Sex with bisexual male 62 3 266 2Sex with person with hemophilia 1 0 11 0Sex with HIV-infected transfusion recipient 7 0 39 0Sex with HIV-infected person risk factor not specified 910 39 4624 37

Receipt of blood transfusion blood components or tissue 12 1 58 0Otherrisk factor not reported or identified 767 33 3843 31

Total 2318 100 12456 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 45

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 31: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

MSA (population gt 500000)

Akron Ohio 66 94 32 46 762 1 763

AlbanyndashSchenectadyndashTroy NY 97 114 105 123 2253 24 2277

Albuquerque N Mex 70 88 50 61 1404 2 1406

AllentownndashBethlehemndashEaston PandashNJ 72 91 119 149 1352 17 1369

AtlantandashSandy SpringsndashMarietta Ga 1586 319 1006 196 21896 128 22024

AugustandashRichmond County GandashSC 106 205 32 61 1851 24 1875

AustinndashRound Rock Tex 227 156 186 123 4830 26 4856

Bakersfield Calif 76 100 122 156 1528 8 1536

BaltimorendashTowson Md 1064 401 1001 377 20352 218 20570

Baton Rouge La 222 304 231 301 3732 20 3752

BirminghamndashHoover Ala 151 139 110 100 2614 25 2639

Boise CityndashNampa Idaho 14 26 14 25 281 0 281

Boston MassndashNHa 441 99 355 80 13476 147 13623

Boston Division 269 146 185 101 8451 91 8542

Cambridge Division 108 74 102 70 3126 35 3161

Essex Division 52 71 51 69 1577 20 1597

BridgeportndashStamfordndashNorwalk Conn 181 201 135 150 3733 57 3790

BuffalondashNiagara Falls NY 117 102 96 84 2476 20 2496

Cape CoralndashFort Myers Fla 44 81 91 159 1692 24 1716

CharlestonndashNorth Charleston SC 92 155 91 151 2034 18 2052

CharlottendashGastoniandashConcord NCndashSC 214 141 285 180 3242 22 3264

Chicago IllndashIndndashWis 1716 182 1159 122 30118 261 30379

Chicago Division 1604 203 1073 135 28300 248 28548

Gary Division 61 88 50 71 1038 8 1046

Lake Division 51 59 36 41 780 5 785

CincinnatindashMiddletown OhiondashKyndashInd 111 53 199 95 2735 17 2752

ClevelandndashElyriandashMentor Ohio 228 107 170 80 4226 48 4274

Colorado Springs Colo 19 32 21 35 576 5 581

Columbia SC 177 256 197 280 3274 24 3298

Columbus Ohio 166 97 165 96 3112 15 3127

Dallas Tex 874 150 929 155 20238 63 20301

Dallas Division 681 175 714 178 16038 37 16075

Fort Worth Division 193 100 215 108 4200 26 4226

Dayton Ohio 58 69 54 64 1217 15 1232

DenverndashAurora Colo 274 116 236 98 6899 22 6921

Des Moines Iowa 30 57 23 43 530 4 534

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 31

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Detroit Mich 570 127 445 100 10373 73 10446

Detroit Division 443 223 330 167 8268 57 8325

Warren Division 127 51 115 46 2105 16 2121

El Paso Tex 56 78 40 54 1476 10 1486

Fresno Calif 52 59 64 72 1430 11 1441

Grand RapidsndashWyoming Mich 46 60 51 66 816 6 822

GreensborondashHigh Point NC 52 77 66 96 1265 14 1279

Greenville SC 70 119 67 111 1292 4 1296

HarrisburgndashCarlisle Pa 23 44 67 128 1224 8 1232

HartfordndashWest HartfordndashEast Hartford Conn 256 216 135 114 5126 46 5172

Honolulu Hawaii 54 60 69 76 2121 14 2135

HoustonndashBaytownndashSugar Land Tex 1017 190 1092 197 25821 172 25993

Indianapolis Ind 191 116 150 90 3824 25 3849

Jackson Miss 134 257 117 221 2419 30 2449

Jacksonville Fla 309 248 315 246 6020 75 6095

Kansas City MondashKans 183 94 160 81 4669 15 4684

Knoxville Tenn 47 72 35 52 882 5 887

Lakeland Fla 103 190 112 199 1811 21 1832

Las VegasndashParadise Nev 245 143 258 145 4616 28 4644

Little RockndashNorth Little Rock Ark 87 135 75 115 1383 14 1397

Los Angeles Calif 1529 118 1684 130 57953 293 58246

Los Angeles Division 1339 135 1435 144 51098 250 51348

Santa Anna Division 190 63 249 83 6855 43 6898

Louisville KyndashInd 123 102 97 79 2286 22 2308

Madison Wis 10 19 29 53 520 4 524

McAllenndashEdinburgndashPharr Tex 57 84 45 64 630 11 641

Memphis TennndashMissndashArk 402 320 346 271 5128 19 5147

Miami Fla 2420 446 2289 419 55807 997 56804

Fort Lauderdale Division 810 455 769 430 16412 262 16674

Miami Division 1243 523 1165 485 29703 512 30215

West Palm Beach Division 367 290 355 279 9692 223 9915

MilwaukeendashWaukeshandashWest Allis Wis 68 45 109 72 2507 18 2525

MinneapolisndashSt PaulndashBloomington MinnndashWis 186 59 184 58 4259 22 4281

Modesto Calif 36 71 22 43 671 6 677

NashvillendashDavidsonndashMurfreesboro Tenn 224 158 172 118 3848 20 3868

New HavenndashMilford Conn 169 200 107 127 4573 73 4646

New OrleansndashMetairiendashKenner La 393 299 271 264 8835 67 8902

32 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

New York NYndashNJndashPa 6215 330 5500 292 195177 2906 198083

Edison Division 191 83 130 56 6709 139 6848

Nassau Division 262 93 246 88 8141 110 8251

New York Division 5266 456 4716 408 160408 2323 162731

Newark Division 496 231 408 190 19919 334 20253

Oklahoma City Okla 125 108 88 75 2255 5 2260

OmahandashCouncil Bluffs NebndashIowa 37 46 80 97 1035 3 1038

Orlando Fla 544 282 517 260 8653 92 8745

OxnardndashThousand OaksndashVentura Calif 49 62 21 26 1008 3 1011

Palm BayndashMelbournendashTitusville Fla 68 129 61 114 1512 11 1523

Philadelphia PandashNJndashDelndashMd 1261 217 1348 231 28221 313 28534

Camden Division 108 87 111 89 3118 42 3160

Philadelphia Division 1022 263 1144 294 22112 250 22362

Wilmington Division 131 191 93 134 2991 21 3012

PhoenixndashMesandashScottsdale Ariz 460 119 376 93 7459 31 7490

Pittsburgh Pa 143 60 135 57 3182 19 3201

PortlandndashSouth Portland Maine 9 18 34 66 562 1 563

PortlandndashVancouverndashBeaverton OrendashWash 170 81 215 101 4825 10 4835

PoughkeepsiendashNewburghndashMiddletown NY 136 204 113 168 3162 24 3186

ProvidencendashNew BedfordndashFall River RIndashMass 132 82 155 96 3900 44 3944

RaleighndashCary NC 138 145 201 202 1987 13 2000

Richmond Va 119 101 122 102 3371 35 3406

RiversidendashSan BernardinondashOntario Calif 361 92 306 76 8568 60 8628

Rochester NY 165 159 124 120 3134 13 3147

SacramentondashArden-ArcadendashRoseville Calif 154 75 169 82 4000 26 4026

St Louis MondashIll 192 69 366 131 5965 40 6005

Salt Lake City Utah 46 44 40 37 1743 10 1753

San Antonio Tex 215 114 247 127 4987 30 5017

San DiegondashCarlsbadndashSan Marcos Calif 491 167 384 131 12934 61 12995

San Francisco Calif 867 209 690 165 40152 96 40248

Oakland Division 312 126 246 99 9546 48 9594

San Francisco Division 555 329 444 261 30606 48 30654

San JosendashSunnyvalendashSanta Clara Calif 88 50 145 81 3747 15 3762

San JuanndashCaguasndashGuaynabo PR 745 289 578 223 21402 277 21679

SarasotandashBradentonndashVenice Fla 82 122 104 152 1978 27 2005

ScrantonndashWilkes-Barre Pa 27 49 47 85 572 6 578

Seattle Wash 353 110 280 86 9172 27 9199

Seattle Division 316 129 255 102 8161 18 8179

Tacoma Division 37 49 25 33 1011 9 1020

Springfield Mass 88 128 45 66 2075 26 2101

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 33

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Stockton Calif 52 78 52 77 1076 15 1091

Syracuse NY 52 80 49 75 1317 8 1325

TampandashSt PetersburgndashClearwater Fla 559 211 605 224 11174 112 11286

Toledo Ohio 25 38 66 101 812 14 826

Tucson Ariz 103 111 100 106 2010 10 2020

Tulsa Okla 83 94 65 72 1494 10 1504

Virginia BeachndashNorfolkndashNewport News VandashNC 183 111 132 80 4711 63 4774

Washington DCndashVandashMdndashWV 1322 252 1684 318 31130 315 31445

Bethesda Division 135 118 173 150 2774 23 2797

Washington Division 1187 289 1511 365 28356 292 28648

Wichita Kans 35 60 38 64 851 2 853

Worcester Mass 76 97 79 101 1783 20 1803

YoungstownndashWarrenndashBoardman OhiondashPa 27 46 26 44 519 0 519

Subtotal for MSAs (population gt500000) 33602 173 31274 159 829633 8171 837804

Metropolitan areas (population of 50000 to 499999) 4477 80 4466 79 94829 847 95676

Nonmetropolitan areas 2666 54 2732 55 52063 445 52508

Totalb 41144 137 38749 128 981708 9494 991202

Note Because of the lack of census information for all US dependent areas includes data for only the 50 states the District of Columbia and Puerto RicoMSA metropolitan statistical areaMSA definitions for this report can be found at httpwwwcensusgovpopulationwwwestimatesmetrodefhtmla Reported case counts for the metropolitan divisions do not sum to the MSA total MSA total includes data from 1 metropolitan division with

population of lt500000b Includes persons whose county of residence is unknown

34 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Alabama (January 1988) 502 6041 48 6089

Alaska (February 1999) 38 285 2 287

Arizona (January 1987) 617 5877 80 5957

Arkansas (July 1989) 206 2349 20 2369

California (April 2006) 6581 7056 92 7148

Colorado (November 1985) 319 6084 31 6115

Connecticut (January 2005)b 826 2500 101 2601

Delaware (February 2006) 788 801 18 819

Florida (July 1997)c 4163 36386 397 36783

Georgia (December 2003) 2245 8197 194 8391

Idaho (June 1986) 35 340 4 344

Illinois (January 2006) 6241 6661 162 6823

Indiana (July 1988) 399 4027 43 4070

Iowa (July 1998) 69 586 5 591

Kansas (July 1999) 142 1225 15 1240

Kentucky (October 2004) 333 1303 13 1316

Louisiana (February 1993) 728 8149 166 8315

Maine (January 2006) 386 393 3 396

Michigan (April 1992) 635 6702 134 6836

Minnesota (October 1985) 309 3356 40 3396

Mississippi (August 1988) 352 4549 59 4608

Missouri (October 1987) 502 5086 55 5141

Nebraska (September 1995) 91 672 14 686

Nevada (February 1992) 339 3532 24 3556

New Hampshire (January 2005) 59 466 9 475

New Jersey (January 1992) 1477 17513 325 17838

New Mexico (January 1998) 114 949 4 953

New York (June 2000) 5326 42345 1820 44165

North Carolina (February 1990) 1615 13879 143 14022

North Dakota (January 1988) 4 82 1 83

Ohio (June 1990) 867 8222 101 8323

Oklahoma (June 1988) 229 2401 30 2431

Oregon (April 2006) 49 95 19 114

Pennsylvania (October 2002)d 4269 9537 179 9716

Rhode Island (July 2006) 14 21 0 21

South Carolina (February 1986) 493 6970 93 7063

South Dakota (January 1988) 18 215 6 221

Tennessee (January 1992) 732 7115 90 7205

Texas (January 1999)e 3370 24282 417 24699

Utah (April 1989) 106 893 14 907

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 35

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Virginia (July 1989) 864 10257 95 10352

Washington (March 2006) 4048 4157 40 4197

West Virginia (January 1989) 66 673 8 681

Wisconsin (November 1985) 261 2500 31 2531

Wyoming (June 1989) 7 93 1 94

Subtotal 50834 274822 5146 279968

US dependent areas

American Samoa (August 2001) 0 1 0 1

Guam (March 2000) 2 66 0 66

Northern Mariana Islands (October 2001) 2 7 0 7

Puerto Rico (January 2003) 1471 5610 91 5701

US Virgin Islands (December 1998) 22 247 6 253

Persons reported from areas with confidential name-based HIV infection reporting but who were residents of other areas 132 685 21 706

Totalf 52878 282640 5314 287954

Note Includes data from 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through 2006b Beginning in 1992 Connecticut had name-based HIV reporting for cases in children only From January 2002 through December 2004

Connecticut had name- or code-based HIV reporting for cases in adolescents and adults As of January 2005 Connecticut has name-based reporting of all cases of HIV infection

c Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterd On October 18 2002 Pennsylvania initiated confidential name-based HIV infection reporting in all areas except Philadelphia Code-based

reporting was implemented in Philadelphia in March 2004 and the switch to name-based reporting was made in October 2005e From February 1994 through December 1998 Texas reported HIV infection in children onlyf Includes 1252 persons reported from areas with confidential name-based HIV infection reporting but whose area of residence is unknown

36 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulativemdashUnited States and dependent areas

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No Adult or adolescentMale-to-male sexual contact 13775 49 429897 54 mdash mdash mdash mdash 13775 35 429897 44Injection drug use 3413 12 163070 21 1826 17 67693 35 5239 13 230763 23Male-to-male sexual contact and

injection drug use 1603 6 65524 8 mdash mdash mdash mdash 1603 4 65524 7Hemophiliacoagulation disorder 43 0 5176 1 11 0 348 0 54 0 5524 1High-risk heterosexual contactc 2997 11 49610 6 4839 46 85186 44 7836 20 134796 14

Sex with injection drug user 330 1 11683 1 706 7 26073 14 1036 3 37756 4Sex with bisexual male mdash mdash mdash mdash 234 2 5162 3 234 1 5162 1Sex with person with hemophilia 1 0 84 0 11 0 502 0 12 0 586 0Sex with HIV-infected transfusion

recipient 22 0 553 0 21 0 793 0 43 0 1346 0Sex with HIV-infected person risk

factor not specified 2644 9 37290 5 3867 37 52656 27 6511 17 89946 9Receipt of blood transfusion blood

d components or tissue 63 0 5213 1 68 1 4176 2 131 0 9389 1Otherrisk factor not reported or

identifiede 6484 23 73136 9 3793 36 34311 18 10278 26 107450 11Subtotal 28378 100 791626 100 10537 100 191714 100 38916 100 983343 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 0 0 222 5 0 0 7 0 0 0 229 2Mother with documented HIV infection or

1 of the following risk factors 24 75 4315 89 50 93 4423 95 74 86 8738 92Injection drug use 4 13 1676 35 4 7 1665 36 8 9 3341 35Sex with injection drug user 4 13 789 16 4 7 750 16 8 9 1539 16Sex with bisexual male 1 3 101 2 2 4 110 2 3 3 211 2Sex with person with hemophilia 0 0 20 0 0 0 16 0 0 0 36 0Sex with HIV-infected transfusion

recipient 0 0 11 0 0 0 15 0 0 0 26 0Sex with HIV-infected person risk

factor not specified 6 19 742 15 17 31 790 17 23 27 1532 16Receipt of blood transfusion blood

components or tissue 0 0 70 1 0 0 82 2 0 0 152 2Has HIV infection risk factor not

specified 9 28 906 19 23 43 995 21 32 37 1901 20Receipt of blood transfusion blood

fcomponents or tissue 1 3 243 5 0 0 144 3 1 1 387 4Otherrisk factor not reported or

identifiedg 7 22 75 2 4 7 93 2 11 13 168 2Subtotal 32 100 4855 100 54 100 4667 100 86 100 9522 100

Total 28410 100 796481 100 10591 100 196381 100 39002 100 992865 100a From the beginning of the epidemic through 2006b From the beginning of the epidemic through 2006 Includes 3 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infectiond AIDS developed in 47 adultsadolescents after they received blood that had tested negative for HIV antibodies AIDS developed in 14 additional adults

after they received tissue organs or artificial insemination from HIV-infected donors Four of the 14 received tissue or organs from a donor who was negative for HIV antibody at the time of donation

e Includes 37 adultsadolescents who were exposed to HIV-infected blood body fluids or concentrated virus in health care laboratory or household settings as supported by seroconversion epidemiologic andor laboratory evidence One person was infected after intentional inoculation with HIV-infected blood Includes an additional 740 persons who acquired HIV infection perinatally but who were more than 12 years of age when AIDS was diagnosed These 740 persons are not counted in the values for the pediatric transmission category

f AIDS developed in 3 children after they received blood that had tested negative for HIV antibodiesg Includes 5 children who were exposed to HIV-infected blood as supported by seroconversion epidemiologic andor laboratory evidence 1 child was

infected after intentional inoculation with HIV-infected blood and 5 children were exposed to HIV-infected blood in a household setting Of the 168 children 26 had sexual contact with an adult with or at high risk for HIV infection

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 37

Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No

Adult or adolescentMale-to-male sexual contact 22912 59 103679 52 mdash mdash mdash mdash 22912 44 103679 37

Injection drug use 3503 9 24255 12 2124 16 13925 17 5627 11 38181 14

Male-to-male sexual contact and injection drug use 1946 5 10704 5 mdash mdash mdash mdash 1946 4 10704 4

Hemophiliacoagulation disorder 43 0 495 0 6 0 73 0 49 0 568 0

High-risk heterosexual contactc 2874 7 16830 8 5939 45 38315 47 8813 17 55145 20

Sex with injection drug user 308 1 2601 1 757 6 6791 8 1065 2 9392 3

Sex with bisexual male mdash mdash mdash mdash 328 2 2265 3 328 1 2265 1

Sex with person with hemophilia 4 0 31 0 16 0 201 0 20 0 232 0

Sex with HIV-infected transfusion recipient 13 0 131 0 28 0 223 0 41 0 354 0

Sex with HIV-infected person risk factor not specified 2549 7 14067 7 4810 36 28835 35 7359 14 42902 15

Receipt of blood transfusion blood components or tissue 61 0 489 0 50 0 536 1 111 0 1025 0

Otherrisk factor not reported or identified 7748 20 44021 22 5106 39 29312 36 12854 25 73338 26

Subtotal 39087 100 200473 100 13225 100 82161 100 52312 100 282640 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 8 3 106 4 0 0 1 0 8 1 107 2

Mother with documented HIV infection or 1 of the following risk factors 197 74 2195 85 254 85 2417 89 451 80 4612 87

Injection drug use 34 13 532 21 53 18 561 21 87 15 1093 21

Sex with injection drug user 12 5 208 8 21 7 213 8 33 6 421 8

Sex with bisexual male 5 2 37 1 4 1 32 1 9 2 69 1

Sex with person with hemophilia 0 0 3 0 1 0 7 0 1 0 10 0

Sex with HIV-infected transfusion recipient 0 0 4 0 0 0 4 0 0 0 8 0

Sex with HIV-infected person risk factor not specified 54 20 534 21 76 25 629 23 130 23 1163 22

Receipt of blood transfusion blood components or tissue 0 0 17 1 2 1 20 1 2 0 37 1

Has HIV infection risk factor not specified 92 35 860 33 97 32 951 35 189 33 1811 34

Receipt of blood transfusion blood components or tissue 6 2 28 1 3 1 24 1 9 2 52 1

Otherrisk factor not reported or identified 55 21 260 10 43 14 283 10 98 17 543 10

Subtotal 266 100 2589 100 300 100 2725 100 566 100 5314 100

Total 39353 100 203062 100 13525 100 84886 100 52878 100 287954 100

Note See Table 16 for the list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006b From the beginning of the epidemic through December 2006 Includes 6 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infection

38 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity

2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 6251 65 253927 73Injection drug use 733 8 31737 9Male-to-male sexual contact and injection drug use 732 8 31434 9Hemophiliacoagulation disorder 26 0 3989 1High-risk heterosexual contactb 416 4 7850 2

Sex with injection drug user 74 1 2310 1

Sex with person with hemophilia 0 0 36 0

Sex with HIV-infected transfusion recipient 2 0 176 0

Sex with HIV-infected person risk factor not specified 340 4 5328 2Receipt of blood transfusion blood components or tissue 20 0 3194 1Otherrisk factor not reported or identified 1400 15 16469 5

Total 9578 100 348600 100

Black not HispanicMale-to-male sexual contact 4309 36 103297 37Injection drug use 1635 14 83369 30Male-to-male sexual contact and injection drug use 526 4 22134 8Hemophiliacoagulation disorder 10 0 604 0High-risk heterosexual contactb 1875 16 29952 11

Sex with injection drug user 167 1 6823 2Sex with person with hemophilia 1 0 36 0Sex with HIV-infected transfusion recipient 15 0 237 0Sex with HIV-infected person risk factor not specified 1692 14 22856 8

Receipt of blood transfusion blood components or tissue 24 0 1218 0Otherrisk factor not reported or identified 3579 30 40268 14

Total 11958 100 280842 100

HispanicMale-to-male sexual contact 2816 47 64893 44Injection drug use 965 16 46337 31Male-to-male sexual contact and injection drug use 287 5 10884 7Hemophiliacoagulation disorder 6 0 466 0High-risk heterosexual contactb 638 11 10950 7

Sex with injection drug user 84 1 2409 2Sex with person with hemophilia 0 0 11 0Sex with HIV-infected transfusion recipient 5 0 125 0Sex with HIV-infected person risk factor not specified 549 9 8405 6

Receipt of blood transfusion blood components or tissue 17 0 657 0Otherrisk factor not reported or identified 1326 22 14832 10

Total 6055 100 149019 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 39

a

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulative

No No

AsianPacific IslanderMale-to-male sexual contact 225 54 4475 68Injection drug use 20 5 317 5Male-to-male sexual contact and injection drug use 17 4 284 4Hemophiliacoagulation disorder 1 0 70 1High-risk heterosexual contactb 34 8 376 6

Sex with injection drug user 1 0 54 1Sex with person with hemophilia 0 0 1 0Sex with HIV-infected transfusion recipient 0 0 8 0Sex with HIV-infected person risk factor not specified 33 8 313 5

Receipt of blood transfusion blood components or tissue 2 0 112 2Otherrisk factor not reported or identified 114 28 949 14

Total 413 100 6583 100

American IndianAlaska NativeMale-to-male sexual contact 61 49 1403 55Injection drug use 15 12 395 15Male-to-male sexual contact and injection drug use 23 19 457 18Hemophiliacoagulation disorder 0 0 27 1High-risk heterosexual contactb 9 7 118 5

Sex with injection drug user 1 1 33 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 8 6 82 3

Receipt of blood transfusion blood components or tissue 0 0 8 0Otherrisk factor not reported or identified 16 13 155 6

Total 124 100 2563 100

Total casesMale-to-male sexual contact 13775 49 429897 54Injection drug use 3413 12 163070 21Male-to-male sexual contact and injection drug use 1603 6 65524 8Hemophiliacoagulation disorder 43 0 5176 1High-risk heterosexual contactb 2997 11 49610 6

Sex with injection drug user 330 1 11683 1Sex with person with hemophilia 1 0 84 0Sex with HIV-infected transfusion recipient 22 0 553 0Sex with HIV-infected person risk factor not specified 2644 9 37290 5

Receipt of blood transfusion blood components or tissue 63 0 5213 1Otherrisk factor not reported or identified 6484 23 73136 9

Total 28378c 100 791626d 100a From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 4019 males of unknown race or multiple races

40 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 11963 73 55725 69Injection drug use 858 5 5512 7Male-to-male sexual contact and injection drug use 1092 7 5578 7Hemophiliacoagulation disorder 29 0 355 0High-risk heterosexual contactb 522 3 2658 3

Sex with injection drug user 65 0 544 1Sex with person with hemophilia 0 0 8 0Sex with HIV-infected transfusion recipient 3 0 33 0Sex with HIV-infected person risk factor not specified 454 3 2073 3

Receipt of blood transfusion blood components or tissue 14 0 197 0Otherrisk factor not reported or identified 1956 12 11147 14

Total 16434 100 81172 100

Black not HispanicMale-to-male sexual contact 6203 44 30148 37Injection drug use 1594 11 11997 15Male-to-male sexual contact and injection drug use 483 3 3489 4Hemophiliacoagulation disorder 10 0 109 0High-risk heterosexual contactb 1714 12 10905 13

Sex with injection drug user 169 1 1554 2Sex with person with hemophilia 4 0 17 0Sex with HIV-infected transfusion recipient 6 0 77 0Sex with HIV-infected person risk factor not specified 1535 11 9257 11

Receipt of blood transfusion blood components or tissue 32 0 223 0Otherrisk factor not reported or identified 4151 29 24632 30

Total 14187 100 81503 100

HispanicMale-to-male sexual contact 4094 55 15623 47Injection drug use 993 13 6407 19Male-to-male sexual contact and injection drug use 316 4 1402 4Hemophiliacoagulation disorder 3 0 26 0High-risk heterosexual contactb 582 8 2963 9

Sex with injection drug user 65 1 455 1Sex with person with hemophilia 0 0 6 0Sex with HIV-infected transfusion recipient 4 0 18 0Sex with HIV-infected person risk factor not specified 513 7 2484 7

Receipt of blood transfusion blood components or tissue 11 0 55 0Otherrisk factor not reported or identified 1475 20 6977 21

Total 7474 100 33453 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 41

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderMale-to-male sexual contact 402 70 1006 63Injection drug use 17 3 55 3Male-to-male sexual contact and injection drug use 15 3 38 2Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 25 4 96 6

Sex with injection drug user 3 1 10 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 22 4 83 5

Receipt of blood transfusion blood components or tissue 4 1 7 0Otherrisk factor not reported or identified 109 19 397 25

Total 572 100 1600 100

American IndianAlaska NativeMale-to-male sexual contact 104 61 516 57Injection drug use 13 8 101 11Male-to-male sexual contact and injection drug use 19 11 110 12Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 10 6 53 6

Sex with injection drug user 2 1 14 2Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 8 5 39 4

Receipt of blood transfusion blood components or tissue 0 0 2 0Otherrisk factor not reported or identified 24 14 125 14

Total 170 100 907 100

Total casesMale-to-male sexual contact 22912 59 103679 52Injection drug use 3503 9 24255 12Male-to-male sexual contact and injection drug use 1946 5 10704 5Hemophiliacoagulation disorder 43 0 495 0High-risk heterosexual contactb 2874 7 16830 8

Sex with injection drug user 308 1 2601 1Sex with person with hemophilia 4 0 31 0Sex with HIV-infected transfusion recipient 13 0 131 0Sex with HIV-infected person risk factor not specified 2549 7 14067 7

Receipt of blood transfusion blood components or tissue 61 0 489 0Otherrisk factor not reported or identified 7748 20 44021 22

Total 39087c 100 200473d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 1838 males of unknown race or multiple races

42 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race

ethnicity 2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 482 28 14981 40Hemophiliacoagulation disorder 4 0 123 0High-risk heterosexual contactb 725 42 15799 42

Sex with injection drug user 153 9 5650 15Sex with bisexual male 63 4 1859 5Sex with person with hemophilia 5 0 329 1Sex with HIV-infected transfusion recipient 5 0 338 1Sex with HIV-infected person risk factor not specified 499 29 7623 20

Receipt of blood transfusion blood components or tissue 15 1 1870 5Otherrisk factor not reported or identified 499 29 4801 13

Total 1725 100 37574 100

Black not HispanicInjection drug use 982 15 38914 34Hemophiliacoagulation disorder 3 0 145 0High-risk heterosexual contactb 3103 46 49876 44

Sex with injection drug user 373 6 13530 12Sex with bisexual male 136 2 2352 2Sex with person with hemophilia 4 0 121 0Sex with HIV-infected transfusion recipient 8 0 277 0Sex with HIV-infected person risk factor not specified 2582 38 33596 29

Receipt of blood transfusion blood components or tissue 39 1 1546 1Otherrisk factor not reported or identified 2612 39 23894 21

Total 6739 100 114375 100

HispanicInjection drug use 322 18 12892 35Hemophiliacoagulation disorder 4 0 67 0High-risk heterosexual contactb 894 49 17995 49

Sex with injection drug user 166 9 6522 18Sex with bisexual male 32 2 818 2Sex with person with hemophilia 1 0 45 0Sex with HIV-infected transfusion recipient 7 0 141 0Sex with HIV-infected person risk factor not specified 688 38 10469 29

Receipt of blood transfusion blood components or tissue 12 1 619 2Otherrisk factor not reported or identified 592 32 5023 14

Total 1824 100 36596 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 43

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 8 8 125 12Hemophiliacoagulation disorder 0 0 7 1High-risk heterosexual contactb 49 47 574 53

Sex with injection drug user 4 4 114 11Sex with bisexual male 2 2 80 7Sex with person with hemophilia 0 0 4 0Sex with HIV-infected transfusion recipient 1 1 25 2Sex with HIV-infected person risk factor not specified 42 40 351 33

Receipt of blood transfusion blood components or tissue 1 1 93 9Otherrisk factor not reported or identified 46 44 279 26

Total 104 100 1078 100

American IndianAlaska NativeInjection drug use 13 32 280 42Hemophiliacoagulation disorder 0 0 3 0High-risk heterosexual contactb 15 37 277 41

Sex with injection drug user 4 10 107 16Sex with bisexual male 1 2 27 4Sex with person with hemophilia 0 0 2 0Sex with HIV-infected transfusion recipient 0 0 6 1Sex with HIV-infected person risk factor not specified 10 24 135 20

Receipt of blood transfusion blood components or tissue 1 2 17 3Otherrisk factor not reported or identified 12 29 95 14

Total 41 100 672 100

Total casesInjection drug use 1826 17 67693 35Hemophiliacoagulation disorder 11 0 348 0High-risk heterosexual contactb 4839 46 85186 44

Sex with injection drug user 706 7 26073 14Sex with bisexual male 234 2 5162 3Sex with person with hemophilia 11 0 502 0Sex with HIV-infected transfusion recipient 21 0 793 0Sex with HIV-infected person risk factor not specified 3867 37 52656 27

Receipt of blood transfusion blood components or tissue 68 1 4176 2Otherrisk factor not reported or identified 3793 36 34311 18

Total 10537c 100 191714d 100a From the beginning of the epidemic through 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 104 females of unknown race or multiple racesd Includes 1419 females of unknown race or multiple races

44 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 690 26 4260 26Hemophiliacoagulation disorder 3 0 24 0

bHigh-risk heterosexual contact 1132 42 7593 46Sex with injection drug user 205 8 1876 11Sex with bisexual male 98 4 659 4Sex with person with hemophilia 10 0 115 1Sex with HIV-infected transfusion recipient 7 0 64 0Sex with HIV-infected person risk factor not specified 812 30 4879 29

Receipt of blood transfusion blood components or tissue 12 0 146 1Otherrisk factor not reported or identified 850 32 4567 28

Total 2687 100 16590 100

Black not HispanicInjection drug use 1034 13 7105 14Hemophiliacoagulation disorder 1 0 35 0

bHigh-risk heterosexual contact 3451 44 23732 46Sex with injection drug user 313 4 3473 7Sex with bisexual male 155 2 1294 3Sex with person with hemophilia 5 0 71 0Sex with HIV-infected transfusion recipient 14 0 120 0Sex with HIV-infected person risk factor not specified 2964 38 18774 36

Receipt of blood transfusion blood components or tissue 26 0 324 1Otherrisk factor not reported or identified 3370 43 20244 39

Total 7882 100 51440 100

HispanicInjection drug use 339 15 2280 18Hemophiliacoagulation disorder 2 0 11 0

bHigh-risk heterosexual contact 1198 52 6264 50Sex with injection drug user 218 9 1324 11Sex with bisexual male 62 3 266 2Sex with person with hemophilia 1 0 11 0Sex with HIV-infected transfusion recipient 7 0 39 0Sex with HIV-infected person risk factor not specified 910 39 4624 37

Receipt of blood transfusion blood components or tissue 12 1 58 0Otherrisk factor not reported or identified 767 33 3843 31

Total 2318 100 12456 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 45

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 32: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Detroit Mich 570 127 445 100 10373 73 10446

Detroit Division 443 223 330 167 8268 57 8325

Warren Division 127 51 115 46 2105 16 2121

El Paso Tex 56 78 40 54 1476 10 1486

Fresno Calif 52 59 64 72 1430 11 1441

Grand RapidsndashWyoming Mich 46 60 51 66 816 6 822

GreensborondashHigh Point NC 52 77 66 96 1265 14 1279

Greenville SC 70 119 67 111 1292 4 1296

HarrisburgndashCarlisle Pa 23 44 67 128 1224 8 1232

HartfordndashWest HartfordndashEast Hartford Conn 256 216 135 114 5126 46 5172

Honolulu Hawaii 54 60 69 76 2121 14 2135

HoustonndashBaytownndashSugar Land Tex 1017 190 1092 197 25821 172 25993

Indianapolis Ind 191 116 150 90 3824 25 3849

Jackson Miss 134 257 117 221 2419 30 2449

Jacksonville Fla 309 248 315 246 6020 75 6095

Kansas City MondashKans 183 94 160 81 4669 15 4684

Knoxville Tenn 47 72 35 52 882 5 887

Lakeland Fla 103 190 112 199 1811 21 1832

Las VegasndashParadise Nev 245 143 258 145 4616 28 4644

Little RockndashNorth Little Rock Ark 87 135 75 115 1383 14 1397

Los Angeles Calif 1529 118 1684 130 57953 293 58246

Los Angeles Division 1339 135 1435 144 51098 250 51348

Santa Anna Division 190 63 249 83 6855 43 6898

Louisville KyndashInd 123 102 97 79 2286 22 2308

Madison Wis 10 19 29 53 520 4 524

McAllenndashEdinburgndashPharr Tex 57 84 45 64 630 11 641

Memphis TennndashMissndashArk 402 320 346 271 5128 19 5147

Miami Fla 2420 446 2289 419 55807 997 56804

Fort Lauderdale Division 810 455 769 430 16412 262 16674

Miami Division 1243 523 1165 485 29703 512 30215

West Palm Beach Division 367 290 355 279 9692 223 9915

MilwaukeendashWaukeshandashWest Allis Wis 68 45 109 72 2507 18 2525

MinneapolisndashSt PaulndashBloomington MinnndashWis 186 59 184 58 4259 22 4281

Modesto Calif 36 71 22 43 671 6 677

NashvillendashDavidsonndashMurfreesboro Tenn 224 158 172 118 3848 20 3868

New HavenndashMilford Conn 169 200 107 127 4573 73 4646

New OrleansndashMetairiendashKenner La 393 299 271 264 8835 67 8902

32 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

New York NYndashNJndashPa 6215 330 5500 292 195177 2906 198083

Edison Division 191 83 130 56 6709 139 6848

Nassau Division 262 93 246 88 8141 110 8251

New York Division 5266 456 4716 408 160408 2323 162731

Newark Division 496 231 408 190 19919 334 20253

Oklahoma City Okla 125 108 88 75 2255 5 2260

OmahandashCouncil Bluffs NebndashIowa 37 46 80 97 1035 3 1038

Orlando Fla 544 282 517 260 8653 92 8745

OxnardndashThousand OaksndashVentura Calif 49 62 21 26 1008 3 1011

Palm BayndashMelbournendashTitusville Fla 68 129 61 114 1512 11 1523

Philadelphia PandashNJndashDelndashMd 1261 217 1348 231 28221 313 28534

Camden Division 108 87 111 89 3118 42 3160

Philadelphia Division 1022 263 1144 294 22112 250 22362

Wilmington Division 131 191 93 134 2991 21 3012

PhoenixndashMesandashScottsdale Ariz 460 119 376 93 7459 31 7490

Pittsburgh Pa 143 60 135 57 3182 19 3201

PortlandndashSouth Portland Maine 9 18 34 66 562 1 563

PortlandndashVancouverndashBeaverton OrendashWash 170 81 215 101 4825 10 4835

PoughkeepsiendashNewburghndashMiddletown NY 136 204 113 168 3162 24 3186

ProvidencendashNew BedfordndashFall River RIndashMass 132 82 155 96 3900 44 3944

RaleighndashCary NC 138 145 201 202 1987 13 2000

Richmond Va 119 101 122 102 3371 35 3406

RiversidendashSan BernardinondashOntario Calif 361 92 306 76 8568 60 8628

Rochester NY 165 159 124 120 3134 13 3147

SacramentondashArden-ArcadendashRoseville Calif 154 75 169 82 4000 26 4026

St Louis MondashIll 192 69 366 131 5965 40 6005

Salt Lake City Utah 46 44 40 37 1743 10 1753

San Antonio Tex 215 114 247 127 4987 30 5017

San DiegondashCarlsbadndashSan Marcos Calif 491 167 384 131 12934 61 12995

San Francisco Calif 867 209 690 165 40152 96 40248

Oakland Division 312 126 246 99 9546 48 9594

San Francisco Division 555 329 444 261 30606 48 30654

San JosendashSunnyvalendashSanta Clara Calif 88 50 145 81 3747 15 3762

San JuanndashCaguasndashGuaynabo PR 745 289 578 223 21402 277 21679

SarasotandashBradentonndashVenice Fla 82 122 104 152 1978 27 2005

ScrantonndashWilkes-Barre Pa 27 49 47 85 572 6 578

Seattle Wash 353 110 280 86 9172 27 9199

Seattle Division 316 129 255 102 8161 18 8179

Tacoma Division 37 49 25 33 1011 9 1020

Springfield Mass 88 128 45 66 2075 26 2101

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 33

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Stockton Calif 52 78 52 77 1076 15 1091

Syracuse NY 52 80 49 75 1317 8 1325

TampandashSt PetersburgndashClearwater Fla 559 211 605 224 11174 112 11286

Toledo Ohio 25 38 66 101 812 14 826

Tucson Ariz 103 111 100 106 2010 10 2020

Tulsa Okla 83 94 65 72 1494 10 1504

Virginia BeachndashNorfolkndashNewport News VandashNC 183 111 132 80 4711 63 4774

Washington DCndashVandashMdndashWV 1322 252 1684 318 31130 315 31445

Bethesda Division 135 118 173 150 2774 23 2797

Washington Division 1187 289 1511 365 28356 292 28648

Wichita Kans 35 60 38 64 851 2 853

Worcester Mass 76 97 79 101 1783 20 1803

YoungstownndashWarrenndashBoardman OhiondashPa 27 46 26 44 519 0 519

Subtotal for MSAs (population gt500000) 33602 173 31274 159 829633 8171 837804

Metropolitan areas (population of 50000 to 499999) 4477 80 4466 79 94829 847 95676

Nonmetropolitan areas 2666 54 2732 55 52063 445 52508

Totalb 41144 137 38749 128 981708 9494 991202

Note Because of the lack of census information for all US dependent areas includes data for only the 50 states the District of Columbia and Puerto RicoMSA metropolitan statistical areaMSA definitions for this report can be found at httpwwwcensusgovpopulationwwwestimatesmetrodefhtmla Reported case counts for the metropolitan divisions do not sum to the MSA total MSA total includes data from 1 metropolitan division with

population of lt500000b Includes persons whose county of residence is unknown

34 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Alabama (January 1988) 502 6041 48 6089

Alaska (February 1999) 38 285 2 287

Arizona (January 1987) 617 5877 80 5957

Arkansas (July 1989) 206 2349 20 2369

California (April 2006) 6581 7056 92 7148

Colorado (November 1985) 319 6084 31 6115

Connecticut (January 2005)b 826 2500 101 2601

Delaware (February 2006) 788 801 18 819

Florida (July 1997)c 4163 36386 397 36783

Georgia (December 2003) 2245 8197 194 8391

Idaho (June 1986) 35 340 4 344

Illinois (January 2006) 6241 6661 162 6823

Indiana (July 1988) 399 4027 43 4070

Iowa (July 1998) 69 586 5 591

Kansas (July 1999) 142 1225 15 1240

Kentucky (October 2004) 333 1303 13 1316

Louisiana (February 1993) 728 8149 166 8315

Maine (January 2006) 386 393 3 396

Michigan (April 1992) 635 6702 134 6836

Minnesota (October 1985) 309 3356 40 3396

Mississippi (August 1988) 352 4549 59 4608

Missouri (October 1987) 502 5086 55 5141

Nebraska (September 1995) 91 672 14 686

Nevada (February 1992) 339 3532 24 3556

New Hampshire (January 2005) 59 466 9 475

New Jersey (January 1992) 1477 17513 325 17838

New Mexico (January 1998) 114 949 4 953

New York (June 2000) 5326 42345 1820 44165

North Carolina (February 1990) 1615 13879 143 14022

North Dakota (January 1988) 4 82 1 83

Ohio (June 1990) 867 8222 101 8323

Oklahoma (June 1988) 229 2401 30 2431

Oregon (April 2006) 49 95 19 114

Pennsylvania (October 2002)d 4269 9537 179 9716

Rhode Island (July 2006) 14 21 0 21

South Carolina (February 1986) 493 6970 93 7063

South Dakota (January 1988) 18 215 6 221

Tennessee (January 1992) 732 7115 90 7205

Texas (January 1999)e 3370 24282 417 24699

Utah (April 1989) 106 893 14 907

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 35

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Virginia (July 1989) 864 10257 95 10352

Washington (March 2006) 4048 4157 40 4197

West Virginia (January 1989) 66 673 8 681

Wisconsin (November 1985) 261 2500 31 2531

Wyoming (June 1989) 7 93 1 94

Subtotal 50834 274822 5146 279968

US dependent areas

American Samoa (August 2001) 0 1 0 1

Guam (March 2000) 2 66 0 66

Northern Mariana Islands (October 2001) 2 7 0 7

Puerto Rico (January 2003) 1471 5610 91 5701

US Virgin Islands (December 1998) 22 247 6 253

Persons reported from areas with confidential name-based HIV infection reporting but who were residents of other areas 132 685 21 706

Totalf 52878 282640 5314 287954

Note Includes data from 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through 2006b Beginning in 1992 Connecticut had name-based HIV reporting for cases in children only From January 2002 through December 2004

Connecticut had name- or code-based HIV reporting for cases in adolescents and adults As of January 2005 Connecticut has name-based reporting of all cases of HIV infection

c Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterd On October 18 2002 Pennsylvania initiated confidential name-based HIV infection reporting in all areas except Philadelphia Code-based

reporting was implemented in Philadelphia in March 2004 and the switch to name-based reporting was made in October 2005e From February 1994 through December 1998 Texas reported HIV infection in children onlyf Includes 1252 persons reported from areas with confidential name-based HIV infection reporting but whose area of residence is unknown

36 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulativemdashUnited States and dependent areas

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No Adult or adolescentMale-to-male sexual contact 13775 49 429897 54 mdash mdash mdash mdash 13775 35 429897 44Injection drug use 3413 12 163070 21 1826 17 67693 35 5239 13 230763 23Male-to-male sexual contact and

injection drug use 1603 6 65524 8 mdash mdash mdash mdash 1603 4 65524 7Hemophiliacoagulation disorder 43 0 5176 1 11 0 348 0 54 0 5524 1High-risk heterosexual contactc 2997 11 49610 6 4839 46 85186 44 7836 20 134796 14

Sex with injection drug user 330 1 11683 1 706 7 26073 14 1036 3 37756 4Sex with bisexual male mdash mdash mdash mdash 234 2 5162 3 234 1 5162 1Sex with person with hemophilia 1 0 84 0 11 0 502 0 12 0 586 0Sex with HIV-infected transfusion

recipient 22 0 553 0 21 0 793 0 43 0 1346 0Sex with HIV-infected person risk

factor not specified 2644 9 37290 5 3867 37 52656 27 6511 17 89946 9Receipt of blood transfusion blood

d components or tissue 63 0 5213 1 68 1 4176 2 131 0 9389 1Otherrisk factor not reported or

identifiede 6484 23 73136 9 3793 36 34311 18 10278 26 107450 11Subtotal 28378 100 791626 100 10537 100 191714 100 38916 100 983343 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 0 0 222 5 0 0 7 0 0 0 229 2Mother with documented HIV infection or

1 of the following risk factors 24 75 4315 89 50 93 4423 95 74 86 8738 92Injection drug use 4 13 1676 35 4 7 1665 36 8 9 3341 35Sex with injection drug user 4 13 789 16 4 7 750 16 8 9 1539 16Sex with bisexual male 1 3 101 2 2 4 110 2 3 3 211 2Sex with person with hemophilia 0 0 20 0 0 0 16 0 0 0 36 0Sex with HIV-infected transfusion

recipient 0 0 11 0 0 0 15 0 0 0 26 0Sex with HIV-infected person risk

factor not specified 6 19 742 15 17 31 790 17 23 27 1532 16Receipt of blood transfusion blood

components or tissue 0 0 70 1 0 0 82 2 0 0 152 2Has HIV infection risk factor not

specified 9 28 906 19 23 43 995 21 32 37 1901 20Receipt of blood transfusion blood

fcomponents or tissue 1 3 243 5 0 0 144 3 1 1 387 4Otherrisk factor not reported or

identifiedg 7 22 75 2 4 7 93 2 11 13 168 2Subtotal 32 100 4855 100 54 100 4667 100 86 100 9522 100

Total 28410 100 796481 100 10591 100 196381 100 39002 100 992865 100a From the beginning of the epidemic through 2006b From the beginning of the epidemic through 2006 Includes 3 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infectiond AIDS developed in 47 adultsadolescents after they received blood that had tested negative for HIV antibodies AIDS developed in 14 additional adults

after they received tissue organs or artificial insemination from HIV-infected donors Four of the 14 received tissue or organs from a donor who was negative for HIV antibody at the time of donation

e Includes 37 adultsadolescents who were exposed to HIV-infected blood body fluids or concentrated virus in health care laboratory or household settings as supported by seroconversion epidemiologic andor laboratory evidence One person was infected after intentional inoculation with HIV-infected blood Includes an additional 740 persons who acquired HIV infection perinatally but who were more than 12 years of age when AIDS was diagnosed These 740 persons are not counted in the values for the pediatric transmission category

f AIDS developed in 3 children after they received blood that had tested negative for HIV antibodiesg Includes 5 children who were exposed to HIV-infected blood as supported by seroconversion epidemiologic andor laboratory evidence 1 child was

infected after intentional inoculation with HIV-infected blood and 5 children were exposed to HIV-infected blood in a household setting Of the 168 children 26 had sexual contact with an adult with or at high risk for HIV infection

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 37

Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No

Adult or adolescentMale-to-male sexual contact 22912 59 103679 52 mdash mdash mdash mdash 22912 44 103679 37

Injection drug use 3503 9 24255 12 2124 16 13925 17 5627 11 38181 14

Male-to-male sexual contact and injection drug use 1946 5 10704 5 mdash mdash mdash mdash 1946 4 10704 4

Hemophiliacoagulation disorder 43 0 495 0 6 0 73 0 49 0 568 0

High-risk heterosexual contactc 2874 7 16830 8 5939 45 38315 47 8813 17 55145 20

Sex with injection drug user 308 1 2601 1 757 6 6791 8 1065 2 9392 3

Sex with bisexual male mdash mdash mdash mdash 328 2 2265 3 328 1 2265 1

Sex with person with hemophilia 4 0 31 0 16 0 201 0 20 0 232 0

Sex with HIV-infected transfusion recipient 13 0 131 0 28 0 223 0 41 0 354 0

Sex with HIV-infected person risk factor not specified 2549 7 14067 7 4810 36 28835 35 7359 14 42902 15

Receipt of blood transfusion blood components or tissue 61 0 489 0 50 0 536 1 111 0 1025 0

Otherrisk factor not reported or identified 7748 20 44021 22 5106 39 29312 36 12854 25 73338 26

Subtotal 39087 100 200473 100 13225 100 82161 100 52312 100 282640 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 8 3 106 4 0 0 1 0 8 1 107 2

Mother with documented HIV infection or 1 of the following risk factors 197 74 2195 85 254 85 2417 89 451 80 4612 87

Injection drug use 34 13 532 21 53 18 561 21 87 15 1093 21

Sex with injection drug user 12 5 208 8 21 7 213 8 33 6 421 8

Sex with bisexual male 5 2 37 1 4 1 32 1 9 2 69 1

Sex with person with hemophilia 0 0 3 0 1 0 7 0 1 0 10 0

Sex with HIV-infected transfusion recipient 0 0 4 0 0 0 4 0 0 0 8 0

Sex with HIV-infected person risk factor not specified 54 20 534 21 76 25 629 23 130 23 1163 22

Receipt of blood transfusion blood components or tissue 0 0 17 1 2 1 20 1 2 0 37 1

Has HIV infection risk factor not specified 92 35 860 33 97 32 951 35 189 33 1811 34

Receipt of blood transfusion blood components or tissue 6 2 28 1 3 1 24 1 9 2 52 1

Otherrisk factor not reported or identified 55 21 260 10 43 14 283 10 98 17 543 10

Subtotal 266 100 2589 100 300 100 2725 100 566 100 5314 100

Total 39353 100 203062 100 13525 100 84886 100 52878 100 287954 100

Note See Table 16 for the list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006b From the beginning of the epidemic through December 2006 Includes 6 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infection

38 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity

2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 6251 65 253927 73Injection drug use 733 8 31737 9Male-to-male sexual contact and injection drug use 732 8 31434 9Hemophiliacoagulation disorder 26 0 3989 1High-risk heterosexual contactb 416 4 7850 2

Sex with injection drug user 74 1 2310 1

Sex with person with hemophilia 0 0 36 0

Sex with HIV-infected transfusion recipient 2 0 176 0

Sex with HIV-infected person risk factor not specified 340 4 5328 2Receipt of blood transfusion blood components or tissue 20 0 3194 1Otherrisk factor not reported or identified 1400 15 16469 5

Total 9578 100 348600 100

Black not HispanicMale-to-male sexual contact 4309 36 103297 37Injection drug use 1635 14 83369 30Male-to-male sexual contact and injection drug use 526 4 22134 8Hemophiliacoagulation disorder 10 0 604 0High-risk heterosexual contactb 1875 16 29952 11

Sex with injection drug user 167 1 6823 2Sex with person with hemophilia 1 0 36 0Sex with HIV-infected transfusion recipient 15 0 237 0Sex with HIV-infected person risk factor not specified 1692 14 22856 8

Receipt of blood transfusion blood components or tissue 24 0 1218 0Otherrisk factor not reported or identified 3579 30 40268 14

Total 11958 100 280842 100

HispanicMale-to-male sexual contact 2816 47 64893 44Injection drug use 965 16 46337 31Male-to-male sexual contact and injection drug use 287 5 10884 7Hemophiliacoagulation disorder 6 0 466 0High-risk heterosexual contactb 638 11 10950 7

Sex with injection drug user 84 1 2409 2Sex with person with hemophilia 0 0 11 0Sex with HIV-infected transfusion recipient 5 0 125 0Sex with HIV-infected person risk factor not specified 549 9 8405 6

Receipt of blood transfusion blood components or tissue 17 0 657 0Otherrisk factor not reported or identified 1326 22 14832 10

Total 6055 100 149019 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 39

a

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulative

No No

AsianPacific IslanderMale-to-male sexual contact 225 54 4475 68Injection drug use 20 5 317 5Male-to-male sexual contact and injection drug use 17 4 284 4Hemophiliacoagulation disorder 1 0 70 1High-risk heterosexual contactb 34 8 376 6

Sex with injection drug user 1 0 54 1Sex with person with hemophilia 0 0 1 0Sex with HIV-infected transfusion recipient 0 0 8 0Sex with HIV-infected person risk factor not specified 33 8 313 5

Receipt of blood transfusion blood components or tissue 2 0 112 2Otherrisk factor not reported or identified 114 28 949 14

Total 413 100 6583 100

American IndianAlaska NativeMale-to-male sexual contact 61 49 1403 55Injection drug use 15 12 395 15Male-to-male sexual contact and injection drug use 23 19 457 18Hemophiliacoagulation disorder 0 0 27 1High-risk heterosexual contactb 9 7 118 5

Sex with injection drug user 1 1 33 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 8 6 82 3

Receipt of blood transfusion blood components or tissue 0 0 8 0Otherrisk factor not reported or identified 16 13 155 6

Total 124 100 2563 100

Total casesMale-to-male sexual contact 13775 49 429897 54Injection drug use 3413 12 163070 21Male-to-male sexual contact and injection drug use 1603 6 65524 8Hemophiliacoagulation disorder 43 0 5176 1High-risk heterosexual contactb 2997 11 49610 6

Sex with injection drug user 330 1 11683 1Sex with person with hemophilia 1 0 84 0Sex with HIV-infected transfusion recipient 22 0 553 0Sex with HIV-infected person risk factor not specified 2644 9 37290 5

Receipt of blood transfusion blood components or tissue 63 0 5213 1Otherrisk factor not reported or identified 6484 23 73136 9

Total 28378c 100 791626d 100a From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 4019 males of unknown race or multiple races

40 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 11963 73 55725 69Injection drug use 858 5 5512 7Male-to-male sexual contact and injection drug use 1092 7 5578 7Hemophiliacoagulation disorder 29 0 355 0High-risk heterosexual contactb 522 3 2658 3

Sex with injection drug user 65 0 544 1Sex with person with hemophilia 0 0 8 0Sex with HIV-infected transfusion recipient 3 0 33 0Sex with HIV-infected person risk factor not specified 454 3 2073 3

Receipt of blood transfusion blood components or tissue 14 0 197 0Otherrisk factor not reported or identified 1956 12 11147 14

Total 16434 100 81172 100

Black not HispanicMale-to-male sexual contact 6203 44 30148 37Injection drug use 1594 11 11997 15Male-to-male sexual contact and injection drug use 483 3 3489 4Hemophiliacoagulation disorder 10 0 109 0High-risk heterosexual contactb 1714 12 10905 13

Sex with injection drug user 169 1 1554 2Sex with person with hemophilia 4 0 17 0Sex with HIV-infected transfusion recipient 6 0 77 0Sex with HIV-infected person risk factor not specified 1535 11 9257 11

Receipt of blood transfusion blood components or tissue 32 0 223 0Otherrisk factor not reported or identified 4151 29 24632 30

Total 14187 100 81503 100

HispanicMale-to-male sexual contact 4094 55 15623 47Injection drug use 993 13 6407 19Male-to-male sexual contact and injection drug use 316 4 1402 4Hemophiliacoagulation disorder 3 0 26 0High-risk heterosexual contactb 582 8 2963 9

Sex with injection drug user 65 1 455 1Sex with person with hemophilia 0 0 6 0Sex with HIV-infected transfusion recipient 4 0 18 0Sex with HIV-infected person risk factor not specified 513 7 2484 7

Receipt of blood transfusion blood components or tissue 11 0 55 0Otherrisk factor not reported or identified 1475 20 6977 21

Total 7474 100 33453 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 41

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderMale-to-male sexual contact 402 70 1006 63Injection drug use 17 3 55 3Male-to-male sexual contact and injection drug use 15 3 38 2Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 25 4 96 6

Sex with injection drug user 3 1 10 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 22 4 83 5

Receipt of blood transfusion blood components or tissue 4 1 7 0Otherrisk factor not reported or identified 109 19 397 25

Total 572 100 1600 100

American IndianAlaska NativeMale-to-male sexual contact 104 61 516 57Injection drug use 13 8 101 11Male-to-male sexual contact and injection drug use 19 11 110 12Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 10 6 53 6

Sex with injection drug user 2 1 14 2Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 8 5 39 4

Receipt of blood transfusion blood components or tissue 0 0 2 0Otherrisk factor not reported or identified 24 14 125 14

Total 170 100 907 100

Total casesMale-to-male sexual contact 22912 59 103679 52Injection drug use 3503 9 24255 12Male-to-male sexual contact and injection drug use 1946 5 10704 5Hemophiliacoagulation disorder 43 0 495 0High-risk heterosexual contactb 2874 7 16830 8

Sex with injection drug user 308 1 2601 1Sex with person with hemophilia 4 0 31 0Sex with HIV-infected transfusion recipient 13 0 131 0Sex with HIV-infected person risk factor not specified 2549 7 14067 7

Receipt of blood transfusion blood components or tissue 61 0 489 0Otherrisk factor not reported or identified 7748 20 44021 22

Total 39087c 100 200473d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 1838 males of unknown race or multiple races

42 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race

ethnicity 2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 482 28 14981 40Hemophiliacoagulation disorder 4 0 123 0High-risk heterosexual contactb 725 42 15799 42

Sex with injection drug user 153 9 5650 15Sex with bisexual male 63 4 1859 5Sex with person with hemophilia 5 0 329 1Sex with HIV-infected transfusion recipient 5 0 338 1Sex with HIV-infected person risk factor not specified 499 29 7623 20

Receipt of blood transfusion blood components or tissue 15 1 1870 5Otherrisk factor not reported or identified 499 29 4801 13

Total 1725 100 37574 100

Black not HispanicInjection drug use 982 15 38914 34Hemophiliacoagulation disorder 3 0 145 0High-risk heterosexual contactb 3103 46 49876 44

Sex with injection drug user 373 6 13530 12Sex with bisexual male 136 2 2352 2Sex with person with hemophilia 4 0 121 0Sex with HIV-infected transfusion recipient 8 0 277 0Sex with HIV-infected person risk factor not specified 2582 38 33596 29

Receipt of blood transfusion blood components or tissue 39 1 1546 1Otherrisk factor not reported or identified 2612 39 23894 21

Total 6739 100 114375 100

HispanicInjection drug use 322 18 12892 35Hemophiliacoagulation disorder 4 0 67 0High-risk heterosexual contactb 894 49 17995 49

Sex with injection drug user 166 9 6522 18Sex with bisexual male 32 2 818 2Sex with person with hemophilia 1 0 45 0Sex with HIV-infected transfusion recipient 7 0 141 0Sex with HIV-infected person risk factor not specified 688 38 10469 29

Receipt of blood transfusion blood components or tissue 12 1 619 2Otherrisk factor not reported or identified 592 32 5023 14

Total 1824 100 36596 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 43

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 8 8 125 12Hemophiliacoagulation disorder 0 0 7 1High-risk heterosexual contactb 49 47 574 53

Sex with injection drug user 4 4 114 11Sex with bisexual male 2 2 80 7Sex with person with hemophilia 0 0 4 0Sex with HIV-infected transfusion recipient 1 1 25 2Sex with HIV-infected person risk factor not specified 42 40 351 33

Receipt of blood transfusion blood components or tissue 1 1 93 9Otherrisk factor not reported or identified 46 44 279 26

Total 104 100 1078 100

American IndianAlaska NativeInjection drug use 13 32 280 42Hemophiliacoagulation disorder 0 0 3 0High-risk heterosexual contactb 15 37 277 41

Sex with injection drug user 4 10 107 16Sex with bisexual male 1 2 27 4Sex with person with hemophilia 0 0 2 0Sex with HIV-infected transfusion recipient 0 0 6 1Sex with HIV-infected person risk factor not specified 10 24 135 20

Receipt of blood transfusion blood components or tissue 1 2 17 3Otherrisk factor not reported or identified 12 29 95 14

Total 41 100 672 100

Total casesInjection drug use 1826 17 67693 35Hemophiliacoagulation disorder 11 0 348 0High-risk heterosexual contactb 4839 46 85186 44

Sex with injection drug user 706 7 26073 14Sex with bisexual male 234 2 5162 3Sex with person with hemophilia 11 0 502 0Sex with HIV-infected transfusion recipient 21 0 793 0Sex with HIV-infected person risk factor not specified 3867 37 52656 27

Receipt of blood transfusion blood components or tissue 68 1 4176 2Otherrisk factor not reported or identified 3793 36 34311 18

Total 10537c 100 191714d 100a From the beginning of the epidemic through 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 104 females of unknown race or multiple racesd Includes 1419 females of unknown race or multiple races

44 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 690 26 4260 26Hemophiliacoagulation disorder 3 0 24 0

bHigh-risk heterosexual contact 1132 42 7593 46Sex with injection drug user 205 8 1876 11Sex with bisexual male 98 4 659 4Sex with person with hemophilia 10 0 115 1Sex with HIV-infected transfusion recipient 7 0 64 0Sex with HIV-infected person risk factor not specified 812 30 4879 29

Receipt of blood transfusion blood components or tissue 12 0 146 1Otherrisk factor not reported or identified 850 32 4567 28

Total 2687 100 16590 100

Black not HispanicInjection drug use 1034 13 7105 14Hemophiliacoagulation disorder 1 0 35 0

bHigh-risk heterosexual contact 3451 44 23732 46Sex with injection drug user 313 4 3473 7Sex with bisexual male 155 2 1294 3Sex with person with hemophilia 5 0 71 0Sex with HIV-infected transfusion recipient 14 0 120 0Sex with HIV-infected person risk factor not specified 2964 38 18774 36

Receipt of blood transfusion blood components or tissue 26 0 324 1Otherrisk factor not reported or identified 3370 43 20244 39

Total 7882 100 51440 100

HispanicInjection drug use 339 15 2280 18Hemophiliacoagulation disorder 2 0 11 0

bHigh-risk heterosexual contact 1198 52 6264 50Sex with injection drug user 218 9 1324 11Sex with bisexual male 62 3 266 2Sex with person with hemophilia 1 0 11 0Sex with HIV-infected transfusion recipient 7 0 39 0Sex with HIV-infected person risk factor not specified 910 39 4624 37

Receipt of blood transfusion blood components or tissue 12 1 58 0Otherrisk factor not reported or identified 767 33 3843 31

Total 2318 100 12456 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 45

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 33: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

New York NYndashNJndashPa 6215 330 5500 292 195177 2906 198083

Edison Division 191 83 130 56 6709 139 6848

Nassau Division 262 93 246 88 8141 110 8251

New York Division 5266 456 4716 408 160408 2323 162731

Newark Division 496 231 408 190 19919 334 20253

Oklahoma City Okla 125 108 88 75 2255 5 2260

OmahandashCouncil Bluffs NebndashIowa 37 46 80 97 1035 3 1038

Orlando Fla 544 282 517 260 8653 92 8745

OxnardndashThousand OaksndashVentura Calif 49 62 21 26 1008 3 1011

Palm BayndashMelbournendashTitusville Fla 68 129 61 114 1512 11 1523

Philadelphia PandashNJndashDelndashMd 1261 217 1348 231 28221 313 28534

Camden Division 108 87 111 89 3118 42 3160

Philadelphia Division 1022 263 1144 294 22112 250 22362

Wilmington Division 131 191 93 134 2991 21 3012

PhoenixndashMesandashScottsdale Ariz 460 119 376 93 7459 31 7490

Pittsburgh Pa 143 60 135 57 3182 19 3201

PortlandndashSouth Portland Maine 9 18 34 66 562 1 563

PortlandndashVancouverndashBeaverton OrendashWash 170 81 215 101 4825 10 4835

PoughkeepsiendashNewburghndashMiddletown NY 136 204 113 168 3162 24 3186

ProvidencendashNew BedfordndashFall River RIndashMass 132 82 155 96 3900 44 3944

RaleighndashCary NC 138 145 201 202 1987 13 2000

Richmond Va 119 101 122 102 3371 35 3406

RiversidendashSan BernardinondashOntario Calif 361 92 306 76 8568 60 8628

Rochester NY 165 159 124 120 3134 13 3147

SacramentondashArden-ArcadendashRoseville Calif 154 75 169 82 4000 26 4026

St Louis MondashIll 192 69 366 131 5965 40 6005

Salt Lake City Utah 46 44 40 37 1743 10 1753

San Antonio Tex 215 114 247 127 4987 30 5017

San DiegondashCarlsbadndashSan Marcos Calif 491 167 384 131 12934 61 12995

San Francisco Calif 867 209 690 165 40152 96 40248

Oakland Division 312 126 246 99 9546 48 9594

San Francisco Division 555 329 444 261 30606 48 30654

San JosendashSunnyvalendashSanta Clara Calif 88 50 145 81 3747 15 3762

San JuanndashCaguasndashGuaynabo PR 745 289 578 223 21402 277 21679

SarasotandashBradentonndashVenice Fla 82 122 104 152 1978 27 2005

ScrantonndashWilkes-Barre Pa 27 49 47 85 572 6 578

Seattle Wash 353 110 280 86 9172 27 9199

Seattle Division 316 129 255 102 8161 18 8179

Tacoma Division 37 49 25 33 1011 9 1020

Springfield Mass 88 128 45 66 2075 26 2101

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 33

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Stockton Calif 52 78 52 77 1076 15 1091

Syracuse NY 52 80 49 75 1317 8 1325

TampandashSt PetersburgndashClearwater Fla 559 211 605 224 11174 112 11286

Toledo Ohio 25 38 66 101 812 14 826

Tucson Ariz 103 111 100 106 2010 10 2020

Tulsa Okla 83 94 65 72 1494 10 1504

Virginia BeachndashNorfolkndashNewport News VandashNC 183 111 132 80 4711 63 4774

Washington DCndashVandashMdndashWV 1322 252 1684 318 31130 315 31445

Bethesda Division 135 118 173 150 2774 23 2797

Washington Division 1187 289 1511 365 28356 292 28648

Wichita Kans 35 60 38 64 851 2 853

Worcester Mass 76 97 79 101 1783 20 1803

YoungstownndashWarrenndashBoardman OhiondashPa 27 46 26 44 519 0 519

Subtotal for MSAs (population gt500000) 33602 173 31274 159 829633 8171 837804

Metropolitan areas (population of 50000 to 499999) 4477 80 4466 79 94829 847 95676

Nonmetropolitan areas 2666 54 2732 55 52063 445 52508

Totalb 41144 137 38749 128 981708 9494 991202

Note Because of the lack of census information for all US dependent areas includes data for only the 50 states the District of Columbia and Puerto RicoMSA metropolitan statistical areaMSA definitions for this report can be found at httpwwwcensusgovpopulationwwwestimatesmetrodefhtmla Reported case counts for the metropolitan divisions do not sum to the MSA total MSA total includes data from 1 metropolitan division with

population of lt500000b Includes persons whose county of residence is unknown

34 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Alabama (January 1988) 502 6041 48 6089

Alaska (February 1999) 38 285 2 287

Arizona (January 1987) 617 5877 80 5957

Arkansas (July 1989) 206 2349 20 2369

California (April 2006) 6581 7056 92 7148

Colorado (November 1985) 319 6084 31 6115

Connecticut (January 2005)b 826 2500 101 2601

Delaware (February 2006) 788 801 18 819

Florida (July 1997)c 4163 36386 397 36783

Georgia (December 2003) 2245 8197 194 8391

Idaho (June 1986) 35 340 4 344

Illinois (January 2006) 6241 6661 162 6823

Indiana (July 1988) 399 4027 43 4070

Iowa (July 1998) 69 586 5 591

Kansas (July 1999) 142 1225 15 1240

Kentucky (October 2004) 333 1303 13 1316

Louisiana (February 1993) 728 8149 166 8315

Maine (January 2006) 386 393 3 396

Michigan (April 1992) 635 6702 134 6836

Minnesota (October 1985) 309 3356 40 3396

Mississippi (August 1988) 352 4549 59 4608

Missouri (October 1987) 502 5086 55 5141

Nebraska (September 1995) 91 672 14 686

Nevada (February 1992) 339 3532 24 3556

New Hampshire (January 2005) 59 466 9 475

New Jersey (January 1992) 1477 17513 325 17838

New Mexico (January 1998) 114 949 4 953

New York (June 2000) 5326 42345 1820 44165

North Carolina (February 1990) 1615 13879 143 14022

North Dakota (January 1988) 4 82 1 83

Ohio (June 1990) 867 8222 101 8323

Oklahoma (June 1988) 229 2401 30 2431

Oregon (April 2006) 49 95 19 114

Pennsylvania (October 2002)d 4269 9537 179 9716

Rhode Island (July 2006) 14 21 0 21

South Carolina (February 1986) 493 6970 93 7063

South Dakota (January 1988) 18 215 6 221

Tennessee (January 1992) 732 7115 90 7205

Texas (January 1999)e 3370 24282 417 24699

Utah (April 1989) 106 893 14 907

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 35

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Virginia (July 1989) 864 10257 95 10352

Washington (March 2006) 4048 4157 40 4197

West Virginia (January 1989) 66 673 8 681

Wisconsin (November 1985) 261 2500 31 2531

Wyoming (June 1989) 7 93 1 94

Subtotal 50834 274822 5146 279968

US dependent areas

American Samoa (August 2001) 0 1 0 1

Guam (March 2000) 2 66 0 66

Northern Mariana Islands (October 2001) 2 7 0 7

Puerto Rico (January 2003) 1471 5610 91 5701

US Virgin Islands (December 1998) 22 247 6 253

Persons reported from areas with confidential name-based HIV infection reporting but who were residents of other areas 132 685 21 706

Totalf 52878 282640 5314 287954

Note Includes data from 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through 2006b Beginning in 1992 Connecticut had name-based HIV reporting for cases in children only From January 2002 through December 2004

Connecticut had name- or code-based HIV reporting for cases in adolescents and adults As of January 2005 Connecticut has name-based reporting of all cases of HIV infection

c Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterd On October 18 2002 Pennsylvania initiated confidential name-based HIV infection reporting in all areas except Philadelphia Code-based

reporting was implemented in Philadelphia in March 2004 and the switch to name-based reporting was made in October 2005e From February 1994 through December 1998 Texas reported HIV infection in children onlyf Includes 1252 persons reported from areas with confidential name-based HIV infection reporting but whose area of residence is unknown

36 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulativemdashUnited States and dependent areas

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No Adult or adolescentMale-to-male sexual contact 13775 49 429897 54 mdash mdash mdash mdash 13775 35 429897 44Injection drug use 3413 12 163070 21 1826 17 67693 35 5239 13 230763 23Male-to-male sexual contact and

injection drug use 1603 6 65524 8 mdash mdash mdash mdash 1603 4 65524 7Hemophiliacoagulation disorder 43 0 5176 1 11 0 348 0 54 0 5524 1High-risk heterosexual contactc 2997 11 49610 6 4839 46 85186 44 7836 20 134796 14

Sex with injection drug user 330 1 11683 1 706 7 26073 14 1036 3 37756 4Sex with bisexual male mdash mdash mdash mdash 234 2 5162 3 234 1 5162 1Sex with person with hemophilia 1 0 84 0 11 0 502 0 12 0 586 0Sex with HIV-infected transfusion

recipient 22 0 553 0 21 0 793 0 43 0 1346 0Sex with HIV-infected person risk

factor not specified 2644 9 37290 5 3867 37 52656 27 6511 17 89946 9Receipt of blood transfusion blood

d components or tissue 63 0 5213 1 68 1 4176 2 131 0 9389 1Otherrisk factor not reported or

identifiede 6484 23 73136 9 3793 36 34311 18 10278 26 107450 11Subtotal 28378 100 791626 100 10537 100 191714 100 38916 100 983343 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 0 0 222 5 0 0 7 0 0 0 229 2Mother with documented HIV infection or

1 of the following risk factors 24 75 4315 89 50 93 4423 95 74 86 8738 92Injection drug use 4 13 1676 35 4 7 1665 36 8 9 3341 35Sex with injection drug user 4 13 789 16 4 7 750 16 8 9 1539 16Sex with bisexual male 1 3 101 2 2 4 110 2 3 3 211 2Sex with person with hemophilia 0 0 20 0 0 0 16 0 0 0 36 0Sex with HIV-infected transfusion

recipient 0 0 11 0 0 0 15 0 0 0 26 0Sex with HIV-infected person risk

factor not specified 6 19 742 15 17 31 790 17 23 27 1532 16Receipt of blood transfusion blood

components or tissue 0 0 70 1 0 0 82 2 0 0 152 2Has HIV infection risk factor not

specified 9 28 906 19 23 43 995 21 32 37 1901 20Receipt of blood transfusion blood

fcomponents or tissue 1 3 243 5 0 0 144 3 1 1 387 4Otherrisk factor not reported or

identifiedg 7 22 75 2 4 7 93 2 11 13 168 2Subtotal 32 100 4855 100 54 100 4667 100 86 100 9522 100

Total 28410 100 796481 100 10591 100 196381 100 39002 100 992865 100a From the beginning of the epidemic through 2006b From the beginning of the epidemic through 2006 Includes 3 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infectiond AIDS developed in 47 adultsadolescents after they received blood that had tested negative for HIV antibodies AIDS developed in 14 additional adults

after they received tissue organs or artificial insemination from HIV-infected donors Four of the 14 received tissue or organs from a donor who was negative for HIV antibody at the time of donation

e Includes 37 adultsadolescents who were exposed to HIV-infected blood body fluids or concentrated virus in health care laboratory or household settings as supported by seroconversion epidemiologic andor laboratory evidence One person was infected after intentional inoculation with HIV-infected blood Includes an additional 740 persons who acquired HIV infection perinatally but who were more than 12 years of age when AIDS was diagnosed These 740 persons are not counted in the values for the pediatric transmission category

f AIDS developed in 3 children after they received blood that had tested negative for HIV antibodiesg Includes 5 children who were exposed to HIV-infected blood as supported by seroconversion epidemiologic andor laboratory evidence 1 child was

infected after intentional inoculation with HIV-infected blood and 5 children were exposed to HIV-infected blood in a household setting Of the 168 children 26 had sexual contact with an adult with or at high risk for HIV infection

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 37

Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No

Adult or adolescentMale-to-male sexual contact 22912 59 103679 52 mdash mdash mdash mdash 22912 44 103679 37

Injection drug use 3503 9 24255 12 2124 16 13925 17 5627 11 38181 14

Male-to-male sexual contact and injection drug use 1946 5 10704 5 mdash mdash mdash mdash 1946 4 10704 4

Hemophiliacoagulation disorder 43 0 495 0 6 0 73 0 49 0 568 0

High-risk heterosexual contactc 2874 7 16830 8 5939 45 38315 47 8813 17 55145 20

Sex with injection drug user 308 1 2601 1 757 6 6791 8 1065 2 9392 3

Sex with bisexual male mdash mdash mdash mdash 328 2 2265 3 328 1 2265 1

Sex with person with hemophilia 4 0 31 0 16 0 201 0 20 0 232 0

Sex with HIV-infected transfusion recipient 13 0 131 0 28 0 223 0 41 0 354 0

Sex with HIV-infected person risk factor not specified 2549 7 14067 7 4810 36 28835 35 7359 14 42902 15

Receipt of blood transfusion blood components or tissue 61 0 489 0 50 0 536 1 111 0 1025 0

Otherrisk factor not reported or identified 7748 20 44021 22 5106 39 29312 36 12854 25 73338 26

Subtotal 39087 100 200473 100 13225 100 82161 100 52312 100 282640 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 8 3 106 4 0 0 1 0 8 1 107 2

Mother with documented HIV infection or 1 of the following risk factors 197 74 2195 85 254 85 2417 89 451 80 4612 87

Injection drug use 34 13 532 21 53 18 561 21 87 15 1093 21

Sex with injection drug user 12 5 208 8 21 7 213 8 33 6 421 8

Sex with bisexual male 5 2 37 1 4 1 32 1 9 2 69 1

Sex with person with hemophilia 0 0 3 0 1 0 7 0 1 0 10 0

Sex with HIV-infected transfusion recipient 0 0 4 0 0 0 4 0 0 0 8 0

Sex with HIV-infected person risk factor not specified 54 20 534 21 76 25 629 23 130 23 1163 22

Receipt of blood transfusion blood components or tissue 0 0 17 1 2 1 20 1 2 0 37 1

Has HIV infection risk factor not specified 92 35 860 33 97 32 951 35 189 33 1811 34

Receipt of blood transfusion blood components or tissue 6 2 28 1 3 1 24 1 9 2 52 1

Otherrisk factor not reported or identified 55 21 260 10 43 14 283 10 98 17 543 10

Subtotal 266 100 2589 100 300 100 2725 100 566 100 5314 100

Total 39353 100 203062 100 13525 100 84886 100 52878 100 287954 100

Note See Table 16 for the list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006b From the beginning of the epidemic through December 2006 Includes 6 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infection

38 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity

2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 6251 65 253927 73Injection drug use 733 8 31737 9Male-to-male sexual contact and injection drug use 732 8 31434 9Hemophiliacoagulation disorder 26 0 3989 1High-risk heterosexual contactb 416 4 7850 2

Sex with injection drug user 74 1 2310 1

Sex with person with hemophilia 0 0 36 0

Sex with HIV-infected transfusion recipient 2 0 176 0

Sex with HIV-infected person risk factor not specified 340 4 5328 2Receipt of blood transfusion blood components or tissue 20 0 3194 1Otherrisk factor not reported or identified 1400 15 16469 5

Total 9578 100 348600 100

Black not HispanicMale-to-male sexual contact 4309 36 103297 37Injection drug use 1635 14 83369 30Male-to-male sexual contact and injection drug use 526 4 22134 8Hemophiliacoagulation disorder 10 0 604 0High-risk heterosexual contactb 1875 16 29952 11

Sex with injection drug user 167 1 6823 2Sex with person with hemophilia 1 0 36 0Sex with HIV-infected transfusion recipient 15 0 237 0Sex with HIV-infected person risk factor not specified 1692 14 22856 8

Receipt of blood transfusion blood components or tissue 24 0 1218 0Otherrisk factor not reported or identified 3579 30 40268 14

Total 11958 100 280842 100

HispanicMale-to-male sexual contact 2816 47 64893 44Injection drug use 965 16 46337 31Male-to-male sexual contact and injection drug use 287 5 10884 7Hemophiliacoagulation disorder 6 0 466 0High-risk heterosexual contactb 638 11 10950 7

Sex with injection drug user 84 1 2409 2Sex with person with hemophilia 0 0 11 0Sex with HIV-infected transfusion recipient 5 0 125 0Sex with HIV-infected person risk factor not specified 549 9 8405 6

Receipt of blood transfusion blood components or tissue 17 0 657 0Otherrisk factor not reported or identified 1326 22 14832 10

Total 6055 100 149019 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 39

a

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulative

No No

AsianPacific IslanderMale-to-male sexual contact 225 54 4475 68Injection drug use 20 5 317 5Male-to-male sexual contact and injection drug use 17 4 284 4Hemophiliacoagulation disorder 1 0 70 1High-risk heterosexual contactb 34 8 376 6

Sex with injection drug user 1 0 54 1Sex with person with hemophilia 0 0 1 0Sex with HIV-infected transfusion recipient 0 0 8 0Sex with HIV-infected person risk factor not specified 33 8 313 5

Receipt of blood transfusion blood components or tissue 2 0 112 2Otherrisk factor not reported or identified 114 28 949 14

Total 413 100 6583 100

American IndianAlaska NativeMale-to-male sexual contact 61 49 1403 55Injection drug use 15 12 395 15Male-to-male sexual contact and injection drug use 23 19 457 18Hemophiliacoagulation disorder 0 0 27 1High-risk heterosexual contactb 9 7 118 5

Sex with injection drug user 1 1 33 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 8 6 82 3

Receipt of blood transfusion blood components or tissue 0 0 8 0Otherrisk factor not reported or identified 16 13 155 6

Total 124 100 2563 100

Total casesMale-to-male sexual contact 13775 49 429897 54Injection drug use 3413 12 163070 21Male-to-male sexual contact and injection drug use 1603 6 65524 8Hemophiliacoagulation disorder 43 0 5176 1High-risk heterosexual contactb 2997 11 49610 6

Sex with injection drug user 330 1 11683 1Sex with person with hemophilia 1 0 84 0Sex with HIV-infected transfusion recipient 22 0 553 0Sex with HIV-infected person risk factor not specified 2644 9 37290 5

Receipt of blood transfusion blood components or tissue 63 0 5213 1Otherrisk factor not reported or identified 6484 23 73136 9

Total 28378c 100 791626d 100a From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 4019 males of unknown race or multiple races

40 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 11963 73 55725 69Injection drug use 858 5 5512 7Male-to-male sexual contact and injection drug use 1092 7 5578 7Hemophiliacoagulation disorder 29 0 355 0High-risk heterosexual contactb 522 3 2658 3

Sex with injection drug user 65 0 544 1Sex with person with hemophilia 0 0 8 0Sex with HIV-infected transfusion recipient 3 0 33 0Sex with HIV-infected person risk factor not specified 454 3 2073 3

Receipt of blood transfusion blood components or tissue 14 0 197 0Otherrisk factor not reported or identified 1956 12 11147 14

Total 16434 100 81172 100

Black not HispanicMale-to-male sexual contact 6203 44 30148 37Injection drug use 1594 11 11997 15Male-to-male sexual contact and injection drug use 483 3 3489 4Hemophiliacoagulation disorder 10 0 109 0High-risk heterosexual contactb 1714 12 10905 13

Sex with injection drug user 169 1 1554 2Sex with person with hemophilia 4 0 17 0Sex with HIV-infected transfusion recipient 6 0 77 0Sex with HIV-infected person risk factor not specified 1535 11 9257 11

Receipt of blood transfusion blood components or tissue 32 0 223 0Otherrisk factor not reported or identified 4151 29 24632 30

Total 14187 100 81503 100

HispanicMale-to-male sexual contact 4094 55 15623 47Injection drug use 993 13 6407 19Male-to-male sexual contact and injection drug use 316 4 1402 4Hemophiliacoagulation disorder 3 0 26 0High-risk heterosexual contactb 582 8 2963 9

Sex with injection drug user 65 1 455 1Sex with person with hemophilia 0 0 6 0Sex with HIV-infected transfusion recipient 4 0 18 0Sex with HIV-infected person risk factor not specified 513 7 2484 7

Receipt of blood transfusion blood components or tissue 11 0 55 0Otherrisk factor not reported or identified 1475 20 6977 21

Total 7474 100 33453 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 41

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderMale-to-male sexual contact 402 70 1006 63Injection drug use 17 3 55 3Male-to-male sexual contact and injection drug use 15 3 38 2Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 25 4 96 6

Sex with injection drug user 3 1 10 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 22 4 83 5

Receipt of blood transfusion blood components or tissue 4 1 7 0Otherrisk factor not reported or identified 109 19 397 25

Total 572 100 1600 100

American IndianAlaska NativeMale-to-male sexual contact 104 61 516 57Injection drug use 13 8 101 11Male-to-male sexual contact and injection drug use 19 11 110 12Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 10 6 53 6

Sex with injection drug user 2 1 14 2Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 8 5 39 4

Receipt of blood transfusion blood components or tissue 0 0 2 0Otherrisk factor not reported or identified 24 14 125 14

Total 170 100 907 100

Total casesMale-to-male sexual contact 22912 59 103679 52Injection drug use 3503 9 24255 12Male-to-male sexual contact and injection drug use 1946 5 10704 5Hemophiliacoagulation disorder 43 0 495 0High-risk heterosexual contactb 2874 7 16830 8

Sex with injection drug user 308 1 2601 1Sex with person with hemophilia 4 0 31 0Sex with HIV-infected transfusion recipient 13 0 131 0Sex with HIV-infected person risk factor not specified 2549 7 14067 7

Receipt of blood transfusion blood components or tissue 61 0 489 0Otherrisk factor not reported or identified 7748 20 44021 22

Total 39087c 100 200473d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 1838 males of unknown race or multiple races

42 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race

ethnicity 2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 482 28 14981 40Hemophiliacoagulation disorder 4 0 123 0High-risk heterosexual contactb 725 42 15799 42

Sex with injection drug user 153 9 5650 15Sex with bisexual male 63 4 1859 5Sex with person with hemophilia 5 0 329 1Sex with HIV-infected transfusion recipient 5 0 338 1Sex with HIV-infected person risk factor not specified 499 29 7623 20

Receipt of blood transfusion blood components or tissue 15 1 1870 5Otherrisk factor not reported or identified 499 29 4801 13

Total 1725 100 37574 100

Black not HispanicInjection drug use 982 15 38914 34Hemophiliacoagulation disorder 3 0 145 0High-risk heterosexual contactb 3103 46 49876 44

Sex with injection drug user 373 6 13530 12Sex with bisexual male 136 2 2352 2Sex with person with hemophilia 4 0 121 0Sex with HIV-infected transfusion recipient 8 0 277 0Sex with HIV-infected person risk factor not specified 2582 38 33596 29

Receipt of blood transfusion blood components or tissue 39 1 1546 1Otherrisk factor not reported or identified 2612 39 23894 21

Total 6739 100 114375 100

HispanicInjection drug use 322 18 12892 35Hemophiliacoagulation disorder 4 0 67 0High-risk heterosexual contactb 894 49 17995 49

Sex with injection drug user 166 9 6522 18Sex with bisexual male 32 2 818 2Sex with person with hemophilia 1 0 45 0Sex with HIV-infected transfusion recipient 7 0 141 0Sex with HIV-infected person risk factor not specified 688 38 10469 29

Receipt of blood transfusion blood components or tissue 12 1 619 2Otherrisk factor not reported or identified 592 32 5023 14

Total 1824 100 36596 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 43

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 8 8 125 12Hemophiliacoagulation disorder 0 0 7 1High-risk heterosexual contactb 49 47 574 53

Sex with injection drug user 4 4 114 11Sex with bisexual male 2 2 80 7Sex with person with hemophilia 0 0 4 0Sex with HIV-infected transfusion recipient 1 1 25 2Sex with HIV-infected person risk factor not specified 42 40 351 33

Receipt of blood transfusion blood components or tissue 1 1 93 9Otherrisk factor not reported or identified 46 44 279 26

Total 104 100 1078 100

American IndianAlaska NativeInjection drug use 13 32 280 42Hemophiliacoagulation disorder 0 0 3 0High-risk heterosexual contactb 15 37 277 41

Sex with injection drug user 4 10 107 16Sex with bisexual male 1 2 27 4Sex with person with hemophilia 0 0 2 0Sex with HIV-infected transfusion recipient 0 0 6 1Sex with HIV-infected person risk factor not specified 10 24 135 20

Receipt of blood transfusion blood components or tissue 1 2 17 3Otherrisk factor not reported or identified 12 29 95 14

Total 41 100 672 100

Total casesInjection drug use 1826 17 67693 35Hemophiliacoagulation disorder 11 0 348 0High-risk heterosexual contactb 4839 46 85186 44

Sex with injection drug user 706 7 26073 14Sex with bisexual male 234 2 5162 3Sex with person with hemophilia 11 0 502 0Sex with HIV-infected transfusion recipient 21 0 793 0Sex with HIV-infected person risk factor not specified 3867 37 52656 27

Receipt of blood transfusion blood components or tissue 68 1 4176 2Otherrisk factor not reported or identified 3793 36 34311 18

Total 10537c 100 191714d 100a From the beginning of the epidemic through 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 104 females of unknown race or multiple racesd Includes 1419 females of unknown race or multiple races

44 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 690 26 4260 26Hemophiliacoagulation disorder 3 0 24 0

bHigh-risk heterosexual contact 1132 42 7593 46Sex with injection drug user 205 8 1876 11Sex with bisexual male 98 4 659 4Sex with person with hemophilia 10 0 115 1Sex with HIV-infected transfusion recipient 7 0 64 0Sex with HIV-infected person risk factor not specified 812 30 4879 29

Receipt of blood transfusion blood components or tissue 12 0 146 1Otherrisk factor not reported or identified 850 32 4567 28

Total 2687 100 16590 100

Black not HispanicInjection drug use 1034 13 7105 14Hemophiliacoagulation disorder 1 0 35 0

bHigh-risk heterosexual contact 3451 44 23732 46Sex with injection drug user 313 4 3473 7Sex with bisexual male 155 2 1294 3Sex with person with hemophilia 5 0 71 0Sex with HIV-infected transfusion recipient 14 0 120 0Sex with HIV-infected person risk factor not specified 2964 38 18774 36

Receipt of blood transfusion blood components or tissue 26 0 324 1Otherrisk factor not reported or identified 3370 43 20244 39

Total 7882 100 51440 100

HispanicInjection drug use 339 15 2280 18Hemophiliacoagulation disorder 2 0 11 0

bHigh-risk heterosexual contact 1198 52 6264 50Sex with injection drug user 218 9 1324 11Sex with bisexual male 62 3 266 2Sex with person with hemophilia 1 0 11 0Sex with HIV-infected transfusion recipient 7 0 39 0Sex with HIV-infected person risk factor not specified 910 39 4624 37

Receipt of blood transfusion blood components or tissue 12 1 58 0Otherrisk factor not reported or identified 767 33 3843 31

Total 2318 100 12456 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 45

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 34: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulativemdashUnited States and Puerto Rico (cont)

Area of residence

2005 2006

Cumulative

No Rate No RateAdults or

adolescentsChildren (lt13 yrs) Total

Stockton Calif 52 78 52 77 1076 15 1091

Syracuse NY 52 80 49 75 1317 8 1325

TampandashSt PetersburgndashClearwater Fla 559 211 605 224 11174 112 11286

Toledo Ohio 25 38 66 101 812 14 826

Tucson Ariz 103 111 100 106 2010 10 2020

Tulsa Okla 83 94 65 72 1494 10 1504

Virginia BeachndashNorfolkndashNewport News VandashNC 183 111 132 80 4711 63 4774

Washington DCndashVandashMdndashWV 1322 252 1684 318 31130 315 31445

Bethesda Division 135 118 173 150 2774 23 2797

Washington Division 1187 289 1511 365 28356 292 28648

Wichita Kans 35 60 38 64 851 2 853

Worcester Mass 76 97 79 101 1783 20 1803

YoungstownndashWarrenndashBoardman OhiondashPa 27 46 26 44 519 0 519

Subtotal for MSAs (population gt500000) 33602 173 31274 159 829633 8171 837804

Metropolitan areas (population of 50000 to 499999) 4477 80 4466 79 94829 847 95676

Nonmetropolitan areas 2666 54 2732 55 52063 445 52508

Totalb 41144 137 38749 128 981708 9494 991202

Note Because of the lack of census information for all US dependent areas includes data for only the 50 states the District of Columbia and Puerto RicoMSA metropolitan statistical areaMSA definitions for this report can be found at httpwwwcensusgovpopulationwwwestimatesmetrodefhtmla Reported case counts for the metropolitan divisions do not sum to the MSA total MSA total includes data from 1 metropolitan division with

population of lt500000b Includes persons whose county of residence is unknown

34 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Alabama (January 1988) 502 6041 48 6089

Alaska (February 1999) 38 285 2 287

Arizona (January 1987) 617 5877 80 5957

Arkansas (July 1989) 206 2349 20 2369

California (April 2006) 6581 7056 92 7148

Colorado (November 1985) 319 6084 31 6115

Connecticut (January 2005)b 826 2500 101 2601

Delaware (February 2006) 788 801 18 819

Florida (July 1997)c 4163 36386 397 36783

Georgia (December 2003) 2245 8197 194 8391

Idaho (June 1986) 35 340 4 344

Illinois (January 2006) 6241 6661 162 6823

Indiana (July 1988) 399 4027 43 4070

Iowa (July 1998) 69 586 5 591

Kansas (July 1999) 142 1225 15 1240

Kentucky (October 2004) 333 1303 13 1316

Louisiana (February 1993) 728 8149 166 8315

Maine (January 2006) 386 393 3 396

Michigan (April 1992) 635 6702 134 6836

Minnesota (October 1985) 309 3356 40 3396

Mississippi (August 1988) 352 4549 59 4608

Missouri (October 1987) 502 5086 55 5141

Nebraska (September 1995) 91 672 14 686

Nevada (February 1992) 339 3532 24 3556

New Hampshire (January 2005) 59 466 9 475

New Jersey (January 1992) 1477 17513 325 17838

New Mexico (January 1998) 114 949 4 953

New York (June 2000) 5326 42345 1820 44165

North Carolina (February 1990) 1615 13879 143 14022

North Dakota (January 1988) 4 82 1 83

Ohio (June 1990) 867 8222 101 8323

Oklahoma (June 1988) 229 2401 30 2431

Oregon (April 2006) 49 95 19 114

Pennsylvania (October 2002)d 4269 9537 179 9716

Rhode Island (July 2006) 14 21 0 21

South Carolina (February 1986) 493 6970 93 7063

South Dakota (January 1988) 18 215 6 221

Tennessee (January 1992) 732 7115 90 7205

Texas (January 1999)e 3370 24282 417 24699

Utah (April 1989) 106 893 14 907

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 35

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Virginia (July 1989) 864 10257 95 10352

Washington (March 2006) 4048 4157 40 4197

West Virginia (January 1989) 66 673 8 681

Wisconsin (November 1985) 261 2500 31 2531

Wyoming (June 1989) 7 93 1 94

Subtotal 50834 274822 5146 279968

US dependent areas

American Samoa (August 2001) 0 1 0 1

Guam (March 2000) 2 66 0 66

Northern Mariana Islands (October 2001) 2 7 0 7

Puerto Rico (January 2003) 1471 5610 91 5701

US Virgin Islands (December 1998) 22 247 6 253

Persons reported from areas with confidential name-based HIV infection reporting but who were residents of other areas 132 685 21 706

Totalf 52878 282640 5314 287954

Note Includes data from 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through 2006b Beginning in 1992 Connecticut had name-based HIV reporting for cases in children only From January 2002 through December 2004

Connecticut had name- or code-based HIV reporting for cases in adolescents and adults As of January 2005 Connecticut has name-based reporting of all cases of HIV infection

c Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterd On October 18 2002 Pennsylvania initiated confidential name-based HIV infection reporting in all areas except Philadelphia Code-based

reporting was implemented in Philadelphia in March 2004 and the switch to name-based reporting was made in October 2005e From February 1994 through December 1998 Texas reported HIV infection in children onlyf Includes 1252 persons reported from areas with confidential name-based HIV infection reporting but whose area of residence is unknown

36 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulativemdashUnited States and dependent areas

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No Adult or adolescentMale-to-male sexual contact 13775 49 429897 54 mdash mdash mdash mdash 13775 35 429897 44Injection drug use 3413 12 163070 21 1826 17 67693 35 5239 13 230763 23Male-to-male sexual contact and

injection drug use 1603 6 65524 8 mdash mdash mdash mdash 1603 4 65524 7Hemophiliacoagulation disorder 43 0 5176 1 11 0 348 0 54 0 5524 1High-risk heterosexual contactc 2997 11 49610 6 4839 46 85186 44 7836 20 134796 14

Sex with injection drug user 330 1 11683 1 706 7 26073 14 1036 3 37756 4Sex with bisexual male mdash mdash mdash mdash 234 2 5162 3 234 1 5162 1Sex with person with hemophilia 1 0 84 0 11 0 502 0 12 0 586 0Sex with HIV-infected transfusion

recipient 22 0 553 0 21 0 793 0 43 0 1346 0Sex with HIV-infected person risk

factor not specified 2644 9 37290 5 3867 37 52656 27 6511 17 89946 9Receipt of blood transfusion blood

d components or tissue 63 0 5213 1 68 1 4176 2 131 0 9389 1Otherrisk factor not reported or

identifiede 6484 23 73136 9 3793 36 34311 18 10278 26 107450 11Subtotal 28378 100 791626 100 10537 100 191714 100 38916 100 983343 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 0 0 222 5 0 0 7 0 0 0 229 2Mother with documented HIV infection or

1 of the following risk factors 24 75 4315 89 50 93 4423 95 74 86 8738 92Injection drug use 4 13 1676 35 4 7 1665 36 8 9 3341 35Sex with injection drug user 4 13 789 16 4 7 750 16 8 9 1539 16Sex with bisexual male 1 3 101 2 2 4 110 2 3 3 211 2Sex with person with hemophilia 0 0 20 0 0 0 16 0 0 0 36 0Sex with HIV-infected transfusion

recipient 0 0 11 0 0 0 15 0 0 0 26 0Sex with HIV-infected person risk

factor not specified 6 19 742 15 17 31 790 17 23 27 1532 16Receipt of blood transfusion blood

components or tissue 0 0 70 1 0 0 82 2 0 0 152 2Has HIV infection risk factor not

specified 9 28 906 19 23 43 995 21 32 37 1901 20Receipt of blood transfusion blood

fcomponents or tissue 1 3 243 5 0 0 144 3 1 1 387 4Otherrisk factor not reported or

identifiedg 7 22 75 2 4 7 93 2 11 13 168 2Subtotal 32 100 4855 100 54 100 4667 100 86 100 9522 100

Total 28410 100 796481 100 10591 100 196381 100 39002 100 992865 100a From the beginning of the epidemic through 2006b From the beginning of the epidemic through 2006 Includes 3 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infectiond AIDS developed in 47 adultsadolescents after they received blood that had tested negative for HIV antibodies AIDS developed in 14 additional adults

after they received tissue organs or artificial insemination from HIV-infected donors Four of the 14 received tissue or organs from a donor who was negative for HIV antibody at the time of donation

e Includes 37 adultsadolescents who were exposed to HIV-infected blood body fluids or concentrated virus in health care laboratory or household settings as supported by seroconversion epidemiologic andor laboratory evidence One person was infected after intentional inoculation with HIV-infected blood Includes an additional 740 persons who acquired HIV infection perinatally but who were more than 12 years of age when AIDS was diagnosed These 740 persons are not counted in the values for the pediatric transmission category

f AIDS developed in 3 children after they received blood that had tested negative for HIV antibodiesg Includes 5 children who were exposed to HIV-infected blood as supported by seroconversion epidemiologic andor laboratory evidence 1 child was

infected after intentional inoculation with HIV-infected blood and 5 children were exposed to HIV-infected blood in a household setting Of the 168 children 26 had sexual contact with an adult with or at high risk for HIV infection

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 37

Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No

Adult or adolescentMale-to-male sexual contact 22912 59 103679 52 mdash mdash mdash mdash 22912 44 103679 37

Injection drug use 3503 9 24255 12 2124 16 13925 17 5627 11 38181 14

Male-to-male sexual contact and injection drug use 1946 5 10704 5 mdash mdash mdash mdash 1946 4 10704 4

Hemophiliacoagulation disorder 43 0 495 0 6 0 73 0 49 0 568 0

High-risk heterosexual contactc 2874 7 16830 8 5939 45 38315 47 8813 17 55145 20

Sex with injection drug user 308 1 2601 1 757 6 6791 8 1065 2 9392 3

Sex with bisexual male mdash mdash mdash mdash 328 2 2265 3 328 1 2265 1

Sex with person with hemophilia 4 0 31 0 16 0 201 0 20 0 232 0

Sex with HIV-infected transfusion recipient 13 0 131 0 28 0 223 0 41 0 354 0

Sex with HIV-infected person risk factor not specified 2549 7 14067 7 4810 36 28835 35 7359 14 42902 15

Receipt of blood transfusion blood components or tissue 61 0 489 0 50 0 536 1 111 0 1025 0

Otherrisk factor not reported or identified 7748 20 44021 22 5106 39 29312 36 12854 25 73338 26

Subtotal 39087 100 200473 100 13225 100 82161 100 52312 100 282640 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 8 3 106 4 0 0 1 0 8 1 107 2

Mother with documented HIV infection or 1 of the following risk factors 197 74 2195 85 254 85 2417 89 451 80 4612 87

Injection drug use 34 13 532 21 53 18 561 21 87 15 1093 21

Sex with injection drug user 12 5 208 8 21 7 213 8 33 6 421 8

Sex with bisexual male 5 2 37 1 4 1 32 1 9 2 69 1

Sex with person with hemophilia 0 0 3 0 1 0 7 0 1 0 10 0

Sex with HIV-infected transfusion recipient 0 0 4 0 0 0 4 0 0 0 8 0

Sex with HIV-infected person risk factor not specified 54 20 534 21 76 25 629 23 130 23 1163 22

Receipt of blood transfusion blood components or tissue 0 0 17 1 2 1 20 1 2 0 37 1

Has HIV infection risk factor not specified 92 35 860 33 97 32 951 35 189 33 1811 34

Receipt of blood transfusion blood components or tissue 6 2 28 1 3 1 24 1 9 2 52 1

Otherrisk factor not reported or identified 55 21 260 10 43 14 283 10 98 17 543 10

Subtotal 266 100 2589 100 300 100 2725 100 566 100 5314 100

Total 39353 100 203062 100 13525 100 84886 100 52878 100 287954 100

Note See Table 16 for the list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006b From the beginning of the epidemic through December 2006 Includes 6 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infection

38 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity

2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 6251 65 253927 73Injection drug use 733 8 31737 9Male-to-male sexual contact and injection drug use 732 8 31434 9Hemophiliacoagulation disorder 26 0 3989 1High-risk heterosexual contactb 416 4 7850 2

Sex with injection drug user 74 1 2310 1

Sex with person with hemophilia 0 0 36 0

Sex with HIV-infected transfusion recipient 2 0 176 0

Sex with HIV-infected person risk factor not specified 340 4 5328 2Receipt of blood transfusion blood components or tissue 20 0 3194 1Otherrisk factor not reported or identified 1400 15 16469 5

Total 9578 100 348600 100

Black not HispanicMale-to-male sexual contact 4309 36 103297 37Injection drug use 1635 14 83369 30Male-to-male sexual contact and injection drug use 526 4 22134 8Hemophiliacoagulation disorder 10 0 604 0High-risk heterosexual contactb 1875 16 29952 11

Sex with injection drug user 167 1 6823 2Sex with person with hemophilia 1 0 36 0Sex with HIV-infected transfusion recipient 15 0 237 0Sex with HIV-infected person risk factor not specified 1692 14 22856 8

Receipt of blood transfusion blood components or tissue 24 0 1218 0Otherrisk factor not reported or identified 3579 30 40268 14

Total 11958 100 280842 100

HispanicMale-to-male sexual contact 2816 47 64893 44Injection drug use 965 16 46337 31Male-to-male sexual contact and injection drug use 287 5 10884 7Hemophiliacoagulation disorder 6 0 466 0High-risk heterosexual contactb 638 11 10950 7

Sex with injection drug user 84 1 2409 2Sex with person with hemophilia 0 0 11 0Sex with HIV-infected transfusion recipient 5 0 125 0Sex with HIV-infected person risk factor not specified 549 9 8405 6

Receipt of blood transfusion blood components or tissue 17 0 657 0Otherrisk factor not reported or identified 1326 22 14832 10

Total 6055 100 149019 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 39

a

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulative

No No

AsianPacific IslanderMale-to-male sexual contact 225 54 4475 68Injection drug use 20 5 317 5Male-to-male sexual contact and injection drug use 17 4 284 4Hemophiliacoagulation disorder 1 0 70 1High-risk heterosexual contactb 34 8 376 6

Sex with injection drug user 1 0 54 1Sex with person with hemophilia 0 0 1 0Sex with HIV-infected transfusion recipient 0 0 8 0Sex with HIV-infected person risk factor not specified 33 8 313 5

Receipt of blood transfusion blood components or tissue 2 0 112 2Otherrisk factor not reported or identified 114 28 949 14

Total 413 100 6583 100

American IndianAlaska NativeMale-to-male sexual contact 61 49 1403 55Injection drug use 15 12 395 15Male-to-male sexual contact and injection drug use 23 19 457 18Hemophiliacoagulation disorder 0 0 27 1High-risk heterosexual contactb 9 7 118 5

Sex with injection drug user 1 1 33 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 8 6 82 3

Receipt of blood transfusion blood components or tissue 0 0 8 0Otherrisk factor not reported or identified 16 13 155 6

Total 124 100 2563 100

Total casesMale-to-male sexual contact 13775 49 429897 54Injection drug use 3413 12 163070 21Male-to-male sexual contact and injection drug use 1603 6 65524 8Hemophiliacoagulation disorder 43 0 5176 1High-risk heterosexual contactb 2997 11 49610 6

Sex with injection drug user 330 1 11683 1Sex with person with hemophilia 1 0 84 0Sex with HIV-infected transfusion recipient 22 0 553 0Sex with HIV-infected person risk factor not specified 2644 9 37290 5

Receipt of blood transfusion blood components or tissue 63 0 5213 1Otherrisk factor not reported or identified 6484 23 73136 9

Total 28378c 100 791626d 100a From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 4019 males of unknown race or multiple races

40 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 11963 73 55725 69Injection drug use 858 5 5512 7Male-to-male sexual contact and injection drug use 1092 7 5578 7Hemophiliacoagulation disorder 29 0 355 0High-risk heterosexual contactb 522 3 2658 3

Sex with injection drug user 65 0 544 1Sex with person with hemophilia 0 0 8 0Sex with HIV-infected transfusion recipient 3 0 33 0Sex with HIV-infected person risk factor not specified 454 3 2073 3

Receipt of blood transfusion blood components or tissue 14 0 197 0Otherrisk factor not reported or identified 1956 12 11147 14

Total 16434 100 81172 100

Black not HispanicMale-to-male sexual contact 6203 44 30148 37Injection drug use 1594 11 11997 15Male-to-male sexual contact and injection drug use 483 3 3489 4Hemophiliacoagulation disorder 10 0 109 0High-risk heterosexual contactb 1714 12 10905 13

Sex with injection drug user 169 1 1554 2Sex with person with hemophilia 4 0 17 0Sex with HIV-infected transfusion recipient 6 0 77 0Sex with HIV-infected person risk factor not specified 1535 11 9257 11

Receipt of blood transfusion blood components or tissue 32 0 223 0Otherrisk factor not reported or identified 4151 29 24632 30

Total 14187 100 81503 100

HispanicMale-to-male sexual contact 4094 55 15623 47Injection drug use 993 13 6407 19Male-to-male sexual contact and injection drug use 316 4 1402 4Hemophiliacoagulation disorder 3 0 26 0High-risk heterosexual contactb 582 8 2963 9

Sex with injection drug user 65 1 455 1Sex with person with hemophilia 0 0 6 0Sex with HIV-infected transfusion recipient 4 0 18 0Sex with HIV-infected person risk factor not specified 513 7 2484 7

Receipt of blood transfusion blood components or tissue 11 0 55 0Otherrisk factor not reported or identified 1475 20 6977 21

Total 7474 100 33453 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 41

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderMale-to-male sexual contact 402 70 1006 63Injection drug use 17 3 55 3Male-to-male sexual contact and injection drug use 15 3 38 2Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 25 4 96 6

Sex with injection drug user 3 1 10 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 22 4 83 5

Receipt of blood transfusion blood components or tissue 4 1 7 0Otherrisk factor not reported or identified 109 19 397 25

Total 572 100 1600 100

American IndianAlaska NativeMale-to-male sexual contact 104 61 516 57Injection drug use 13 8 101 11Male-to-male sexual contact and injection drug use 19 11 110 12Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 10 6 53 6

Sex with injection drug user 2 1 14 2Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 8 5 39 4

Receipt of blood transfusion blood components or tissue 0 0 2 0Otherrisk factor not reported or identified 24 14 125 14

Total 170 100 907 100

Total casesMale-to-male sexual contact 22912 59 103679 52Injection drug use 3503 9 24255 12Male-to-male sexual contact and injection drug use 1946 5 10704 5Hemophiliacoagulation disorder 43 0 495 0High-risk heterosexual contactb 2874 7 16830 8

Sex with injection drug user 308 1 2601 1Sex with person with hemophilia 4 0 31 0Sex with HIV-infected transfusion recipient 13 0 131 0Sex with HIV-infected person risk factor not specified 2549 7 14067 7

Receipt of blood transfusion blood components or tissue 61 0 489 0Otherrisk factor not reported or identified 7748 20 44021 22

Total 39087c 100 200473d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 1838 males of unknown race or multiple races

42 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race

ethnicity 2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 482 28 14981 40Hemophiliacoagulation disorder 4 0 123 0High-risk heterosexual contactb 725 42 15799 42

Sex with injection drug user 153 9 5650 15Sex with bisexual male 63 4 1859 5Sex with person with hemophilia 5 0 329 1Sex with HIV-infected transfusion recipient 5 0 338 1Sex with HIV-infected person risk factor not specified 499 29 7623 20

Receipt of blood transfusion blood components or tissue 15 1 1870 5Otherrisk factor not reported or identified 499 29 4801 13

Total 1725 100 37574 100

Black not HispanicInjection drug use 982 15 38914 34Hemophiliacoagulation disorder 3 0 145 0High-risk heterosexual contactb 3103 46 49876 44

Sex with injection drug user 373 6 13530 12Sex with bisexual male 136 2 2352 2Sex with person with hemophilia 4 0 121 0Sex with HIV-infected transfusion recipient 8 0 277 0Sex with HIV-infected person risk factor not specified 2582 38 33596 29

Receipt of blood transfusion blood components or tissue 39 1 1546 1Otherrisk factor not reported or identified 2612 39 23894 21

Total 6739 100 114375 100

HispanicInjection drug use 322 18 12892 35Hemophiliacoagulation disorder 4 0 67 0High-risk heterosexual contactb 894 49 17995 49

Sex with injection drug user 166 9 6522 18Sex with bisexual male 32 2 818 2Sex with person with hemophilia 1 0 45 0Sex with HIV-infected transfusion recipient 7 0 141 0Sex with HIV-infected person risk factor not specified 688 38 10469 29

Receipt of blood transfusion blood components or tissue 12 1 619 2Otherrisk factor not reported or identified 592 32 5023 14

Total 1824 100 36596 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 43

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 8 8 125 12Hemophiliacoagulation disorder 0 0 7 1High-risk heterosexual contactb 49 47 574 53

Sex with injection drug user 4 4 114 11Sex with bisexual male 2 2 80 7Sex with person with hemophilia 0 0 4 0Sex with HIV-infected transfusion recipient 1 1 25 2Sex with HIV-infected person risk factor not specified 42 40 351 33

Receipt of blood transfusion blood components or tissue 1 1 93 9Otherrisk factor not reported or identified 46 44 279 26

Total 104 100 1078 100

American IndianAlaska NativeInjection drug use 13 32 280 42Hemophiliacoagulation disorder 0 0 3 0High-risk heterosexual contactb 15 37 277 41

Sex with injection drug user 4 10 107 16Sex with bisexual male 1 2 27 4Sex with person with hemophilia 0 0 2 0Sex with HIV-infected transfusion recipient 0 0 6 1Sex with HIV-infected person risk factor not specified 10 24 135 20

Receipt of blood transfusion blood components or tissue 1 2 17 3Otherrisk factor not reported or identified 12 29 95 14

Total 41 100 672 100

Total casesInjection drug use 1826 17 67693 35Hemophiliacoagulation disorder 11 0 348 0High-risk heterosexual contactb 4839 46 85186 44

Sex with injection drug user 706 7 26073 14Sex with bisexual male 234 2 5162 3Sex with person with hemophilia 11 0 502 0Sex with HIV-infected transfusion recipient 21 0 793 0Sex with HIV-infected person risk factor not specified 3867 37 52656 27

Receipt of blood transfusion blood components or tissue 68 1 4176 2Otherrisk factor not reported or identified 3793 36 34311 18

Total 10537c 100 191714d 100a From the beginning of the epidemic through 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 104 females of unknown race or multiple racesd Includes 1419 females of unknown race or multiple races

44 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 690 26 4260 26Hemophiliacoagulation disorder 3 0 24 0

bHigh-risk heterosexual contact 1132 42 7593 46Sex with injection drug user 205 8 1876 11Sex with bisexual male 98 4 659 4Sex with person with hemophilia 10 0 115 1Sex with HIV-infected transfusion recipient 7 0 64 0Sex with HIV-infected person risk factor not specified 812 30 4879 29

Receipt of blood transfusion blood components or tissue 12 0 146 1Otherrisk factor not reported or identified 850 32 4567 28

Total 2687 100 16590 100

Black not HispanicInjection drug use 1034 13 7105 14Hemophiliacoagulation disorder 1 0 35 0

bHigh-risk heterosexual contact 3451 44 23732 46Sex with injection drug user 313 4 3473 7Sex with bisexual male 155 2 1294 3Sex with person with hemophilia 5 0 71 0Sex with HIV-infected transfusion recipient 14 0 120 0Sex with HIV-infected person risk factor not specified 2964 38 18774 36

Receipt of blood transfusion blood components or tissue 26 0 324 1Otherrisk factor not reported or identified 3370 43 20244 39

Total 7882 100 51440 100

HispanicInjection drug use 339 15 2280 18Hemophiliacoagulation disorder 2 0 11 0

bHigh-risk heterosexual contact 1198 52 6264 50Sex with injection drug user 218 9 1324 11Sex with bisexual male 62 3 266 2Sex with person with hemophilia 1 0 11 0Sex with HIV-infected transfusion recipient 7 0 39 0Sex with HIV-infected person risk factor not specified 910 39 4624 37

Receipt of blood transfusion blood components or tissue 12 1 58 0Otherrisk factor not reported or identified 767 33 3843 31

Total 2318 100 12456 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 45

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 35: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Alabama (January 1988) 502 6041 48 6089

Alaska (February 1999) 38 285 2 287

Arizona (January 1987) 617 5877 80 5957

Arkansas (July 1989) 206 2349 20 2369

California (April 2006) 6581 7056 92 7148

Colorado (November 1985) 319 6084 31 6115

Connecticut (January 2005)b 826 2500 101 2601

Delaware (February 2006) 788 801 18 819

Florida (July 1997)c 4163 36386 397 36783

Georgia (December 2003) 2245 8197 194 8391

Idaho (June 1986) 35 340 4 344

Illinois (January 2006) 6241 6661 162 6823

Indiana (July 1988) 399 4027 43 4070

Iowa (July 1998) 69 586 5 591

Kansas (July 1999) 142 1225 15 1240

Kentucky (October 2004) 333 1303 13 1316

Louisiana (February 1993) 728 8149 166 8315

Maine (January 2006) 386 393 3 396

Michigan (April 1992) 635 6702 134 6836

Minnesota (October 1985) 309 3356 40 3396

Mississippi (August 1988) 352 4549 59 4608

Missouri (October 1987) 502 5086 55 5141

Nebraska (September 1995) 91 672 14 686

Nevada (February 1992) 339 3532 24 3556

New Hampshire (January 2005) 59 466 9 475

New Jersey (January 1992) 1477 17513 325 17838

New Mexico (January 1998) 114 949 4 953

New York (June 2000) 5326 42345 1820 44165

North Carolina (February 1990) 1615 13879 143 14022

North Dakota (January 1988) 4 82 1 83

Ohio (June 1990) 867 8222 101 8323

Oklahoma (June 1988) 229 2401 30 2431

Oregon (April 2006) 49 95 19 114

Pennsylvania (October 2002)d 4269 9537 179 9716

Rhode Island (July 2006) 14 21 0 21

South Carolina (February 1986) 493 6970 93 7063

South Dakota (January 1988) 18 215 6 221

Tennessee (January 1992) 732 7115 90 7205

Texas (January 1999)e 3370 24282 417 24699

Utah (April 1989) 106 893 14 907

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 35

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Virginia (July 1989) 864 10257 95 10352

Washington (March 2006) 4048 4157 40 4197

West Virginia (January 1989) 66 673 8 681

Wisconsin (November 1985) 261 2500 31 2531

Wyoming (June 1989) 7 93 1 94

Subtotal 50834 274822 5146 279968

US dependent areas

American Samoa (August 2001) 0 1 0 1

Guam (March 2000) 2 66 0 66

Northern Mariana Islands (October 2001) 2 7 0 7

Puerto Rico (January 2003) 1471 5610 91 5701

US Virgin Islands (December 1998) 22 247 6 253

Persons reported from areas with confidential name-based HIV infection reporting but who were residents of other areas 132 685 21 706

Totalf 52878 282640 5314 287954

Note Includes data from 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through 2006b Beginning in 1992 Connecticut had name-based HIV reporting for cases in children only From January 2002 through December 2004

Connecticut had name- or code-based HIV reporting for cases in adolescents and adults As of January 2005 Connecticut has name-based reporting of all cases of HIV infection

c Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterd On October 18 2002 Pennsylvania initiated confidential name-based HIV infection reporting in all areas except Philadelphia Code-based

reporting was implemented in Philadelphia in March 2004 and the switch to name-based reporting was made in October 2005e From February 1994 through December 1998 Texas reported HIV infection in children onlyf Includes 1252 persons reported from areas with confidential name-based HIV infection reporting but whose area of residence is unknown

36 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulativemdashUnited States and dependent areas

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No Adult or adolescentMale-to-male sexual contact 13775 49 429897 54 mdash mdash mdash mdash 13775 35 429897 44Injection drug use 3413 12 163070 21 1826 17 67693 35 5239 13 230763 23Male-to-male sexual contact and

injection drug use 1603 6 65524 8 mdash mdash mdash mdash 1603 4 65524 7Hemophiliacoagulation disorder 43 0 5176 1 11 0 348 0 54 0 5524 1High-risk heterosexual contactc 2997 11 49610 6 4839 46 85186 44 7836 20 134796 14

Sex with injection drug user 330 1 11683 1 706 7 26073 14 1036 3 37756 4Sex with bisexual male mdash mdash mdash mdash 234 2 5162 3 234 1 5162 1Sex with person with hemophilia 1 0 84 0 11 0 502 0 12 0 586 0Sex with HIV-infected transfusion

recipient 22 0 553 0 21 0 793 0 43 0 1346 0Sex with HIV-infected person risk

factor not specified 2644 9 37290 5 3867 37 52656 27 6511 17 89946 9Receipt of blood transfusion blood

d components or tissue 63 0 5213 1 68 1 4176 2 131 0 9389 1Otherrisk factor not reported or

identifiede 6484 23 73136 9 3793 36 34311 18 10278 26 107450 11Subtotal 28378 100 791626 100 10537 100 191714 100 38916 100 983343 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 0 0 222 5 0 0 7 0 0 0 229 2Mother with documented HIV infection or

1 of the following risk factors 24 75 4315 89 50 93 4423 95 74 86 8738 92Injection drug use 4 13 1676 35 4 7 1665 36 8 9 3341 35Sex with injection drug user 4 13 789 16 4 7 750 16 8 9 1539 16Sex with bisexual male 1 3 101 2 2 4 110 2 3 3 211 2Sex with person with hemophilia 0 0 20 0 0 0 16 0 0 0 36 0Sex with HIV-infected transfusion

recipient 0 0 11 0 0 0 15 0 0 0 26 0Sex with HIV-infected person risk

factor not specified 6 19 742 15 17 31 790 17 23 27 1532 16Receipt of blood transfusion blood

components or tissue 0 0 70 1 0 0 82 2 0 0 152 2Has HIV infection risk factor not

specified 9 28 906 19 23 43 995 21 32 37 1901 20Receipt of blood transfusion blood

fcomponents or tissue 1 3 243 5 0 0 144 3 1 1 387 4Otherrisk factor not reported or

identifiedg 7 22 75 2 4 7 93 2 11 13 168 2Subtotal 32 100 4855 100 54 100 4667 100 86 100 9522 100

Total 28410 100 796481 100 10591 100 196381 100 39002 100 992865 100a From the beginning of the epidemic through 2006b From the beginning of the epidemic through 2006 Includes 3 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infectiond AIDS developed in 47 adultsadolescents after they received blood that had tested negative for HIV antibodies AIDS developed in 14 additional adults

after they received tissue organs or artificial insemination from HIV-infected donors Four of the 14 received tissue or organs from a donor who was negative for HIV antibody at the time of donation

e Includes 37 adultsadolescents who were exposed to HIV-infected blood body fluids or concentrated virus in health care laboratory or household settings as supported by seroconversion epidemiologic andor laboratory evidence One person was infected after intentional inoculation with HIV-infected blood Includes an additional 740 persons who acquired HIV infection perinatally but who were more than 12 years of age when AIDS was diagnosed These 740 persons are not counted in the values for the pediatric transmission category

f AIDS developed in 3 children after they received blood that had tested negative for HIV antibodiesg Includes 5 children who were exposed to HIV-infected blood as supported by seroconversion epidemiologic andor laboratory evidence 1 child was

infected after intentional inoculation with HIV-infected blood and 5 children were exposed to HIV-infected blood in a household setting Of the 168 children 26 had sexual contact with an adult with or at high risk for HIV infection

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 37

Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No

Adult or adolescentMale-to-male sexual contact 22912 59 103679 52 mdash mdash mdash mdash 22912 44 103679 37

Injection drug use 3503 9 24255 12 2124 16 13925 17 5627 11 38181 14

Male-to-male sexual contact and injection drug use 1946 5 10704 5 mdash mdash mdash mdash 1946 4 10704 4

Hemophiliacoagulation disorder 43 0 495 0 6 0 73 0 49 0 568 0

High-risk heterosexual contactc 2874 7 16830 8 5939 45 38315 47 8813 17 55145 20

Sex with injection drug user 308 1 2601 1 757 6 6791 8 1065 2 9392 3

Sex with bisexual male mdash mdash mdash mdash 328 2 2265 3 328 1 2265 1

Sex with person with hemophilia 4 0 31 0 16 0 201 0 20 0 232 0

Sex with HIV-infected transfusion recipient 13 0 131 0 28 0 223 0 41 0 354 0

Sex with HIV-infected person risk factor not specified 2549 7 14067 7 4810 36 28835 35 7359 14 42902 15

Receipt of blood transfusion blood components or tissue 61 0 489 0 50 0 536 1 111 0 1025 0

Otherrisk factor not reported or identified 7748 20 44021 22 5106 39 29312 36 12854 25 73338 26

Subtotal 39087 100 200473 100 13225 100 82161 100 52312 100 282640 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 8 3 106 4 0 0 1 0 8 1 107 2

Mother with documented HIV infection or 1 of the following risk factors 197 74 2195 85 254 85 2417 89 451 80 4612 87

Injection drug use 34 13 532 21 53 18 561 21 87 15 1093 21

Sex with injection drug user 12 5 208 8 21 7 213 8 33 6 421 8

Sex with bisexual male 5 2 37 1 4 1 32 1 9 2 69 1

Sex with person with hemophilia 0 0 3 0 1 0 7 0 1 0 10 0

Sex with HIV-infected transfusion recipient 0 0 4 0 0 0 4 0 0 0 8 0

Sex with HIV-infected person risk factor not specified 54 20 534 21 76 25 629 23 130 23 1163 22

Receipt of blood transfusion blood components or tissue 0 0 17 1 2 1 20 1 2 0 37 1

Has HIV infection risk factor not specified 92 35 860 33 97 32 951 35 189 33 1811 34

Receipt of blood transfusion blood components or tissue 6 2 28 1 3 1 24 1 9 2 52 1

Otherrisk factor not reported or identified 55 21 260 10 43 14 283 10 98 17 543 10

Subtotal 266 100 2589 100 300 100 2725 100 566 100 5314 100

Total 39353 100 203062 100 13525 100 84886 100 52878 100 287954 100

Note See Table 16 for the list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006b From the beginning of the epidemic through December 2006 Includes 6 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infection

38 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity

2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 6251 65 253927 73Injection drug use 733 8 31737 9Male-to-male sexual contact and injection drug use 732 8 31434 9Hemophiliacoagulation disorder 26 0 3989 1High-risk heterosexual contactb 416 4 7850 2

Sex with injection drug user 74 1 2310 1

Sex with person with hemophilia 0 0 36 0

Sex with HIV-infected transfusion recipient 2 0 176 0

Sex with HIV-infected person risk factor not specified 340 4 5328 2Receipt of blood transfusion blood components or tissue 20 0 3194 1Otherrisk factor not reported or identified 1400 15 16469 5

Total 9578 100 348600 100

Black not HispanicMale-to-male sexual contact 4309 36 103297 37Injection drug use 1635 14 83369 30Male-to-male sexual contact and injection drug use 526 4 22134 8Hemophiliacoagulation disorder 10 0 604 0High-risk heterosexual contactb 1875 16 29952 11

Sex with injection drug user 167 1 6823 2Sex with person with hemophilia 1 0 36 0Sex with HIV-infected transfusion recipient 15 0 237 0Sex with HIV-infected person risk factor not specified 1692 14 22856 8

Receipt of blood transfusion blood components or tissue 24 0 1218 0Otherrisk factor not reported or identified 3579 30 40268 14

Total 11958 100 280842 100

HispanicMale-to-male sexual contact 2816 47 64893 44Injection drug use 965 16 46337 31Male-to-male sexual contact and injection drug use 287 5 10884 7Hemophiliacoagulation disorder 6 0 466 0High-risk heterosexual contactb 638 11 10950 7

Sex with injection drug user 84 1 2409 2Sex with person with hemophilia 0 0 11 0Sex with HIV-infected transfusion recipient 5 0 125 0Sex with HIV-infected person risk factor not specified 549 9 8405 6

Receipt of blood transfusion blood components or tissue 17 0 657 0Otherrisk factor not reported or identified 1326 22 14832 10

Total 6055 100 149019 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 39

a

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulative

No No

AsianPacific IslanderMale-to-male sexual contact 225 54 4475 68Injection drug use 20 5 317 5Male-to-male sexual contact and injection drug use 17 4 284 4Hemophiliacoagulation disorder 1 0 70 1High-risk heterosexual contactb 34 8 376 6

Sex with injection drug user 1 0 54 1Sex with person with hemophilia 0 0 1 0Sex with HIV-infected transfusion recipient 0 0 8 0Sex with HIV-infected person risk factor not specified 33 8 313 5

Receipt of blood transfusion blood components or tissue 2 0 112 2Otherrisk factor not reported or identified 114 28 949 14

Total 413 100 6583 100

American IndianAlaska NativeMale-to-male sexual contact 61 49 1403 55Injection drug use 15 12 395 15Male-to-male sexual contact and injection drug use 23 19 457 18Hemophiliacoagulation disorder 0 0 27 1High-risk heterosexual contactb 9 7 118 5

Sex with injection drug user 1 1 33 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 8 6 82 3

Receipt of blood transfusion blood components or tissue 0 0 8 0Otherrisk factor not reported or identified 16 13 155 6

Total 124 100 2563 100

Total casesMale-to-male sexual contact 13775 49 429897 54Injection drug use 3413 12 163070 21Male-to-male sexual contact and injection drug use 1603 6 65524 8Hemophiliacoagulation disorder 43 0 5176 1High-risk heterosexual contactb 2997 11 49610 6

Sex with injection drug user 330 1 11683 1Sex with person with hemophilia 1 0 84 0Sex with HIV-infected transfusion recipient 22 0 553 0Sex with HIV-infected person risk factor not specified 2644 9 37290 5

Receipt of blood transfusion blood components or tissue 63 0 5213 1Otherrisk factor not reported or identified 6484 23 73136 9

Total 28378c 100 791626d 100a From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 4019 males of unknown race or multiple races

40 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 11963 73 55725 69Injection drug use 858 5 5512 7Male-to-male sexual contact and injection drug use 1092 7 5578 7Hemophiliacoagulation disorder 29 0 355 0High-risk heterosexual contactb 522 3 2658 3

Sex with injection drug user 65 0 544 1Sex with person with hemophilia 0 0 8 0Sex with HIV-infected transfusion recipient 3 0 33 0Sex with HIV-infected person risk factor not specified 454 3 2073 3

Receipt of blood transfusion blood components or tissue 14 0 197 0Otherrisk factor not reported or identified 1956 12 11147 14

Total 16434 100 81172 100

Black not HispanicMale-to-male sexual contact 6203 44 30148 37Injection drug use 1594 11 11997 15Male-to-male sexual contact and injection drug use 483 3 3489 4Hemophiliacoagulation disorder 10 0 109 0High-risk heterosexual contactb 1714 12 10905 13

Sex with injection drug user 169 1 1554 2Sex with person with hemophilia 4 0 17 0Sex with HIV-infected transfusion recipient 6 0 77 0Sex with HIV-infected person risk factor not specified 1535 11 9257 11

Receipt of blood transfusion blood components or tissue 32 0 223 0Otherrisk factor not reported or identified 4151 29 24632 30

Total 14187 100 81503 100

HispanicMale-to-male sexual contact 4094 55 15623 47Injection drug use 993 13 6407 19Male-to-male sexual contact and injection drug use 316 4 1402 4Hemophiliacoagulation disorder 3 0 26 0High-risk heterosexual contactb 582 8 2963 9

Sex with injection drug user 65 1 455 1Sex with person with hemophilia 0 0 6 0Sex with HIV-infected transfusion recipient 4 0 18 0Sex with HIV-infected person risk factor not specified 513 7 2484 7

Receipt of blood transfusion blood components or tissue 11 0 55 0Otherrisk factor not reported or identified 1475 20 6977 21

Total 7474 100 33453 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 41

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderMale-to-male sexual contact 402 70 1006 63Injection drug use 17 3 55 3Male-to-male sexual contact and injection drug use 15 3 38 2Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 25 4 96 6

Sex with injection drug user 3 1 10 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 22 4 83 5

Receipt of blood transfusion blood components or tissue 4 1 7 0Otherrisk factor not reported or identified 109 19 397 25

Total 572 100 1600 100

American IndianAlaska NativeMale-to-male sexual contact 104 61 516 57Injection drug use 13 8 101 11Male-to-male sexual contact and injection drug use 19 11 110 12Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 10 6 53 6

Sex with injection drug user 2 1 14 2Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 8 5 39 4

Receipt of blood transfusion blood components or tissue 0 0 2 0Otherrisk factor not reported or identified 24 14 125 14

Total 170 100 907 100

Total casesMale-to-male sexual contact 22912 59 103679 52Injection drug use 3503 9 24255 12Male-to-male sexual contact and injection drug use 1946 5 10704 5Hemophiliacoagulation disorder 43 0 495 0High-risk heterosexual contactb 2874 7 16830 8

Sex with injection drug user 308 1 2601 1Sex with person with hemophilia 4 0 31 0Sex with HIV-infected transfusion recipient 13 0 131 0Sex with HIV-infected person risk factor not specified 2549 7 14067 7

Receipt of blood transfusion blood components or tissue 61 0 489 0Otherrisk factor not reported or identified 7748 20 44021 22

Total 39087c 100 200473d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 1838 males of unknown race or multiple races

42 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race

ethnicity 2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 482 28 14981 40Hemophiliacoagulation disorder 4 0 123 0High-risk heterosexual contactb 725 42 15799 42

Sex with injection drug user 153 9 5650 15Sex with bisexual male 63 4 1859 5Sex with person with hemophilia 5 0 329 1Sex with HIV-infected transfusion recipient 5 0 338 1Sex with HIV-infected person risk factor not specified 499 29 7623 20

Receipt of blood transfusion blood components or tissue 15 1 1870 5Otherrisk factor not reported or identified 499 29 4801 13

Total 1725 100 37574 100

Black not HispanicInjection drug use 982 15 38914 34Hemophiliacoagulation disorder 3 0 145 0High-risk heterosexual contactb 3103 46 49876 44

Sex with injection drug user 373 6 13530 12Sex with bisexual male 136 2 2352 2Sex with person with hemophilia 4 0 121 0Sex with HIV-infected transfusion recipient 8 0 277 0Sex with HIV-infected person risk factor not specified 2582 38 33596 29

Receipt of blood transfusion blood components or tissue 39 1 1546 1Otherrisk factor not reported or identified 2612 39 23894 21

Total 6739 100 114375 100

HispanicInjection drug use 322 18 12892 35Hemophiliacoagulation disorder 4 0 67 0High-risk heterosexual contactb 894 49 17995 49

Sex with injection drug user 166 9 6522 18Sex with bisexual male 32 2 818 2Sex with person with hemophilia 1 0 45 0Sex with HIV-infected transfusion recipient 7 0 141 0Sex with HIV-infected person risk factor not specified 688 38 10469 29

Receipt of blood transfusion blood components or tissue 12 1 619 2Otherrisk factor not reported or identified 592 32 5023 14

Total 1824 100 36596 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 43

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 8 8 125 12Hemophiliacoagulation disorder 0 0 7 1High-risk heterosexual contactb 49 47 574 53

Sex with injection drug user 4 4 114 11Sex with bisexual male 2 2 80 7Sex with person with hemophilia 0 0 4 0Sex with HIV-infected transfusion recipient 1 1 25 2Sex with HIV-infected person risk factor not specified 42 40 351 33

Receipt of blood transfusion blood components or tissue 1 1 93 9Otherrisk factor not reported or identified 46 44 279 26

Total 104 100 1078 100

American IndianAlaska NativeInjection drug use 13 32 280 42Hemophiliacoagulation disorder 0 0 3 0High-risk heterosexual contactb 15 37 277 41

Sex with injection drug user 4 10 107 16Sex with bisexual male 1 2 27 4Sex with person with hemophilia 0 0 2 0Sex with HIV-infected transfusion recipient 0 0 6 1Sex with HIV-infected person risk factor not specified 10 24 135 20

Receipt of blood transfusion blood components or tissue 1 2 17 3Otherrisk factor not reported or identified 12 29 95 14

Total 41 100 672 100

Total casesInjection drug use 1826 17 67693 35Hemophiliacoagulation disorder 11 0 348 0High-risk heterosexual contactb 4839 46 85186 44

Sex with injection drug user 706 7 26073 14Sex with bisexual male 234 2 5162 3Sex with person with hemophilia 11 0 502 0Sex with HIV-infected transfusion recipient 21 0 793 0Sex with HIV-infected person risk factor not specified 3867 37 52656 27

Receipt of blood transfusion blood components or tissue 68 1 4176 2Otherrisk factor not reported or identified 3793 36 34311 18

Total 10537c 100 191714d 100a From the beginning of the epidemic through 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 104 females of unknown race or multiple racesd Includes 1419 females of unknown race or multiple races

44 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 690 26 4260 26Hemophiliacoagulation disorder 3 0 24 0

bHigh-risk heterosexual contact 1132 42 7593 46Sex with injection drug user 205 8 1876 11Sex with bisexual male 98 4 659 4Sex with person with hemophilia 10 0 115 1Sex with HIV-infected transfusion recipient 7 0 64 0Sex with HIV-infected person risk factor not specified 812 30 4879 29

Receipt of blood transfusion blood components or tissue 12 0 146 1Otherrisk factor not reported or identified 850 32 4567 28

Total 2687 100 16590 100

Black not HispanicInjection drug use 1034 13 7105 14Hemophiliacoagulation disorder 1 0 35 0

bHigh-risk heterosexual contact 3451 44 23732 46Sex with injection drug user 313 4 3473 7Sex with bisexual male 155 2 1294 3Sex with person with hemophilia 5 0 71 0Sex with HIV-infected transfusion recipient 14 0 120 0Sex with HIV-infected person risk factor not specified 2964 38 18774 36

Receipt of blood transfusion blood components or tissue 26 0 324 1Otherrisk factor not reported or identified 3370 43 20244 39

Total 7882 100 51440 100

HispanicInjection drug use 339 15 2280 18Hemophiliacoagulation disorder 2 0 11 0

bHigh-risk heterosexual contact 1198 52 6264 50Sex with injection drug user 218 9 1324 11Sex with bisexual male 62 3 266 2Sex with person with hemophilia 1 0 11 0Sex with HIV-infected transfusion recipient 7 0 39 0Sex with HIV-infected person risk factor not specified 910 39 4624 37

Receipt of blood transfusion blood components or tissue 12 1 58 0Otherrisk factor not reported or identified 767 33 3843 31

Total 2318 100 12456 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 45

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 36: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Area of residence(Date HIV reporting initiated)

2006No

Cumulativea

Adults or adolescents

Children (lt13 yrs) Total

Virginia (July 1989) 864 10257 95 10352

Washington (March 2006) 4048 4157 40 4197

West Virginia (January 1989) 66 673 8 681

Wisconsin (November 1985) 261 2500 31 2531

Wyoming (June 1989) 7 93 1 94

Subtotal 50834 274822 5146 279968

US dependent areas

American Samoa (August 2001) 0 1 0 1

Guam (March 2000) 2 66 0 66

Northern Mariana Islands (October 2001) 2 7 0 7

Puerto Rico (January 2003) 1471 5610 91 5701

US Virgin Islands (December 1998) 22 247 6 253

Persons reported from areas with confidential name-based HIV infection reporting but who were residents of other areas 132 685 21 706

Totalf 52878 282640 5314 287954

Note Includes data from 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through 2006b Beginning in 1992 Connecticut had name-based HIV reporting for cases in children only From January 2002 through December 2004

Connecticut had name- or code-based HIV reporting for cases in adolescents and adults As of January 2005 Connecticut has name-based reporting of all cases of HIV infection

c Florida has confidential name-based HIV infection reporting for only the diagnoses made during July 1997 or laterd On October 18 2002 Pennsylvania initiated confidential name-based HIV infection reporting in all areas except Philadelphia Code-based

reporting was implemented in Philadelphia in March 2004 and the switch to name-based reporting was made in October 2005e From February 1994 through December 1998 Texas reported HIV infection in children onlyf Includes 1252 persons reported from areas with confidential name-based HIV infection reporting but whose area of residence is unknown

36 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulativemdashUnited States and dependent areas

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No Adult or adolescentMale-to-male sexual contact 13775 49 429897 54 mdash mdash mdash mdash 13775 35 429897 44Injection drug use 3413 12 163070 21 1826 17 67693 35 5239 13 230763 23Male-to-male sexual contact and

injection drug use 1603 6 65524 8 mdash mdash mdash mdash 1603 4 65524 7Hemophiliacoagulation disorder 43 0 5176 1 11 0 348 0 54 0 5524 1High-risk heterosexual contactc 2997 11 49610 6 4839 46 85186 44 7836 20 134796 14

Sex with injection drug user 330 1 11683 1 706 7 26073 14 1036 3 37756 4Sex with bisexual male mdash mdash mdash mdash 234 2 5162 3 234 1 5162 1Sex with person with hemophilia 1 0 84 0 11 0 502 0 12 0 586 0Sex with HIV-infected transfusion

recipient 22 0 553 0 21 0 793 0 43 0 1346 0Sex with HIV-infected person risk

factor not specified 2644 9 37290 5 3867 37 52656 27 6511 17 89946 9Receipt of blood transfusion blood

d components or tissue 63 0 5213 1 68 1 4176 2 131 0 9389 1Otherrisk factor not reported or

identifiede 6484 23 73136 9 3793 36 34311 18 10278 26 107450 11Subtotal 28378 100 791626 100 10537 100 191714 100 38916 100 983343 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 0 0 222 5 0 0 7 0 0 0 229 2Mother with documented HIV infection or

1 of the following risk factors 24 75 4315 89 50 93 4423 95 74 86 8738 92Injection drug use 4 13 1676 35 4 7 1665 36 8 9 3341 35Sex with injection drug user 4 13 789 16 4 7 750 16 8 9 1539 16Sex with bisexual male 1 3 101 2 2 4 110 2 3 3 211 2Sex with person with hemophilia 0 0 20 0 0 0 16 0 0 0 36 0Sex with HIV-infected transfusion

recipient 0 0 11 0 0 0 15 0 0 0 26 0Sex with HIV-infected person risk

factor not specified 6 19 742 15 17 31 790 17 23 27 1532 16Receipt of blood transfusion blood

components or tissue 0 0 70 1 0 0 82 2 0 0 152 2Has HIV infection risk factor not

specified 9 28 906 19 23 43 995 21 32 37 1901 20Receipt of blood transfusion blood

fcomponents or tissue 1 3 243 5 0 0 144 3 1 1 387 4Otherrisk factor not reported or

identifiedg 7 22 75 2 4 7 93 2 11 13 168 2Subtotal 32 100 4855 100 54 100 4667 100 86 100 9522 100

Total 28410 100 796481 100 10591 100 196381 100 39002 100 992865 100a From the beginning of the epidemic through 2006b From the beginning of the epidemic through 2006 Includes 3 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infectiond AIDS developed in 47 adultsadolescents after they received blood that had tested negative for HIV antibodies AIDS developed in 14 additional adults

after they received tissue organs or artificial insemination from HIV-infected donors Four of the 14 received tissue or organs from a donor who was negative for HIV antibody at the time of donation

e Includes 37 adultsadolescents who were exposed to HIV-infected blood body fluids or concentrated virus in health care laboratory or household settings as supported by seroconversion epidemiologic andor laboratory evidence One person was infected after intentional inoculation with HIV-infected blood Includes an additional 740 persons who acquired HIV infection perinatally but who were more than 12 years of age when AIDS was diagnosed These 740 persons are not counted in the values for the pediatric transmission category

f AIDS developed in 3 children after they received blood that had tested negative for HIV antibodiesg Includes 5 children who were exposed to HIV-infected blood as supported by seroconversion epidemiologic andor laboratory evidence 1 child was

infected after intentional inoculation with HIV-infected blood and 5 children were exposed to HIV-infected blood in a household setting Of the 168 children 26 had sexual contact with an adult with or at high risk for HIV infection

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 37

Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No

Adult or adolescentMale-to-male sexual contact 22912 59 103679 52 mdash mdash mdash mdash 22912 44 103679 37

Injection drug use 3503 9 24255 12 2124 16 13925 17 5627 11 38181 14

Male-to-male sexual contact and injection drug use 1946 5 10704 5 mdash mdash mdash mdash 1946 4 10704 4

Hemophiliacoagulation disorder 43 0 495 0 6 0 73 0 49 0 568 0

High-risk heterosexual contactc 2874 7 16830 8 5939 45 38315 47 8813 17 55145 20

Sex with injection drug user 308 1 2601 1 757 6 6791 8 1065 2 9392 3

Sex with bisexual male mdash mdash mdash mdash 328 2 2265 3 328 1 2265 1

Sex with person with hemophilia 4 0 31 0 16 0 201 0 20 0 232 0

Sex with HIV-infected transfusion recipient 13 0 131 0 28 0 223 0 41 0 354 0

Sex with HIV-infected person risk factor not specified 2549 7 14067 7 4810 36 28835 35 7359 14 42902 15

Receipt of blood transfusion blood components or tissue 61 0 489 0 50 0 536 1 111 0 1025 0

Otherrisk factor not reported or identified 7748 20 44021 22 5106 39 29312 36 12854 25 73338 26

Subtotal 39087 100 200473 100 13225 100 82161 100 52312 100 282640 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 8 3 106 4 0 0 1 0 8 1 107 2

Mother with documented HIV infection or 1 of the following risk factors 197 74 2195 85 254 85 2417 89 451 80 4612 87

Injection drug use 34 13 532 21 53 18 561 21 87 15 1093 21

Sex with injection drug user 12 5 208 8 21 7 213 8 33 6 421 8

Sex with bisexual male 5 2 37 1 4 1 32 1 9 2 69 1

Sex with person with hemophilia 0 0 3 0 1 0 7 0 1 0 10 0

Sex with HIV-infected transfusion recipient 0 0 4 0 0 0 4 0 0 0 8 0

Sex with HIV-infected person risk factor not specified 54 20 534 21 76 25 629 23 130 23 1163 22

Receipt of blood transfusion blood components or tissue 0 0 17 1 2 1 20 1 2 0 37 1

Has HIV infection risk factor not specified 92 35 860 33 97 32 951 35 189 33 1811 34

Receipt of blood transfusion blood components or tissue 6 2 28 1 3 1 24 1 9 2 52 1

Otherrisk factor not reported or identified 55 21 260 10 43 14 283 10 98 17 543 10

Subtotal 266 100 2589 100 300 100 2725 100 566 100 5314 100

Total 39353 100 203062 100 13525 100 84886 100 52878 100 287954 100

Note See Table 16 for the list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006b From the beginning of the epidemic through December 2006 Includes 6 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infection

38 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity

2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 6251 65 253927 73Injection drug use 733 8 31737 9Male-to-male sexual contact and injection drug use 732 8 31434 9Hemophiliacoagulation disorder 26 0 3989 1High-risk heterosexual contactb 416 4 7850 2

Sex with injection drug user 74 1 2310 1

Sex with person with hemophilia 0 0 36 0

Sex with HIV-infected transfusion recipient 2 0 176 0

Sex with HIV-infected person risk factor not specified 340 4 5328 2Receipt of blood transfusion blood components or tissue 20 0 3194 1Otherrisk factor not reported or identified 1400 15 16469 5

Total 9578 100 348600 100

Black not HispanicMale-to-male sexual contact 4309 36 103297 37Injection drug use 1635 14 83369 30Male-to-male sexual contact and injection drug use 526 4 22134 8Hemophiliacoagulation disorder 10 0 604 0High-risk heterosexual contactb 1875 16 29952 11

Sex with injection drug user 167 1 6823 2Sex with person with hemophilia 1 0 36 0Sex with HIV-infected transfusion recipient 15 0 237 0Sex with HIV-infected person risk factor not specified 1692 14 22856 8

Receipt of blood transfusion blood components or tissue 24 0 1218 0Otherrisk factor not reported or identified 3579 30 40268 14

Total 11958 100 280842 100

HispanicMale-to-male sexual contact 2816 47 64893 44Injection drug use 965 16 46337 31Male-to-male sexual contact and injection drug use 287 5 10884 7Hemophiliacoagulation disorder 6 0 466 0High-risk heterosexual contactb 638 11 10950 7

Sex with injection drug user 84 1 2409 2Sex with person with hemophilia 0 0 11 0Sex with HIV-infected transfusion recipient 5 0 125 0Sex with HIV-infected person risk factor not specified 549 9 8405 6

Receipt of blood transfusion blood components or tissue 17 0 657 0Otherrisk factor not reported or identified 1326 22 14832 10

Total 6055 100 149019 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 39

a

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulative

No No

AsianPacific IslanderMale-to-male sexual contact 225 54 4475 68Injection drug use 20 5 317 5Male-to-male sexual contact and injection drug use 17 4 284 4Hemophiliacoagulation disorder 1 0 70 1High-risk heterosexual contactb 34 8 376 6

Sex with injection drug user 1 0 54 1Sex with person with hemophilia 0 0 1 0Sex with HIV-infected transfusion recipient 0 0 8 0Sex with HIV-infected person risk factor not specified 33 8 313 5

Receipt of blood transfusion blood components or tissue 2 0 112 2Otherrisk factor not reported or identified 114 28 949 14

Total 413 100 6583 100

American IndianAlaska NativeMale-to-male sexual contact 61 49 1403 55Injection drug use 15 12 395 15Male-to-male sexual contact and injection drug use 23 19 457 18Hemophiliacoagulation disorder 0 0 27 1High-risk heterosexual contactb 9 7 118 5

Sex with injection drug user 1 1 33 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 8 6 82 3

Receipt of blood transfusion blood components or tissue 0 0 8 0Otherrisk factor not reported or identified 16 13 155 6

Total 124 100 2563 100

Total casesMale-to-male sexual contact 13775 49 429897 54Injection drug use 3413 12 163070 21Male-to-male sexual contact and injection drug use 1603 6 65524 8Hemophiliacoagulation disorder 43 0 5176 1High-risk heterosexual contactb 2997 11 49610 6

Sex with injection drug user 330 1 11683 1Sex with person with hemophilia 1 0 84 0Sex with HIV-infected transfusion recipient 22 0 553 0Sex with HIV-infected person risk factor not specified 2644 9 37290 5

Receipt of blood transfusion blood components or tissue 63 0 5213 1Otherrisk factor not reported or identified 6484 23 73136 9

Total 28378c 100 791626d 100a From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 4019 males of unknown race or multiple races

40 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 11963 73 55725 69Injection drug use 858 5 5512 7Male-to-male sexual contact and injection drug use 1092 7 5578 7Hemophiliacoagulation disorder 29 0 355 0High-risk heterosexual contactb 522 3 2658 3

Sex with injection drug user 65 0 544 1Sex with person with hemophilia 0 0 8 0Sex with HIV-infected transfusion recipient 3 0 33 0Sex with HIV-infected person risk factor not specified 454 3 2073 3

Receipt of blood transfusion blood components or tissue 14 0 197 0Otherrisk factor not reported or identified 1956 12 11147 14

Total 16434 100 81172 100

Black not HispanicMale-to-male sexual contact 6203 44 30148 37Injection drug use 1594 11 11997 15Male-to-male sexual contact and injection drug use 483 3 3489 4Hemophiliacoagulation disorder 10 0 109 0High-risk heterosexual contactb 1714 12 10905 13

Sex with injection drug user 169 1 1554 2Sex with person with hemophilia 4 0 17 0Sex with HIV-infected transfusion recipient 6 0 77 0Sex with HIV-infected person risk factor not specified 1535 11 9257 11

Receipt of blood transfusion blood components or tissue 32 0 223 0Otherrisk factor not reported or identified 4151 29 24632 30

Total 14187 100 81503 100

HispanicMale-to-male sexual contact 4094 55 15623 47Injection drug use 993 13 6407 19Male-to-male sexual contact and injection drug use 316 4 1402 4Hemophiliacoagulation disorder 3 0 26 0High-risk heterosexual contactb 582 8 2963 9

Sex with injection drug user 65 1 455 1Sex with person with hemophilia 0 0 6 0Sex with HIV-infected transfusion recipient 4 0 18 0Sex with HIV-infected person risk factor not specified 513 7 2484 7

Receipt of blood transfusion blood components or tissue 11 0 55 0Otherrisk factor not reported or identified 1475 20 6977 21

Total 7474 100 33453 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 41

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderMale-to-male sexual contact 402 70 1006 63Injection drug use 17 3 55 3Male-to-male sexual contact and injection drug use 15 3 38 2Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 25 4 96 6

Sex with injection drug user 3 1 10 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 22 4 83 5

Receipt of blood transfusion blood components or tissue 4 1 7 0Otherrisk factor not reported or identified 109 19 397 25

Total 572 100 1600 100

American IndianAlaska NativeMale-to-male sexual contact 104 61 516 57Injection drug use 13 8 101 11Male-to-male sexual contact and injection drug use 19 11 110 12Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 10 6 53 6

Sex with injection drug user 2 1 14 2Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 8 5 39 4

Receipt of blood transfusion blood components or tissue 0 0 2 0Otherrisk factor not reported or identified 24 14 125 14

Total 170 100 907 100

Total casesMale-to-male sexual contact 22912 59 103679 52Injection drug use 3503 9 24255 12Male-to-male sexual contact and injection drug use 1946 5 10704 5Hemophiliacoagulation disorder 43 0 495 0High-risk heterosexual contactb 2874 7 16830 8

Sex with injection drug user 308 1 2601 1Sex with person with hemophilia 4 0 31 0Sex with HIV-infected transfusion recipient 13 0 131 0Sex with HIV-infected person risk factor not specified 2549 7 14067 7

Receipt of blood transfusion blood components or tissue 61 0 489 0Otherrisk factor not reported or identified 7748 20 44021 22

Total 39087c 100 200473d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 1838 males of unknown race or multiple races

42 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race

ethnicity 2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 482 28 14981 40Hemophiliacoagulation disorder 4 0 123 0High-risk heterosexual contactb 725 42 15799 42

Sex with injection drug user 153 9 5650 15Sex with bisexual male 63 4 1859 5Sex with person with hemophilia 5 0 329 1Sex with HIV-infected transfusion recipient 5 0 338 1Sex with HIV-infected person risk factor not specified 499 29 7623 20

Receipt of blood transfusion blood components or tissue 15 1 1870 5Otherrisk factor not reported or identified 499 29 4801 13

Total 1725 100 37574 100

Black not HispanicInjection drug use 982 15 38914 34Hemophiliacoagulation disorder 3 0 145 0High-risk heterosexual contactb 3103 46 49876 44

Sex with injection drug user 373 6 13530 12Sex with bisexual male 136 2 2352 2Sex with person with hemophilia 4 0 121 0Sex with HIV-infected transfusion recipient 8 0 277 0Sex with HIV-infected person risk factor not specified 2582 38 33596 29

Receipt of blood transfusion blood components or tissue 39 1 1546 1Otherrisk factor not reported or identified 2612 39 23894 21

Total 6739 100 114375 100

HispanicInjection drug use 322 18 12892 35Hemophiliacoagulation disorder 4 0 67 0High-risk heterosexual contactb 894 49 17995 49

Sex with injection drug user 166 9 6522 18Sex with bisexual male 32 2 818 2Sex with person with hemophilia 1 0 45 0Sex with HIV-infected transfusion recipient 7 0 141 0Sex with HIV-infected person risk factor not specified 688 38 10469 29

Receipt of blood transfusion blood components or tissue 12 1 619 2Otherrisk factor not reported or identified 592 32 5023 14

Total 1824 100 36596 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 43

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 8 8 125 12Hemophiliacoagulation disorder 0 0 7 1High-risk heterosexual contactb 49 47 574 53

Sex with injection drug user 4 4 114 11Sex with bisexual male 2 2 80 7Sex with person with hemophilia 0 0 4 0Sex with HIV-infected transfusion recipient 1 1 25 2Sex with HIV-infected person risk factor not specified 42 40 351 33

Receipt of blood transfusion blood components or tissue 1 1 93 9Otherrisk factor not reported or identified 46 44 279 26

Total 104 100 1078 100

American IndianAlaska NativeInjection drug use 13 32 280 42Hemophiliacoagulation disorder 0 0 3 0High-risk heterosexual contactb 15 37 277 41

Sex with injection drug user 4 10 107 16Sex with bisexual male 1 2 27 4Sex with person with hemophilia 0 0 2 0Sex with HIV-infected transfusion recipient 0 0 6 1Sex with HIV-infected person risk factor not specified 10 24 135 20

Receipt of blood transfusion blood components or tissue 1 2 17 3Otherrisk factor not reported or identified 12 29 95 14

Total 41 100 672 100

Total casesInjection drug use 1826 17 67693 35Hemophiliacoagulation disorder 11 0 348 0High-risk heterosexual contactb 4839 46 85186 44

Sex with injection drug user 706 7 26073 14Sex with bisexual male 234 2 5162 3Sex with person with hemophilia 11 0 502 0Sex with HIV-infected transfusion recipient 21 0 793 0Sex with HIV-infected person risk factor not specified 3867 37 52656 27

Receipt of blood transfusion blood components or tissue 68 1 4176 2Otherrisk factor not reported or identified 3793 36 34311 18

Total 10537c 100 191714d 100a From the beginning of the epidemic through 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 104 females of unknown race or multiple racesd Includes 1419 females of unknown race or multiple races

44 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 690 26 4260 26Hemophiliacoagulation disorder 3 0 24 0

bHigh-risk heterosexual contact 1132 42 7593 46Sex with injection drug user 205 8 1876 11Sex with bisexual male 98 4 659 4Sex with person with hemophilia 10 0 115 1Sex with HIV-infected transfusion recipient 7 0 64 0Sex with HIV-infected person risk factor not specified 812 30 4879 29

Receipt of blood transfusion blood components or tissue 12 0 146 1Otherrisk factor not reported or identified 850 32 4567 28

Total 2687 100 16590 100

Black not HispanicInjection drug use 1034 13 7105 14Hemophiliacoagulation disorder 1 0 35 0

bHigh-risk heterosexual contact 3451 44 23732 46Sex with injection drug user 313 4 3473 7Sex with bisexual male 155 2 1294 3Sex with person with hemophilia 5 0 71 0Sex with HIV-infected transfusion recipient 14 0 120 0Sex with HIV-infected person risk factor not specified 2964 38 18774 36

Receipt of blood transfusion blood components or tissue 26 0 324 1Otherrisk factor not reported or identified 3370 43 20244 39

Total 7882 100 51440 100

HispanicInjection drug use 339 15 2280 18Hemophiliacoagulation disorder 2 0 11 0

bHigh-risk heterosexual contact 1198 52 6264 50Sex with injection drug user 218 9 1324 11Sex with bisexual male 62 3 266 2Sex with person with hemophilia 1 0 11 0Sex with HIV-infected transfusion recipient 7 0 39 0Sex with HIV-infected person risk factor not specified 910 39 4624 37

Receipt of blood transfusion blood components or tissue 12 1 58 0Otherrisk factor not reported or identified 767 33 3843 31

Total 2318 100 12456 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 45

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 37: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulativemdashUnited States and dependent areas

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No Adult or adolescentMale-to-male sexual contact 13775 49 429897 54 mdash mdash mdash mdash 13775 35 429897 44Injection drug use 3413 12 163070 21 1826 17 67693 35 5239 13 230763 23Male-to-male sexual contact and

injection drug use 1603 6 65524 8 mdash mdash mdash mdash 1603 4 65524 7Hemophiliacoagulation disorder 43 0 5176 1 11 0 348 0 54 0 5524 1High-risk heterosexual contactc 2997 11 49610 6 4839 46 85186 44 7836 20 134796 14

Sex with injection drug user 330 1 11683 1 706 7 26073 14 1036 3 37756 4Sex with bisexual male mdash mdash mdash mdash 234 2 5162 3 234 1 5162 1Sex with person with hemophilia 1 0 84 0 11 0 502 0 12 0 586 0Sex with HIV-infected transfusion

recipient 22 0 553 0 21 0 793 0 43 0 1346 0Sex with HIV-infected person risk

factor not specified 2644 9 37290 5 3867 37 52656 27 6511 17 89946 9Receipt of blood transfusion blood

d components or tissue 63 0 5213 1 68 1 4176 2 131 0 9389 1Otherrisk factor not reported or

identifiede 6484 23 73136 9 3793 36 34311 18 10278 26 107450 11Subtotal 28378 100 791626 100 10537 100 191714 100 38916 100 983343 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 0 0 222 5 0 0 7 0 0 0 229 2Mother with documented HIV infection or

1 of the following risk factors 24 75 4315 89 50 93 4423 95 74 86 8738 92Injection drug use 4 13 1676 35 4 7 1665 36 8 9 3341 35Sex with injection drug user 4 13 789 16 4 7 750 16 8 9 1539 16Sex with bisexual male 1 3 101 2 2 4 110 2 3 3 211 2Sex with person with hemophilia 0 0 20 0 0 0 16 0 0 0 36 0Sex with HIV-infected transfusion

recipient 0 0 11 0 0 0 15 0 0 0 26 0Sex with HIV-infected person risk

factor not specified 6 19 742 15 17 31 790 17 23 27 1532 16Receipt of blood transfusion blood

components or tissue 0 0 70 1 0 0 82 2 0 0 152 2Has HIV infection risk factor not

specified 9 28 906 19 23 43 995 21 32 37 1901 20Receipt of blood transfusion blood

fcomponents or tissue 1 3 243 5 0 0 144 3 1 1 387 4Otherrisk factor not reported or

identifiedg 7 22 75 2 4 7 93 2 11 13 168 2Subtotal 32 100 4855 100 54 100 4667 100 86 100 9522 100

Total 28410 100 796481 100 10591 100 196381 100 39002 100 992865 100a From the beginning of the epidemic through 2006b From the beginning of the epidemic through 2006 Includes 3 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infectiond AIDS developed in 47 adultsadolescents after they received blood that had tested negative for HIV antibodies AIDS developed in 14 additional adults

after they received tissue organs or artificial insemination from HIV-infected donors Four of the 14 received tissue or organs from a donor who was negative for HIV antibody at the time of donation

e Includes 37 adultsadolescents who were exposed to HIV-infected blood body fluids or concentrated virus in health care laboratory or household settings as supported by seroconversion epidemiologic andor laboratory evidence One person was infected after intentional inoculation with HIV-infected blood Includes an additional 740 persons who acquired HIV infection perinatally but who were more than 12 years of age when AIDS was diagnosed These 740 persons are not counted in the values for the pediatric transmission category

f AIDS developed in 3 children after they received blood that had tested negative for HIV antibodiesg Includes 5 children who were exposed to HIV-infected blood as supported by seroconversion epidemiologic andor laboratory evidence 1 child was

infected after intentional inoculation with HIV-infected blood and 5 children were exposed to HIV-infected blood in a household setting Of the 168 children 26 had sexual contact with an adult with or at high risk for HIV infection

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 37

Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No

Adult or adolescentMale-to-male sexual contact 22912 59 103679 52 mdash mdash mdash mdash 22912 44 103679 37

Injection drug use 3503 9 24255 12 2124 16 13925 17 5627 11 38181 14

Male-to-male sexual contact and injection drug use 1946 5 10704 5 mdash mdash mdash mdash 1946 4 10704 4

Hemophiliacoagulation disorder 43 0 495 0 6 0 73 0 49 0 568 0

High-risk heterosexual contactc 2874 7 16830 8 5939 45 38315 47 8813 17 55145 20

Sex with injection drug user 308 1 2601 1 757 6 6791 8 1065 2 9392 3

Sex with bisexual male mdash mdash mdash mdash 328 2 2265 3 328 1 2265 1

Sex with person with hemophilia 4 0 31 0 16 0 201 0 20 0 232 0

Sex with HIV-infected transfusion recipient 13 0 131 0 28 0 223 0 41 0 354 0

Sex with HIV-infected person risk factor not specified 2549 7 14067 7 4810 36 28835 35 7359 14 42902 15

Receipt of blood transfusion blood components or tissue 61 0 489 0 50 0 536 1 111 0 1025 0

Otherrisk factor not reported or identified 7748 20 44021 22 5106 39 29312 36 12854 25 73338 26

Subtotal 39087 100 200473 100 13225 100 82161 100 52312 100 282640 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 8 3 106 4 0 0 1 0 8 1 107 2

Mother with documented HIV infection or 1 of the following risk factors 197 74 2195 85 254 85 2417 89 451 80 4612 87

Injection drug use 34 13 532 21 53 18 561 21 87 15 1093 21

Sex with injection drug user 12 5 208 8 21 7 213 8 33 6 421 8

Sex with bisexual male 5 2 37 1 4 1 32 1 9 2 69 1

Sex with person with hemophilia 0 0 3 0 1 0 7 0 1 0 10 0

Sex with HIV-infected transfusion recipient 0 0 4 0 0 0 4 0 0 0 8 0

Sex with HIV-infected person risk factor not specified 54 20 534 21 76 25 629 23 130 23 1163 22

Receipt of blood transfusion blood components or tissue 0 0 17 1 2 1 20 1 2 0 37 1

Has HIV infection risk factor not specified 92 35 860 33 97 32 951 35 189 33 1811 34

Receipt of blood transfusion blood components or tissue 6 2 28 1 3 1 24 1 9 2 52 1

Otherrisk factor not reported or identified 55 21 260 10 43 14 283 10 98 17 543 10

Subtotal 266 100 2589 100 300 100 2725 100 566 100 5314 100

Total 39353 100 203062 100 13525 100 84886 100 52878 100 287954 100

Note See Table 16 for the list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006b From the beginning of the epidemic through December 2006 Includes 6 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infection

38 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity

2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 6251 65 253927 73Injection drug use 733 8 31737 9Male-to-male sexual contact and injection drug use 732 8 31434 9Hemophiliacoagulation disorder 26 0 3989 1High-risk heterosexual contactb 416 4 7850 2

Sex with injection drug user 74 1 2310 1

Sex with person with hemophilia 0 0 36 0

Sex with HIV-infected transfusion recipient 2 0 176 0

Sex with HIV-infected person risk factor not specified 340 4 5328 2Receipt of blood transfusion blood components or tissue 20 0 3194 1Otherrisk factor not reported or identified 1400 15 16469 5

Total 9578 100 348600 100

Black not HispanicMale-to-male sexual contact 4309 36 103297 37Injection drug use 1635 14 83369 30Male-to-male sexual contact and injection drug use 526 4 22134 8Hemophiliacoagulation disorder 10 0 604 0High-risk heterosexual contactb 1875 16 29952 11

Sex with injection drug user 167 1 6823 2Sex with person with hemophilia 1 0 36 0Sex with HIV-infected transfusion recipient 15 0 237 0Sex with HIV-infected person risk factor not specified 1692 14 22856 8

Receipt of blood transfusion blood components or tissue 24 0 1218 0Otherrisk factor not reported or identified 3579 30 40268 14

Total 11958 100 280842 100

HispanicMale-to-male sexual contact 2816 47 64893 44Injection drug use 965 16 46337 31Male-to-male sexual contact and injection drug use 287 5 10884 7Hemophiliacoagulation disorder 6 0 466 0High-risk heterosexual contactb 638 11 10950 7

Sex with injection drug user 84 1 2409 2Sex with person with hemophilia 0 0 11 0Sex with HIV-infected transfusion recipient 5 0 125 0Sex with HIV-infected person risk factor not specified 549 9 8405 6

Receipt of blood transfusion blood components or tissue 17 0 657 0Otherrisk factor not reported or identified 1326 22 14832 10

Total 6055 100 149019 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 39

a

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulative

No No

AsianPacific IslanderMale-to-male sexual contact 225 54 4475 68Injection drug use 20 5 317 5Male-to-male sexual contact and injection drug use 17 4 284 4Hemophiliacoagulation disorder 1 0 70 1High-risk heterosexual contactb 34 8 376 6

Sex with injection drug user 1 0 54 1Sex with person with hemophilia 0 0 1 0Sex with HIV-infected transfusion recipient 0 0 8 0Sex with HIV-infected person risk factor not specified 33 8 313 5

Receipt of blood transfusion blood components or tissue 2 0 112 2Otherrisk factor not reported or identified 114 28 949 14

Total 413 100 6583 100

American IndianAlaska NativeMale-to-male sexual contact 61 49 1403 55Injection drug use 15 12 395 15Male-to-male sexual contact and injection drug use 23 19 457 18Hemophiliacoagulation disorder 0 0 27 1High-risk heterosexual contactb 9 7 118 5

Sex with injection drug user 1 1 33 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 8 6 82 3

Receipt of blood transfusion blood components or tissue 0 0 8 0Otherrisk factor not reported or identified 16 13 155 6

Total 124 100 2563 100

Total casesMale-to-male sexual contact 13775 49 429897 54Injection drug use 3413 12 163070 21Male-to-male sexual contact and injection drug use 1603 6 65524 8Hemophiliacoagulation disorder 43 0 5176 1High-risk heterosexual contactb 2997 11 49610 6

Sex with injection drug user 330 1 11683 1Sex with person with hemophilia 1 0 84 0Sex with HIV-infected transfusion recipient 22 0 553 0Sex with HIV-infected person risk factor not specified 2644 9 37290 5

Receipt of blood transfusion blood components or tissue 63 0 5213 1Otherrisk factor not reported or identified 6484 23 73136 9

Total 28378c 100 791626d 100a From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 4019 males of unknown race or multiple races

40 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 11963 73 55725 69Injection drug use 858 5 5512 7Male-to-male sexual contact and injection drug use 1092 7 5578 7Hemophiliacoagulation disorder 29 0 355 0High-risk heterosexual contactb 522 3 2658 3

Sex with injection drug user 65 0 544 1Sex with person with hemophilia 0 0 8 0Sex with HIV-infected transfusion recipient 3 0 33 0Sex with HIV-infected person risk factor not specified 454 3 2073 3

Receipt of blood transfusion blood components or tissue 14 0 197 0Otherrisk factor not reported or identified 1956 12 11147 14

Total 16434 100 81172 100

Black not HispanicMale-to-male sexual contact 6203 44 30148 37Injection drug use 1594 11 11997 15Male-to-male sexual contact and injection drug use 483 3 3489 4Hemophiliacoagulation disorder 10 0 109 0High-risk heterosexual contactb 1714 12 10905 13

Sex with injection drug user 169 1 1554 2Sex with person with hemophilia 4 0 17 0Sex with HIV-infected transfusion recipient 6 0 77 0Sex with HIV-infected person risk factor not specified 1535 11 9257 11

Receipt of blood transfusion blood components or tissue 32 0 223 0Otherrisk factor not reported or identified 4151 29 24632 30

Total 14187 100 81503 100

HispanicMale-to-male sexual contact 4094 55 15623 47Injection drug use 993 13 6407 19Male-to-male sexual contact and injection drug use 316 4 1402 4Hemophiliacoagulation disorder 3 0 26 0High-risk heterosexual contactb 582 8 2963 9

Sex with injection drug user 65 1 455 1Sex with person with hemophilia 0 0 6 0Sex with HIV-infected transfusion recipient 4 0 18 0Sex with HIV-infected person risk factor not specified 513 7 2484 7

Receipt of blood transfusion blood components or tissue 11 0 55 0Otherrisk factor not reported or identified 1475 20 6977 21

Total 7474 100 33453 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 41

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderMale-to-male sexual contact 402 70 1006 63Injection drug use 17 3 55 3Male-to-male sexual contact and injection drug use 15 3 38 2Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 25 4 96 6

Sex with injection drug user 3 1 10 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 22 4 83 5

Receipt of blood transfusion blood components or tissue 4 1 7 0Otherrisk factor not reported or identified 109 19 397 25

Total 572 100 1600 100

American IndianAlaska NativeMale-to-male sexual contact 104 61 516 57Injection drug use 13 8 101 11Male-to-male sexual contact and injection drug use 19 11 110 12Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 10 6 53 6

Sex with injection drug user 2 1 14 2Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 8 5 39 4

Receipt of blood transfusion blood components or tissue 0 0 2 0Otherrisk factor not reported or identified 24 14 125 14

Total 170 100 907 100

Total casesMale-to-male sexual contact 22912 59 103679 52Injection drug use 3503 9 24255 12Male-to-male sexual contact and injection drug use 1946 5 10704 5Hemophiliacoagulation disorder 43 0 495 0High-risk heterosexual contactb 2874 7 16830 8

Sex with injection drug user 308 1 2601 1Sex with person with hemophilia 4 0 31 0Sex with HIV-infected transfusion recipient 13 0 131 0Sex with HIV-infected person risk factor not specified 2549 7 14067 7

Receipt of blood transfusion blood components or tissue 61 0 489 0Otherrisk factor not reported or identified 7748 20 44021 22

Total 39087c 100 200473d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 1838 males of unknown race or multiple races

42 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race

ethnicity 2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 482 28 14981 40Hemophiliacoagulation disorder 4 0 123 0High-risk heterosexual contactb 725 42 15799 42

Sex with injection drug user 153 9 5650 15Sex with bisexual male 63 4 1859 5Sex with person with hemophilia 5 0 329 1Sex with HIV-infected transfusion recipient 5 0 338 1Sex with HIV-infected person risk factor not specified 499 29 7623 20

Receipt of blood transfusion blood components or tissue 15 1 1870 5Otherrisk factor not reported or identified 499 29 4801 13

Total 1725 100 37574 100

Black not HispanicInjection drug use 982 15 38914 34Hemophiliacoagulation disorder 3 0 145 0High-risk heterosexual contactb 3103 46 49876 44

Sex with injection drug user 373 6 13530 12Sex with bisexual male 136 2 2352 2Sex with person with hemophilia 4 0 121 0Sex with HIV-infected transfusion recipient 8 0 277 0Sex with HIV-infected person risk factor not specified 2582 38 33596 29

Receipt of blood transfusion blood components or tissue 39 1 1546 1Otherrisk factor not reported or identified 2612 39 23894 21

Total 6739 100 114375 100

HispanicInjection drug use 322 18 12892 35Hemophiliacoagulation disorder 4 0 67 0High-risk heterosexual contactb 894 49 17995 49

Sex with injection drug user 166 9 6522 18Sex with bisexual male 32 2 818 2Sex with person with hemophilia 1 0 45 0Sex with HIV-infected transfusion recipient 7 0 141 0Sex with HIV-infected person risk factor not specified 688 38 10469 29

Receipt of blood transfusion blood components or tissue 12 1 619 2Otherrisk factor not reported or identified 592 32 5023 14

Total 1824 100 36596 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 43

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 8 8 125 12Hemophiliacoagulation disorder 0 0 7 1High-risk heterosexual contactb 49 47 574 53

Sex with injection drug user 4 4 114 11Sex with bisexual male 2 2 80 7Sex with person with hemophilia 0 0 4 0Sex with HIV-infected transfusion recipient 1 1 25 2Sex with HIV-infected person risk factor not specified 42 40 351 33

Receipt of blood transfusion blood components or tissue 1 1 93 9Otherrisk factor not reported or identified 46 44 279 26

Total 104 100 1078 100

American IndianAlaska NativeInjection drug use 13 32 280 42Hemophiliacoagulation disorder 0 0 3 0High-risk heterosexual contactb 15 37 277 41

Sex with injection drug user 4 10 107 16Sex with bisexual male 1 2 27 4Sex with person with hemophilia 0 0 2 0Sex with HIV-infected transfusion recipient 0 0 6 1Sex with HIV-infected person risk factor not specified 10 24 135 20

Receipt of blood transfusion blood components or tissue 1 2 17 3Otherrisk factor not reported or identified 12 29 95 14

Total 41 100 672 100

Total casesInjection drug use 1826 17 67693 35Hemophiliacoagulation disorder 11 0 348 0High-risk heterosexual contactb 4839 46 85186 44

Sex with injection drug user 706 7 26073 14Sex with bisexual male 234 2 5162 3Sex with person with hemophilia 11 0 502 0Sex with HIV-infected transfusion recipient 21 0 793 0Sex with HIV-infected person risk factor not specified 3867 37 52656 27

Receipt of blood transfusion blood components or tissue 68 1 4176 2Otherrisk factor not reported or identified 3793 36 34311 18

Total 10537c 100 191714d 100a From the beginning of the epidemic through 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 104 females of unknown race or multiple racesd Includes 1419 females of unknown race or multiple races

44 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 690 26 4260 26Hemophiliacoagulation disorder 3 0 24 0

bHigh-risk heterosexual contact 1132 42 7593 46Sex with injection drug user 205 8 1876 11Sex with bisexual male 98 4 659 4Sex with person with hemophilia 10 0 115 1Sex with HIV-infected transfusion recipient 7 0 64 0Sex with HIV-infected person risk factor not specified 812 30 4879 29

Receipt of blood transfusion blood components or tissue 12 0 146 1Otherrisk factor not reported or identified 850 32 4567 28

Total 2687 100 16590 100

Black not HispanicInjection drug use 1034 13 7105 14Hemophiliacoagulation disorder 1 0 35 0

bHigh-risk heterosexual contact 3451 44 23732 46Sex with injection drug user 313 4 3473 7Sex with bisexual male 155 2 1294 3Sex with person with hemophilia 5 0 71 0Sex with HIV-infected transfusion recipient 14 0 120 0Sex with HIV-infected person risk factor not specified 2964 38 18774 36

Receipt of blood transfusion blood components or tissue 26 0 324 1Otherrisk factor not reported or identified 3370 43 20244 39

Total 7882 100 51440 100

HispanicInjection drug use 339 15 2280 18Hemophiliacoagulation disorder 2 0 11 0

bHigh-risk heterosexual contact 1198 52 6264 50Sex with injection drug user 218 9 1324 11Sex with bisexual male 62 3 266 2Sex with person with hemophilia 1 0 11 0Sex with HIV-infected transfusion recipient 7 0 39 0Sex with HIV-infected person risk factor not specified 910 39 4624 37

Receipt of blood transfusion blood components or tissue 12 1 58 0Otherrisk factor not reported or identified 767 33 3843 31

Total 2318 100 12456 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 45

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 38: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

Males Females Total

2006 Cumulativea 2006 Cumulativea 2006 Cumulativeb

No No No No No No

Adult or adolescentMale-to-male sexual contact 22912 59 103679 52 mdash mdash mdash mdash 22912 44 103679 37

Injection drug use 3503 9 24255 12 2124 16 13925 17 5627 11 38181 14

Male-to-male sexual contact and injection drug use 1946 5 10704 5 mdash mdash mdash mdash 1946 4 10704 4

Hemophiliacoagulation disorder 43 0 495 0 6 0 73 0 49 0 568 0

High-risk heterosexual contactc 2874 7 16830 8 5939 45 38315 47 8813 17 55145 20

Sex with injection drug user 308 1 2601 1 757 6 6791 8 1065 2 9392 3

Sex with bisexual male mdash mdash mdash mdash 328 2 2265 3 328 1 2265 1

Sex with person with hemophilia 4 0 31 0 16 0 201 0 20 0 232 0

Sex with HIV-infected transfusion recipient 13 0 131 0 28 0 223 0 41 0 354 0

Sex with HIV-infected person risk factor not specified 2549 7 14067 7 4810 36 28835 35 7359 14 42902 15

Receipt of blood transfusion blood components or tissue 61 0 489 0 50 0 536 1 111 0 1025 0

Otherrisk factor not reported or identified 7748 20 44021 22 5106 39 29312 36 12854 25 73338 26

Subtotal 39087 100 200473 100 13225 100 82161 100 52312 100 282640 100

Child (lt13 yrs at diagnosis)Hemophiliacoagulation disorder 8 3 106 4 0 0 1 0 8 1 107 2

Mother with documented HIV infection or 1 of the following risk factors 197 74 2195 85 254 85 2417 89 451 80 4612 87

Injection drug use 34 13 532 21 53 18 561 21 87 15 1093 21

Sex with injection drug user 12 5 208 8 21 7 213 8 33 6 421 8

Sex with bisexual male 5 2 37 1 4 1 32 1 9 2 69 1

Sex with person with hemophilia 0 0 3 0 1 0 7 0 1 0 10 0

Sex with HIV-infected transfusion recipient 0 0 4 0 0 0 4 0 0 0 8 0

Sex with HIV-infected person risk factor not specified 54 20 534 21 76 25 629 23 130 23 1163 22

Receipt of blood transfusion blood components or tissue 0 0 17 1 2 1 20 1 2 0 37 1

Has HIV infection risk factor not specified 92 35 860 33 97 32 951 35 189 33 1811 34

Receipt of blood transfusion blood components or tissue 6 2 28 1 3 1 24 1 9 2 52 1

Otherrisk factor not reported or identified 55 21 260 10 43 14 283 10 98 17 543 10

Subtotal 266 100 2589 100 300 100 2725 100 566 100 5314 100

Total 39353 100 203062 100 13525 100 84886 100 52878 100 287954 100

Note See Table 16 for the list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006b From the beginning of the epidemic through December 2006 Includes 6 persons of unknown sexc Heterosexual contact with a person known to have or to be at high risk for HIV infection

38 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity

2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 6251 65 253927 73Injection drug use 733 8 31737 9Male-to-male sexual contact and injection drug use 732 8 31434 9Hemophiliacoagulation disorder 26 0 3989 1High-risk heterosexual contactb 416 4 7850 2

Sex with injection drug user 74 1 2310 1

Sex with person with hemophilia 0 0 36 0

Sex with HIV-infected transfusion recipient 2 0 176 0

Sex with HIV-infected person risk factor not specified 340 4 5328 2Receipt of blood transfusion blood components or tissue 20 0 3194 1Otherrisk factor not reported or identified 1400 15 16469 5

Total 9578 100 348600 100

Black not HispanicMale-to-male sexual contact 4309 36 103297 37Injection drug use 1635 14 83369 30Male-to-male sexual contact and injection drug use 526 4 22134 8Hemophiliacoagulation disorder 10 0 604 0High-risk heterosexual contactb 1875 16 29952 11

Sex with injection drug user 167 1 6823 2Sex with person with hemophilia 1 0 36 0Sex with HIV-infected transfusion recipient 15 0 237 0Sex with HIV-infected person risk factor not specified 1692 14 22856 8

Receipt of blood transfusion blood components or tissue 24 0 1218 0Otherrisk factor not reported or identified 3579 30 40268 14

Total 11958 100 280842 100

HispanicMale-to-male sexual contact 2816 47 64893 44Injection drug use 965 16 46337 31Male-to-male sexual contact and injection drug use 287 5 10884 7Hemophiliacoagulation disorder 6 0 466 0High-risk heterosexual contactb 638 11 10950 7

Sex with injection drug user 84 1 2409 2Sex with person with hemophilia 0 0 11 0Sex with HIV-infected transfusion recipient 5 0 125 0Sex with HIV-infected person risk factor not specified 549 9 8405 6

Receipt of blood transfusion blood components or tissue 17 0 657 0Otherrisk factor not reported or identified 1326 22 14832 10

Total 6055 100 149019 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 39

a

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulative

No No

AsianPacific IslanderMale-to-male sexual contact 225 54 4475 68Injection drug use 20 5 317 5Male-to-male sexual contact and injection drug use 17 4 284 4Hemophiliacoagulation disorder 1 0 70 1High-risk heterosexual contactb 34 8 376 6

Sex with injection drug user 1 0 54 1Sex with person with hemophilia 0 0 1 0Sex with HIV-infected transfusion recipient 0 0 8 0Sex with HIV-infected person risk factor not specified 33 8 313 5

Receipt of blood transfusion blood components or tissue 2 0 112 2Otherrisk factor not reported or identified 114 28 949 14

Total 413 100 6583 100

American IndianAlaska NativeMale-to-male sexual contact 61 49 1403 55Injection drug use 15 12 395 15Male-to-male sexual contact and injection drug use 23 19 457 18Hemophiliacoagulation disorder 0 0 27 1High-risk heterosexual contactb 9 7 118 5

Sex with injection drug user 1 1 33 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 8 6 82 3

Receipt of blood transfusion blood components or tissue 0 0 8 0Otherrisk factor not reported or identified 16 13 155 6

Total 124 100 2563 100

Total casesMale-to-male sexual contact 13775 49 429897 54Injection drug use 3413 12 163070 21Male-to-male sexual contact and injection drug use 1603 6 65524 8Hemophiliacoagulation disorder 43 0 5176 1High-risk heterosexual contactb 2997 11 49610 6

Sex with injection drug user 330 1 11683 1Sex with person with hemophilia 1 0 84 0Sex with HIV-infected transfusion recipient 22 0 553 0Sex with HIV-infected person risk factor not specified 2644 9 37290 5

Receipt of blood transfusion blood components or tissue 63 0 5213 1Otherrisk factor not reported or identified 6484 23 73136 9

Total 28378c 100 791626d 100a From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 4019 males of unknown race or multiple races

40 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 11963 73 55725 69Injection drug use 858 5 5512 7Male-to-male sexual contact and injection drug use 1092 7 5578 7Hemophiliacoagulation disorder 29 0 355 0High-risk heterosexual contactb 522 3 2658 3

Sex with injection drug user 65 0 544 1Sex with person with hemophilia 0 0 8 0Sex with HIV-infected transfusion recipient 3 0 33 0Sex with HIV-infected person risk factor not specified 454 3 2073 3

Receipt of blood transfusion blood components or tissue 14 0 197 0Otherrisk factor not reported or identified 1956 12 11147 14

Total 16434 100 81172 100

Black not HispanicMale-to-male sexual contact 6203 44 30148 37Injection drug use 1594 11 11997 15Male-to-male sexual contact and injection drug use 483 3 3489 4Hemophiliacoagulation disorder 10 0 109 0High-risk heterosexual contactb 1714 12 10905 13

Sex with injection drug user 169 1 1554 2Sex with person with hemophilia 4 0 17 0Sex with HIV-infected transfusion recipient 6 0 77 0Sex with HIV-infected person risk factor not specified 1535 11 9257 11

Receipt of blood transfusion blood components or tissue 32 0 223 0Otherrisk factor not reported or identified 4151 29 24632 30

Total 14187 100 81503 100

HispanicMale-to-male sexual contact 4094 55 15623 47Injection drug use 993 13 6407 19Male-to-male sexual contact and injection drug use 316 4 1402 4Hemophiliacoagulation disorder 3 0 26 0High-risk heterosexual contactb 582 8 2963 9

Sex with injection drug user 65 1 455 1Sex with person with hemophilia 0 0 6 0Sex with HIV-infected transfusion recipient 4 0 18 0Sex with HIV-infected person risk factor not specified 513 7 2484 7

Receipt of blood transfusion blood components or tissue 11 0 55 0Otherrisk factor not reported or identified 1475 20 6977 21

Total 7474 100 33453 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 41

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderMale-to-male sexual contact 402 70 1006 63Injection drug use 17 3 55 3Male-to-male sexual contact and injection drug use 15 3 38 2Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 25 4 96 6

Sex with injection drug user 3 1 10 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 22 4 83 5

Receipt of blood transfusion blood components or tissue 4 1 7 0Otherrisk factor not reported or identified 109 19 397 25

Total 572 100 1600 100

American IndianAlaska NativeMale-to-male sexual contact 104 61 516 57Injection drug use 13 8 101 11Male-to-male sexual contact and injection drug use 19 11 110 12Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 10 6 53 6

Sex with injection drug user 2 1 14 2Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 8 5 39 4

Receipt of blood transfusion blood components or tissue 0 0 2 0Otherrisk factor not reported or identified 24 14 125 14

Total 170 100 907 100

Total casesMale-to-male sexual contact 22912 59 103679 52Injection drug use 3503 9 24255 12Male-to-male sexual contact and injection drug use 1946 5 10704 5Hemophiliacoagulation disorder 43 0 495 0High-risk heterosexual contactb 2874 7 16830 8

Sex with injection drug user 308 1 2601 1Sex with person with hemophilia 4 0 31 0Sex with HIV-infected transfusion recipient 13 0 131 0Sex with HIV-infected person risk factor not specified 2549 7 14067 7

Receipt of blood transfusion blood components or tissue 61 0 489 0Otherrisk factor not reported or identified 7748 20 44021 22

Total 39087c 100 200473d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 1838 males of unknown race or multiple races

42 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race

ethnicity 2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 482 28 14981 40Hemophiliacoagulation disorder 4 0 123 0High-risk heterosexual contactb 725 42 15799 42

Sex with injection drug user 153 9 5650 15Sex with bisexual male 63 4 1859 5Sex with person with hemophilia 5 0 329 1Sex with HIV-infected transfusion recipient 5 0 338 1Sex with HIV-infected person risk factor not specified 499 29 7623 20

Receipt of blood transfusion blood components or tissue 15 1 1870 5Otherrisk factor not reported or identified 499 29 4801 13

Total 1725 100 37574 100

Black not HispanicInjection drug use 982 15 38914 34Hemophiliacoagulation disorder 3 0 145 0High-risk heterosexual contactb 3103 46 49876 44

Sex with injection drug user 373 6 13530 12Sex with bisexual male 136 2 2352 2Sex with person with hemophilia 4 0 121 0Sex with HIV-infected transfusion recipient 8 0 277 0Sex with HIV-infected person risk factor not specified 2582 38 33596 29

Receipt of blood transfusion blood components or tissue 39 1 1546 1Otherrisk factor not reported or identified 2612 39 23894 21

Total 6739 100 114375 100

HispanicInjection drug use 322 18 12892 35Hemophiliacoagulation disorder 4 0 67 0High-risk heterosexual contactb 894 49 17995 49

Sex with injection drug user 166 9 6522 18Sex with bisexual male 32 2 818 2Sex with person with hemophilia 1 0 45 0Sex with HIV-infected transfusion recipient 7 0 141 0Sex with HIV-infected person risk factor not specified 688 38 10469 29

Receipt of blood transfusion blood components or tissue 12 1 619 2Otherrisk factor not reported or identified 592 32 5023 14

Total 1824 100 36596 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 43

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 8 8 125 12Hemophiliacoagulation disorder 0 0 7 1High-risk heterosexual contactb 49 47 574 53

Sex with injection drug user 4 4 114 11Sex with bisexual male 2 2 80 7Sex with person with hemophilia 0 0 4 0Sex with HIV-infected transfusion recipient 1 1 25 2Sex with HIV-infected person risk factor not specified 42 40 351 33

Receipt of blood transfusion blood components or tissue 1 1 93 9Otherrisk factor not reported or identified 46 44 279 26

Total 104 100 1078 100

American IndianAlaska NativeInjection drug use 13 32 280 42Hemophiliacoagulation disorder 0 0 3 0High-risk heterosexual contactb 15 37 277 41

Sex with injection drug user 4 10 107 16Sex with bisexual male 1 2 27 4Sex with person with hemophilia 0 0 2 0Sex with HIV-infected transfusion recipient 0 0 6 1Sex with HIV-infected person risk factor not specified 10 24 135 20

Receipt of blood transfusion blood components or tissue 1 2 17 3Otherrisk factor not reported or identified 12 29 95 14

Total 41 100 672 100

Total casesInjection drug use 1826 17 67693 35Hemophiliacoagulation disorder 11 0 348 0High-risk heterosexual contactb 4839 46 85186 44

Sex with injection drug user 706 7 26073 14Sex with bisexual male 234 2 5162 3Sex with person with hemophilia 11 0 502 0Sex with HIV-infected transfusion recipient 21 0 793 0Sex with HIV-infected person risk factor not specified 3867 37 52656 27

Receipt of blood transfusion blood components or tissue 68 1 4176 2Otherrisk factor not reported or identified 3793 36 34311 18

Total 10537c 100 191714d 100a From the beginning of the epidemic through 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 104 females of unknown race or multiple racesd Includes 1419 females of unknown race or multiple races

44 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 690 26 4260 26Hemophiliacoagulation disorder 3 0 24 0

bHigh-risk heterosexual contact 1132 42 7593 46Sex with injection drug user 205 8 1876 11Sex with bisexual male 98 4 659 4Sex with person with hemophilia 10 0 115 1Sex with HIV-infected transfusion recipient 7 0 64 0Sex with HIV-infected person risk factor not specified 812 30 4879 29

Receipt of blood transfusion blood components or tissue 12 0 146 1Otherrisk factor not reported or identified 850 32 4567 28

Total 2687 100 16590 100

Black not HispanicInjection drug use 1034 13 7105 14Hemophiliacoagulation disorder 1 0 35 0

bHigh-risk heterosexual contact 3451 44 23732 46Sex with injection drug user 313 4 3473 7Sex with bisexual male 155 2 1294 3Sex with person with hemophilia 5 0 71 0Sex with HIV-infected transfusion recipient 14 0 120 0Sex with HIV-infected person risk factor not specified 2964 38 18774 36

Receipt of blood transfusion blood components or tissue 26 0 324 1Otherrisk factor not reported or identified 3370 43 20244 39

Total 7882 100 51440 100

HispanicInjection drug use 339 15 2280 18Hemophiliacoagulation disorder 2 0 11 0

bHigh-risk heterosexual contact 1198 52 6264 50Sex with injection drug user 218 9 1324 11Sex with bisexual male 62 3 266 2Sex with person with hemophilia 1 0 11 0Sex with HIV-infected transfusion recipient 7 0 39 0Sex with HIV-infected person risk factor not specified 910 39 4624 37

Receipt of blood transfusion blood components or tissue 12 1 58 0Otherrisk factor not reported or identified 767 33 3843 31

Total 2318 100 12456 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 45

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 39: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity

2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 6251 65 253927 73Injection drug use 733 8 31737 9Male-to-male sexual contact and injection drug use 732 8 31434 9Hemophiliacoagulation disorder 26 0 3989 1High-risk heterosexual contactb 416 4 7850 2

Sex with injection drug user 74 1 2310 1

Sex with person with hemophilia 0 0 36 0

Sex with HIV-infected transfusion recipient 2 0 176 0

Sex with HIV-infected person risk factor not specified 340 4 5328 2Receipt of blood transfusion blood components or tissue 20 0 3194 1Otherrisk factor not reported or identified 1400 15 16469 5

Total 9578 100 348600 100

Black not HispanicMale-to-male sexual contact 4309 36 103297 37Injection drug use 1635 14 83369 30Male-to-male sexual contact and injection drug use 526 4 22134 8Hemophiliacoagulation disorder 10 0 604 0High-risk heterosexual contactb 1875 16 29952 11

Sex with injection drug user 167 1 6823 2Sex with person with hemophilia 1 0 36 0Sex with HIV-infected transfusion recipient 15 0 237 0Sex with HIV-infected person risk factor not specified 1692 14 22856 8

Receipt of blood transfusion blood components or tissue 24 0 1218 0Otherrisk factor not reported or identified 3579 30 40268 14

Total 11958 100 280842 100

HispanicMale-to-male sexual contact 2816 47 64893 44Injection drug use 965 16 46337 31Male-to-male sexual contact and injection drug use 287 5 10884 7Hemophiliacoagulation disorder 6 0 466 0High-risk heterosexual contactb 638 11 10950 7

Sex with injection drug user 84 1 2409 2Sex with person with hemophilia 0 0 11 0Sex with HIV-infected transfusion recipient 5 0 125 0Sex with HIV-infected person risk factor not specified 549 9 8405 6

Receipt of blood transfusion blood components or tissue 17 0 657 0Otherrisk factor not reported or identified 1326 22 14832 10

Total 6055 100 149019 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 39

a

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulative

No No

AsianPacific IslanderMale-to-male sexual contact 225 54 4475 68Injection drug use 20 5 317 5Male-to-male sexual contact and injection drug use 17 4 284 4Hemophiliacoagulation disorder 1 0 70 1High-risk heterosexual contactb 34 8 376 6

Sex with injection drug user 1 0 54 1Sex with person with hemophilia 0 0 1 0Sex with HIV-infected transfusion recipient 0 0 8 0Sex with HIV-infected person risk factor not specified 33 8 313 5

Receipt of blood transfusion blood components or tissue 2 0 112 2Otherrisk factor not reported or identified 114 28 949 14

Total 413 100 6583 100

American IndianAlaska NativeMale-to-male sexual contact 61 49 1403 55Injection drug use 15 12 395 15Male-to-male sexual contact and injection drug use 23 19 457 18Hemophiliacoagulation disorder 0 0 27 1High-risk heterosexual contactb 9 7 118 5

Sex with injection drug user 1 1 33 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 8 6 82 3

Receipt of blood transfusion blood components or tissue 0 0 8 0Otherrisk factor not reported or identified 16 13 155 6

Total 124 100 2563 100

Total casesMale-to-male sexual contact 13775 49 429897 54Injection drug use 3413 12 163070 21Male-to-male sexual contact and injection drug use 1603 6 65524 8Hemophiliacoagulation disorder 43 0 5176 1High-risk heterosexual contactb 2997 11 49610 6

Sex with injection drug user 330 1 11683 1Sex with person with hemophilia 1 0 84 0Sex with HIV-infected transfusion recipient 22 0 553 0Sex with HIV-infected person risk factor not specified 2644 9 37290 5

Receipt of blood transfusion blood components or tissue 63 0 5213 1Otherrisk factor not reported or identified 6484 23 73136 9

Total 28378c 100 791626d 100a From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 4019 males of unknown race or multiple races

40 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 11963 73 55725 69Injection drug use 858 5 5512 7Male-to-male sexual contact and injection drug use 1092 7 5578 7Hemophiliacoagulation disorder 29 0 355 0High-risk heterosexual contactb 522 3 2658 3

Sex with injection drug user 65 0 544 1Sex with person with hemophilia 0 0 8 0Sex with HIV-infected transfusion recipient 3 0 33 0Sex with HIV-infected person risk factor not specified 454 3 2073 3

Receipt of blood transfusion blood components or tissue 14 0 197 0Otherrisk factor not reported or identified 1956 12 11147 14

Total 16434 100 81172 100

Black not HispanicMale-to-male sexual contact 6203 44 30148 37Injection drug use 1594 11 11997 15Male-to-male sexual contact and injection drug use 483 3 3489 4Hemophiliacoagulation disorder 10 0 109 0High-risk heterosexual contactb 1714 12 10905 13

Sex with injection drug user 169 1 1554 2Sex with person with hemophilia 4 0 17 0Sex with HIV-infected transfusion recipient 6 0 77 0Sex with HIV-infected person risk factor not specified 1535 11 9257 11

Receipt of blood transfusion blood components or tissue 32 0 223 0Otherrisk factor not reported or identified 4151 29 24632 30

Total 14187 100 81503 100

HispanicMale-to-male sexual contact 4094 55 15623 47Injection drug use 993 13 6407 19Male-to-male sexual contact and injection drug use 316 4 1402 4Hemophiliacoagulation disorder 3 0 26 0High-risk heterosexual contactb 582 8 2963 9

Sex with injection drug user 65 1 455 1Sex with person with hemophilia 0 0 6 0Sex with HIV-infected transfusion recipient 4 0 18 0Sex with HIV-infected person risk factor not specified 513 7 2484 7

Receipt of blood transfusion blood components or tissue 11 0 55 0Otherrisk factor not reported or identified 1475 20 6977 21

Total 7474 100 33453 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 41

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderMale-to-male sexual contact 402 70 1006 63Injection drug use 17 3 55 3Male-to-male sexual contact and injection drug use 15 3 38 2Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 25 4 96 6

Sex with injection drug user 3 1 10 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 22 4 83 5

Receipt of blood transfusion blood components or tissue 4 1 7 0Otherrisk factor not reported or identified 109 19 397 25

Total 572 100 1600 100

American IndianAlaska NativeMale-to-male sexual contact 104 61 516 57Injection drug use 13 8 101 11Male-to-male sexual contact and injection drug use 19 11 110 12Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 10 6 53 6

Sex with injection drug user 2 1 14 2Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 8 5 39 4

Receipt of blood transfusion blood components or tissue 0 0 2 0Otherrisk factor not reported or identified 24 14 125 14

Total 170 100 907 100

Total casesMale-to-male sexual contact 22912 59 103679 52Injection drug use 3503 9 24255 12Male-to-male sexual contact and injection drug use 1946 5 10704 5Hemophiliacoagulation disorder 43 0 495 0High-risk heterosexual contactb 2874 7 16830 8

Sex with injection drug user 308 1 2601 1Sex with person with hemophilia 4 0 31 0Sex with HIV-infected transfusion recipient 13 0 131 0Sex with HIV-infected person risk factor not specified 2549 7 14067 7

Receipt of blood transfusion blood components or tissue 61 0 489 0Otherrisk factor not reported or identified 7748 20 44021 22

Total 39087c 100 200473d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 1838 males of unknown race or multiple races

42 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race

ethnicity 2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 482 28 14981 40Hemophiliacoagulation disorder 4 0 123 0High-risk heterosexual contactb 725 42 15799 42

Sex with injection drug user 153 9 5650 15Sex with bisexual male 63 4 1859 5Sex with person with hemophilia 5 0 329 1Sex with HIV-infected transfusion recipient 5 0 338 1Sex with HIV-infected person risk factor not specified 499 29 7623 20

Receipt of blood transfusion blood components or tissue 15 1 1870 5Otherrisk factor not reported or identified 499 29 4801 13

Total 1725 100 37574 100

Black not HispanicInjection drug use 982 15 38914 34Hemophiliacoagulation disorder 3 0 145 0High-risk heterosexual contactb 3103 46 49876 44

Sex with injection drug user 373 6 13530 12Sex with bisexual male 136 2 2352 2Sex with person with hemophilia 4 0 121 0Sex with HIV-infected transfusion recipient 8 0 277 0Sex with HIV-infected person risk factor not specified 2582 38 33596 29

Receipt of blood transfusion blood components or tissue 39 1 1546 1Otherrisk factor not reported or identified 2612 39 23894 21

Total 6739 100 114375 100

HispanicInjection drug use 322 18 12892 35Hemophiliacoagulation disorder 4 0 67 0High-risk heterosexual contactb 894 49 17995 49

Sex with injection drug user 166 9 6522 18Sex with bisexual male 32 2 818 2Sex with person with hemophilia 1 0 45 0Sex with HIV-infected transfusion recipient 7 0 141 0Sex with HIV-infected person risk factor not specified 688 38 10469 29

Receipt of blood transfusion blood components or tissue 12 1 619 2Otherrisk factor not reported or identified 592 32 5023 14

Total 1824 100 36596 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 43

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 8 8 125 12Hemophiliacoagulation disorder 0 0 7 1High-risk heterosexual contactb 49 47 574 53

Sex with injection drug user 4 4 114 11Sex with bisexual male 2 2 80 7Sex with person with hemophilia 0 0 4 0Sex with HIV-infected transfusion recipient 1 1 25 2Sex with HIV-infected person risk factor not specified 42 40 351 33

Receipt of blood transfusion blood components or tissue 1 1 93 9Otherrisk factor not reported or identified 46 44 279 26

Total 104 100 1078 100

American IndianAlaska NativeInjection drug use 13 32 280 42Hemophiliacoagulation disorder 0 0 3 0High-risk heterosexual contactb 15 37 277 41

Sex with injection drug user 4 10 107 16Sex with bisexual male 1 2 27 4Sex with person with hemophilia 0 0 2 0Sex with HIV-infected transfusion recipient 0 0 6 1Sex with HIV-infected person risk factor not specified 10 24 135 20

Receipt of blood transfusion blood components or tissue 1 2 17 3Otherrisk factor not reported or identified 12 29 95 14

Total 41 100 672 100

Total casesInjection drug use 1826 17 67693 35Hemophiliacoagulation disorder 11 0 348 0High-risk heterosexual contactb 4839 46 85186 44

Sex with injection drug user 706 7 26073 14Sex with bisexual male 234 2 5162 3Sex with person with hemophilia 11 0 502 0Sex with HIV-infected transfusion recipient 21 0 793 0Sex with HIV-infected person risk factor not specified 3867 37 52656 27

Receipt of blood transfusion blood components or tissue 68 1 4176 2Otherrisk factor not reported or identified 3793 36 34311 18

Total 10537c 100 191714d 100a From the beginning of the epidemic through 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 104 females of unknown race or multiple racesd Includes 1419 females of unknown race or multiple races

44 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 690 26 4260 26Hemophiliacoagulation disorder 3 0 24 0

bHigh-risk heterosexual contact 1132 42 7593 46Sex with injection drug user 205 8 1876 11Sex with bisexual male 98 4 659 4Sex with person with hemophilia 10 0 115 1Sex with HIV-infected transfusion recipient 7 0 64 0Sex with HIV-infected person risk factor not specified 812 30 4879 29

Receipt of blood transfusion blood components or tissue 12 0 146 1Otherrisk factor not reported or identified 850 32 4567 28

Total 2687 100 16590 100

Black not HispanicInjection drug use 1034 13 7105 14Hemophiliacoagulation disorder 1 0 35 0

bHigh-risk heterosexual contact 3451 44 23732 46Sex with injection drug user 313 4 3473 7Sex with bisexual male 155 2 1294 3Sex with person with hemophilia 5 0 71 0Sex with HIV-infected transfusion recipient 14 0 120 0Sex with HIV-infected person risk factor not specified 2964 38 18774 36

Receipt of blood transfusion blood components or tissue 26 0 324 1Otherrisk factor not reported or identified 3370 43 20244 39

Total 7882 100 51440 100

HispanicInjection drug use 339 15 2280 18Hemophiliacoagulation disorder 2 0 11 0

bHigh-risk heterosexual contact 1198 52 6264 50Sex with injection drug user 218 9 1324 11Sex with bisexual male 62 3 266 2Sex with person with hemophilia 1 0 11 0Sex with HIV-infected transfusion recipient 7 0 39 0Sex with HIV-infected person risk factor not specified 910 39 4624 37

Receipt of blood transfusion blood components or tissue 12 1 58 0Otherrisk factor not reported or identified 767 33 3843 31

Total 2318 100 12456 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 45

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 40: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

a

Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulative

No No

AsianPacific IslanderMale-to-male sexual contact 225 54 4475 68Injection drug use 20 5 317 5Male-to-male sexual contact and injection drug use 17 4 284 4Hemophiliacoagulation disorder 1 0 70 1High-risk heterosexual contactb 34 8 376 6

Sex with injection drug user 1 0 54 1Sex with person with hemophilia 0 0 1 0Sex with HIV-infected transfusion recipient 0 0 8 0Sex with HIV-infected person risk factor not specified 33 8 313 5

Receipt of blood transfusion blood components or tissue 2 0 112 2Otherrisk factor not reported or identified 114 28 949 14

Total 413 100 6583 100

American IndianAlaska NativeMale-to-male sexual contact 61 49 1403 55Injection drug use 15 12 395 15Male-to-male sexual contact and injection drug use 23 19 457 18Hemophiliacoagulation disorder 0 0 27 1High-risk heterosexual contactb 9 7 118 5

Sex with injection drug user 1 1 33 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 8 6 82 3

Receipt of blood transfusion blood components or tissue 0 0 8 0Otherrisk factor not reported or identified 16 13 155 6

Total 124 100 2563 100

Total casesMale-to-male sexual contact 13775 49 429897 54Injection drug use 3413 12 163070 21Male-to-male sexual contact and injection drug use 1603 6 65524 8Hemophiliacoagulation disorder 43 0 5176 1High-risk heterosexual contactb 2997 11 49610 6

Sex with injection drug user 330 1 11683 1Sex with person with hemophilia 1 0 84 0Sex with HIV-infected transfusion recipient 22 0 553 0Sex with HIV-infected person risk factor not specified 2644 9 37290 5

Receipt of blood transfusion blood components or tissue 63 0 5213 1Otherrisk factor not reported or identified 6484 23 73136 9

Total 28378c 100 791626d 100a From the beginning of the epidemic through 2006b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 4019 males of unknown race or multiple races

40 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 11963 73 55725 69Injection drug use 858 5 5512 7Male-to-male sexual contact and injection drug use 1092 7 5578 7Hemophiliacoagulation disorder 29 0 355 0High-risk heterosexual contactb 522 3 2658 3

Sex with injection drug user 65 0 544 1Sex with person with hemophilia 0 0 8 0Sex with HIV-infected transfusion recipient 3 0 33 0Sex with HIV-infected person risk factor not specified 454 3 2073 3

Receipt of blood transfusion blood components or tissue 14 0 197 0Otherrisk factor not reported or identified 1956 12 11147 14

Total 16434 100 81172 100

Black not HispanicMale-to-male sexual contact 6203 44 30148 37Injection drug use 1594 11 11997 15Male-to-male sexual contact and injection drug use 483 3 3489 4Hemophiliacoagulation disorder 10 0 109 0High-risk heterosexual contactb 1714 12 10905 13

Sex with injection drug user 169 1 1554 2Sex with person with hemophilia 4 0 17 0Sex with HIV-infected transfusion recipient 6 0 77 0Sex with HIV-infected person risk factor not specified 1535 11 9257 11

Receipt of blood transfusion blood components or tissue 32 0 223 0Otherrisk factor not reported or identified 4151 29 24632 30

Total 14187 100 81503 100

HispanicMale-to-male sexual contact 4094 55 15623 47Injection drug use 993 13 6407 19Male-to-male sexual contact and injection drug use 316 4 1402 4Hemophiliacoagulation disorder 3 0 26 0High-risk heterosexual contactb 582 8 2963 9

Sex with injection drug user 65 1 455 1Sex with person with hemophilia 0 0 6 0Sex with HIV-infected transfusion recipient 4 0 18 0Sex with HIV-infected person risk factor not specified 513 7 2484 7

Receipt of blood transfusion blood components or tissue 11 0 55 0Otherrisk factor not reported or identified 1475 20 6977 21

Total 7474 100 33453 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 41

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderMale-to-male sexual contact 402 70 1006 63Injection drug use 17 3 55 3Male-to-male sexual contact and injection drug use 15 3 38 2Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 25 4 96 6

Sex with injection drug user 3 1 10 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 22 4 83 5

Receipt of blood transfusion blood components or tissue 4 1 7 0Otherrisk factor not reported or identified 109 19 397 25

Total 572 100 1600 100

American IndianAlaska NativeMale-to-male sexual contact 104 61 516 57Injection drug use 13 8 101 11Male-to-male sexual contact and injection drug use 19 11 110 12Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 10 6 53 6

Sex with injection drug user 2 1 14 2Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 8 5 39 4

Receipt of blood transfusion blood components or tissue 0 0 2 0Otherrisk factor not reported or identified 24 14 125 14

Total 170 100 907 100

Total casesMale-to-male sexual contact 22912 59 103679 52Injection drug use 3503 9 24255 12Male-to-male sexual contact and injection drug use 1946 5 10704 5Hemophiliacoagulation disorder 43 0 495 0High-risk heterosexual contactb 2874 7 16830 8

Sex with injection drug user 308 1 2601 1Sex with person with hemophilia 4 0 31 0Sex with HIV-infected transfusion recipient 13 0 131 0Sex with HIV-infected person risk factor not specified 2549 7 14067 7

Receipt of blood transfusion blood components or tissue 61 0 489 0Otherrisk factor not reported or identified 7748 20 44021 22

Total 39087c 100 200473d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 1838 males of unknown race or multiple races

42 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race

ethnicity 2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 482 28 14981 40Hemophiliacoagulation disorder 4 0 123 0High-risk heterosexual contactb 725 42 15799 42

Sex with injection drug user 153 9 5650 15Sex with bisexual male 63 4 1859 5Sex with person with hemophilia 5 0 329 1Sex with HIV-infected transfusion recipient 5 0 338 1Sex with HIV-infected person risk factor not specified 499 29 7623 20

Receipt of blood transfusion blood components or tissue 15 1 1870 5Otherrisk factor not reported or identified 499 29 4801 13

Total 1725 100 37574 100

Black not HispanicInjection drug use 982 15 38914 34Hemophiliacoagulation disorder 3 0 145 0High-risk heterosexual contactb 3103 46 49876 44

Sex with injection drug user 373 6 13530 12Sex with bisexual male 136 2 2352 2Sex with person with hemophilia 4 0 121 0Sex with HIV-infected transfusion recipient 8 0 277 0Sex with HIV-infected person risk factor not specified 2582 38 33596 29

Receipt of blood transfusion blood components or tissue 39 1 1546 1Otherrisk factor not reported or identified 2612 39 23894 21

Total 6739 100 114375 100

HispanicInjection drug use 322 18 12892 35Hemophiliacoagulation disorder 4 0 67 0High-risk heterosexual contactb 894 49 17995 49

Sex with injection drug user 166 9 6522 18Sex with bisexual male 32 2 818 2Sex with person with hemophilia 1 0 45 0Sex with HIV-infected transfusion recipient 7 0 141 0Sex with HIV-infected person risk factor not specified 688 38 10469 29

Receipt of blood transfusion blood components or tissue 12 1 619 2Otherrisk factor not reported or identified 592 32 5023 14

Total 1824 100 36596 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 43

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 8 8 125 12Hemophiliacoagulation disorder 0 0 7 1High-risk heterosexual contactb 49 47 574 53

Sex with injection drug user 4 4 114 11Sex with bisexual male 2 2 80 7Sex with person with hemophilia 0 0 4 0Sex with HIV-infected transfusion recipient 1 1 25 2Sex with HIV-infected person risk factor not specified 42 40 351 33

Receipt of blood transfusion blood components or tissue 1 1 93 9Otherrisk factor not reported or identified 46 44 279 26

Total 104 100 1078 100

American IndianAlaska NativeInjection drug use 13 32 280 42Hemophiliacoagulation disorder 0 0 3 0High-risk heterosexual contactb 15 37 277 41

Sex with injection drug user 4 10 107 16Sex with bisexual male 1 2 27 4Sex with person with hemophilia 0 0 2 0Sex with HIV-infected transfusion recipient 0 0 6 1Sex with HIV-infected person risk factor not specified 10 24 135 20

Receipt of blood transfusion blood components or tissue 1 2 17 3Otherrisk factor not reported or identified 12 29 95 14

Total 41 100 672 100

Total casesInjection drug use 1826 17 67693 35Hemophiliacoagulation disorder 11 0 348 0High-risk heterosexual contactb 4839 46 85186 44

Sex with injection drug user 706 7 26073 14Sex with bisexual male 234 2 5162 3Sex with person with hemophilia 11 0 502 0Sex with HIV-infected transfusion recipient 21 0 793 0Sex with HIV-infected person risk factor not specified 3867 37 52656 27

Receipt of blood transfusion blood components or tissue 68 1 4176 2Otherrisk factor not reported or identified 3793 36 34311 18

Total 10537c 100 191714d 100a From the beginning of the epidemic through 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 104 females of unknown race or multiple racesd Includes 1419 females of unknown race or multiple races

44 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 690 26 4260 26Hemophiliacoagulation disorder 3 0 24 0

bHigh-risk heterosexual contact 1132 42 7593 46Sex with injection drug user 205 8 1876 11Sex with bisexual male 98 4 659 4Sex with person with hemophilia 10 0 115 1Sex with HIV-infected transfusion recipient 7 0 64 0Sex with HIV-infected person risk factor not specified 812 30 4879 29

Receipt of blood transfusion blood components or tissue 12 0 146 1Otherrisk factor not reported or identified 850 32 4567 28

Total 2687 100 16590 100

Black not HispanicInjection drug use 1034 13 7105 14Hemophiliacoagulation disorder 1 0 35 0

bHigh-risk heterosexual contact 3451 44 23732 46Sex with injection drug user 313 4 3473 7Sex with bisexual male 155 2 1294 3Sex with person with hemophilia 5 0 71 0Sex with HIV-infected transfusion recipient 14 0 120 0Sex with HIV-infected person risk factor not specified 2964 38 18774 36

Receipt of blood transfusion blood components or tissue 26 0 324 1Otherrisk factor not reported or identified 3370 43 20244 39

Total 7882 100 51440 100

HispanicInjection drug use 339 15 2280 18Hemophiliacoagulation disorder 2 0 11 0

bHigh-risk heterosexual contact 1198 52 6264 50Sex with injection drug user 218 9 1324 11Sex with bisexual male 62 3 266 2Sex with person with hemophilia 1 0 11 0Sex with HIV-infected transfusion recipient 7 0 39 0Sex with HIV-infected person risk factor not specified 910 39 4624 37

Receipt of blood transfusion blood components or tissue 12 1 58 0Otherrisk factor not reported or identified 767 33 3843 31

Total 2318 100 12456 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 45

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 41: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicMale-to-male sexual contact 11963 73 55725 69Injection drug use 858 5 5512 7Male-to-male sexual contact and injection drug use 1092 7 5578 7Hemophiliacoagulation disorder 29 0 355 0High-risk heterosexual contactb 522 3 2658 3

Sex with injection drug user 65 0 544 1Sex with person with hemophilia 0 0 8 0Sex with HIV-infected transfusion recipient 3 0 33 0Sex with HIV-infected person risk factor not specified 454 3 2073 3

Receipt of blood transfusion blood components or tissue 14 0 197 0Otherrisk factor not reported or identified 1956 12 11147 14

Total 16434 100 81172 100

Black not HispanicMale-to-male sexual contact 6203 44 30148 37Injection drug use 1594 11 11997 15Male-to-male sexual contact and injection drug use 483 3 3489 4Hemophiliacoagulation disorder 10 0 109 0High-risk heterosexual contactb 1714 12 10905 13

Sex with injection drug user 169 1 1554 2Sex with person with hemophilia 4 0 17 0Sex with HIV-infected transfusion recipient 6 0 77 0Sex with HIV-infected person risk factor not specified 1535 11 9257 11

Receipt of blood transfusion blood components or tissue 32 0 223 0Otherrisk factor not reported or identified 4151 29 24632 30

Total 14187 100 81503 100

HispanicMale-to-male sexual contact 4094 55 15623 47Injection drug use 993 13 6407 19Male-to-male sexual contact and injection drug use 316 4 1402 4Hemophiliacoagulation disorder 3 0 26 0High-risk heterosexual contactb 582 8 2963 9

Sex with injection drug user 65 1 455 1Sex with person with hemophilia 0 0 6 0Sex with HIV-infected transfusion recipient 4 0 18 0Sex with HIV-infected person risk factor not specified 513 7 2484 7

Receipt of blood transfusion blood components or tissue 11 0 55 0Otherrisk factor not reported or identified 1475 20 6977 21

Total 7474 100 33453 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 41

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderMale-to-male sexual contact 402 70 1006 63Injection drug use 17 3 55 3Male-to-male sexual contact and injection drug use 15 3 38 2Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 25 4 96 6

Sex with injection drug user 3 1 10 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 22 4 83 5

Receipt of blood transfusion blood components or tissue 4 1 7 0Otherrisk factor not reported or identified 109 19 397 25

Total 572 100 1600 100

American IndianAlaska NativeMale-to-male sexual contact 104 61 516 57Injection drug use 13 8 101 11Male-to-male sexual contact and injection drug use 19 11 110 12Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 10 6 53 6

Sex with injection drug user 2 1 14 2Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 8 5 39 4

Receipt of blood transfusion blood components or tissue 0 0 2 0Otherrisk factor not reported or identified 24 14 125 14

Total 170 100 907 100

Total casesMale-to-male sexual contact 22912 59 103679 52Injection drug use 3503 9 24255 12Male-to-male sexual contact and injection drug use 1946 5 10704 5Hemophiliacoagulation disorder 43 0 495 0High-risk heterosexual contactb 2874 7 16830 8

Sex with injection drug user 308 1 2601 1Sex with person with hemophilia 4 0 31 0Sex with HIV-infected transfusion recipient 13 0 131 0Sex with HIV-infected person risk factor not specified 2549 7 14067 7

Receipt of blood transfusion blood components or tissue 61 0 489 0Otherrisk factor not reported or identified 7748 20 44021 22

Total 39087c 100 200473d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 1838 males of unknown race or multiple races

42 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race

ethnicity 2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 482 28 14981 40Hemophiliacoagulation disorder 4 0 123 0High-risk heterosexual contactb 725 42 15799 42

Sex with injection drug user 153 9 5650 15Sex with bisexual male 63 4 1859 5Sex with person with hemophilia 5 0 329 1Sex with HIV-infected transfusion recipient 5 0 338 1Sex with HIV-infected person risk factor not specified 499 29 7623 20

Receipt of blood transfusion blood components or tissue 15 1 1870 5Otherrisk factor not reported or identified 499 29 4801 13

Total 1725 100 37574 100

Black not HispanicInjection drug use 982 15 38914 34Hemophiliacoagulation disorder 3 0 145 0High-risk heterosexual contactb 3103 46 49876 44

Sex with injection drug user 373 6 13530 12Sex with bisexual male 136 2 2352 2Sex with person with hemophilia 4 0 121 0Sex with HIV-infected transfusion recipient 8 0 277 0Sex with HIV-infected person risk factor not specified 2582 38 33596 29

Receipt of blood transfusion blood components or tissue 39 1 1546 1Otherrisk factor not reported or identified 2612 39 23894 21

Total 6739 100 114375 100

HispanicInjection drug use 322 18 12892 35Hemophiliacoagulation disorder 4 0 67 0High-risk heterosexual contactb 894 49 17995 49

Sex with injection drug user 166 9 6522 18Sex with bisexual male 32 2 818 2Sex with person with hemophilia 1 0 45 0Sex with HIV-infected transfusion recipient 7 0 141 0Sex with HIV-infected person risk factor not specified 688 38 10469 29

Receipt of blood transfusion blood components or tissue 12 1 619 2Otherrisk factor not reported or identified 592 32 5023 14

Total 1824 100 36596 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 43

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 8 8 125 12Hemophiliacoagulation disorder 0 0 7 1High-risk heterosexual contactb 49 47 574 53

Sex with injection drug user 4 4 114 11Sex with bisexual male 2 2 80 7Sex with person with hemophilia 0 0 4 0Sex with HIV-infected transfusion recipient 1 1 25 2Sex with HIV-infected person risk factor not specified 42 40 351 33

Receipt of blood transfusion blood components or tissue 1 1 93 9Otherrisk factor not reported or identified 46 44 279 26

Total 104 100 1078 100

American IndianAlaska NativeInjection drug use 13 32 280 42Hemophiliacoagulation disorder 0 0 3 0High-risk heterosexual contactb 15 37 277 41

Sex with injection drug user 4 10 107 16Sex with bisexual male 1 2 27 4Sex with person with hemophilia 0 0 2 0Sex with HIV-infected transfusion recipient 0 0 6 1Sex with HIV-infected person risk factor not specified 10 24 135 20

Receipt of blood transfusion blood components or tissue 1 2 17 3Otherrisk factor not reported or identified 12 29 95 14

Total 41 100 672 100

Total casesInjection drug use 1826 17 67693 35Hemophiliacoagulation disorder 11 0 348 0High-risk heterosexual contactb 4839 46 85186 44

Sex with injection drug user 706 7 26073 14Sex with bisexual male 234 2 5162 3Sex with person with hemophilia 11 0 502 0Sex with HIV-infected transfusion recipient 21 0 793 0Sex with HIV-infected person risk factor not specified 3867 37 52656 27

Receipt of blood transfusion blood components or tissue 68 1 4176 2Otherrisk factor not reported or identified 3793 36 34311 18

Total 10537c 100 191714d 100a From the beginning of the epidemic through 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 104 females of unknown race or multiple racesd Includes 1419 females of unknown race or multiple races

44 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 690 26 4260 26Hemophiliacoagulation disorder 3 0 24 0

bHigh-risk heterosexual contact 1132 42 7593 46Sex with injection drug user 205 8 1876 11Sex with bisexual male 98 4 659 4Sex with person with hemophilia 10 0 115 1Sex with HIV-infected transfusion recipient 7 0 64 0Sex with HIV-infected person risk factor not specified 812 30 4879 29

Receipt of blood transfusion blood components or tissue 12 0 146 1Otherrisk factor not reported or identified 850 32 4567 28

Total 2687 100 16590 100

Black not HispanicInjection drug use 1034 13 7105 14Hemophiliacoagulation disorder 1 0 35 0

bHigh-risk heterosexual contact 3451 44 23732 46Sex with injection drug user 313 4 3473 7Sex with bisexual male 155 2 1294 3Sex with person with hemophilia 5 0 71 0Sex with HIV-infected transfusion recipient 14 0 120 0Sex with HIV-infected person risk factor not specified 2964 38 18774 36

Receipt of blood transfusion blood components or tissue 26 0 324 1Otherrisk factor not reported or identified 3370 43 20244 39

Total 7882 100 51440 100

HispanicInjection drug use 339 15 2280 18Hemophiliacoagulation disorder 2 0 11 0

bHigh-risk heterosexual contact 1198 52 6264 50Sex with injection drug user 218 9 1324 11Sex with bisexual male 62 3 266 2Sex with person with hemophilia 1 0 11 0Sex with HIV-infected transfusion recipient 7 0 39 0Sex with HIV-infected person risk factor not specified 910 39 4624 37

Receipt of blood transfusion blood components or tissue 12 1 58 0Otherrisk factor not reported or identified 767 33 3843 31

Total 2318 100 12456 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 45

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 42: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderMale-to-male sexual contact 402 70 1006 63Injection drug use 17 3 55 3Male-to-male sexual contact and injection drug use 15 3 38 2Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 25 4 96 6

Sex with injection drug user 3 1 10 1Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 3 0Sex with HIV-infected person risk factor not specified 22 4 83 5

Receipt of blood transfusion blood components or tissue 4 1 7 0Otherrisk factor not reported or identified 109 19 397 25

Total 572 100 1600 100

American IndianAlaska NativeMale-to-male sexual contact 104 61 516 57Injection drug use 13 8 101 11Male-to-male sexual contact and injection drug use 19 11 110 12Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 10 6 53 6

Sex with injection drug user 2 1 14 2Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 8 5 39 4

Receipt of blood transfusion blood components or tissue 0 0 2 0Otherrisk factor not reported or identified 24 14 125 14

Total 170 100 907 100

Total casesMale-to-male sexual contact 22912 59 103679 52Injection drug use 3503 9 24255 12Male-to-male sexual contact and injection drug use 1946 5 10704 5Hemophiliacoagulation disorder 43 0 495 0High-risk heterosexual contactb 2874 7 16830 8

Sex with injection drug user 308 1 2601 1Sex with person with hemophilia 4 0 31 0Sex with HIV-infected transfusion recipient 13 0 131 0Sex with HIV-infected person risk factor not specified 2549 7 14067 7

Receipt of blood transfusion blood components or tissue 61 0 489 0Otherrisk factor not reported or identified 7748 20 44021 22

Total 39087c 100 200473d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 250 males of unknown race or multiple racesd Includes 1838 males of unknown race or multiple races

42 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race

ethnicity 2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 482 28 14981 40Hemophiliacoagulation disorder 4 0 123 0High-risk heterosexual contactb 725 42 15799 42

Sex with injection drug user 153 9 5650 15Sex with bisexual male 63 4 1859 5Sex with person with hemophilia 5 0 329 1Sex with HIV-infected transfusion recipient 5 0 338 1Sex with HIV-infected person risk factor not specified 499 29 7623 20

Receipt of blood transfusion blood components or tissue 15 1 1870 5Otherrisk factor not reported or identified 499 29 4801 13

Total 1725 100 37574 100

Black not HispanicInjection drug use 982 15 38914 34Hemophiliacoagulation disorder 3 0 145 0High-risk heterosexual contactb 3103 46 49876 44

Sex with injection drug user 373 6 13530 12Sex with bisexual male 136 2 2352 2Sex with person with hemophilia 4 0 121 0Sex with HIV-infected transfusion recipient 8 0 277 0Sex with HIV-infected person risk factor not specified 2582 38 33596 29

Receipt of blood transfusion blood components or tissue 39 1 1546 1Otherrisk factor not reported or identified 2612 39 23894 21

Total 6739 100 114375 100

HispanicInjection drug use 322 18 12892 35Hemophiliacoagulation disorder 4 0 67 0High-risk heterosexual contactb 894 49 17995 49

Sex with injection drug user 166 9 6522 18Sex with bisexual male 32 2 818 2Sex with person with hemophilia 1 0 45 0Sex with HIV-infected transfusion recipient 7 0 141 0Sex with HIV-infected person risk factor not specified 688 38 10469 29

Receipt of blood transfusion blood components or tissue 12 1 619 2Otherrisk factor not reported or identified 592 32 5023 14

Total 1824 100 36596 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 43

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 8 8 125 12Hemophiliacoagulation disorder 0 0 7 1High-risk heterosexual contactb 49 47 574 53

Sex with injection drug user 4 4 114 11Sex with bisexual male 2 2 80 7Sex with person with hemophilia 0 0 4 0Sex with HIV-infected transfusion recipient 1 1 25 2Sex with HIV-infected person risk factor not specified 42 40 351 33

Receipt of blood transfusion blood components or tissue 1 1 93 9Otherrisk factor not reported or identified 46 44 279 26

Total 104 100 1078 100

American IndianAlaska NativeInjection drug use 13 32 280 42Hemophiliacoagulation disorder 0 0 3 0High-risk heterosexual contactb 15 37 277 41

Sex with injection drug user 4 10 107 16Sex with bisexual male 1 2 27 4Sex with person with hemophilia 0 0 2 0Sex with HIV-infected transfusion recipient 0 0 6 1Sex with HIV-infected person risk factor not specified 10 24 135 20

Receipt of blood transfusion blood components or tissue 1 2 17 3Otherrisk factor not reported or identified 12 29 95 14

Total 41 100 672 100

Total casesInjection drug use 1826 17 67693 35Hemophiliacoagulation disorder 11 0 348 0High-risk heterosexual contactb 4839 46 85186 44

Sex with injection drug user 706 7 26073 14Sex with bisexual male 234 2 5162 3Sex with person with hemophilia 11 0 502 0Sex with HIV-infected transfusion recipient 21 0 793 0Sex with HIV-infected person risk factor not specified 3867 37 52656 27

Receipt of blood transfusion blood components or tissue 68 1 4176 2Otherrisk factor not reported or identified 3793 36 34311 18

Total 10537c 100 191714d 100a From the beginning of the epidemic through 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 104 females of unknown race or multiple racesd Includes 1419 females of unknown race or multiple races

44 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 690 26 4260 26Hemophiliacoagulation disorder 3 0 24 0

bHigh-risk heterosexual contact 1132 42 7593 46Sex with injection drug user 205 8 1876 11Sex with bisexual male 98 4 659 4Sex with person with hemophilia 10 0 115 1Sex with HIV-infected transfusion recipient 7 0 64 0Sex with HIV-infected person risk factor not specified 812 30 4879 29

Receipt of blood transfusion blood components or tissue 12 0 146 1Otherrisk factor not reported or identified 850 32 4567 28

Total 2687 100 16590 100

Black not HispanicInjection drug use 1034 13 7105 14Hemophiliacoagulation disorder 1 0 35 0

bHigh-risk heterosexual contact 3451 44 23732 46Sex with injection drug user 313 4 3473 7Sex with bisexual male 155 2 1294 3Sex with person with hemophilia 5 0 71 0Sex with HIV-infected transfusion recipient 14 0 120 0Sex with HIV-infected person risk factor not specified 2964 38 18774 36

Receipt of blood transfusion blood components or tissue 26 0 324 1Otherrisk factor not reported or identified 3370 43 20244 39

Total 7882 100 51440 100

HispanicInjection drug use 339 15 2280 18Hemophiliacoagulation disorder 2 0 11 0

bHigh-risk heterosexual contact 1198 52 6264 50Sex with injection drug user 218 9 1324 11Sex with bisexual male 62 3 266 2Sex with person with hemophilia 1 0 11 0Sex with HIV-infected transfusion recipient 7 0 39 0Sex with HIV-infected person risk factor not specified 910 39 4624 37

Receipt of blood transfusion blood components or tissue 12 1 58 0Otherrisk factor not reported or identified 767 33 3843 31

Total 2318 100 12456 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 45

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 43: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race

ethnicity 2006 and cumulativemdashUnited States and dependent areas

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 482 28 14981 40Hemophiliacoagulation disorder 4 0 123 0High-risk heterosexual contactb 725 42 15799 42

Sex with injection drug user 153 9 5650 15Sex with bisexual male 63 4 1859 5Sex with person with hemophilia 5 0 329 1Sex with HIV-infected transfusion recipient 5 0 338 1Sex with HIV-infected person risk factor not specified 499 29 7623 20

Receipt of blood transfusion blood components or tissue 15 1 1870 5Otherrisk factor not reported or identified 499 29 4801 13

Total 1725 100 37574 100

Black not HispanicInjection drug use 982 15 38914 34Hemophiliacoagulation disorder 3 0 145 0High-risk heterosexual contactb 3103 46 49876 44

Sex with injection drug user 373 6 13530 12Sex with bisexual male 136 2 2352 2Sex with person with hemophilia 4 0 121 0Sex with HIV-infected transfusion recipient 8 0 277 0Sex with HIV-infected person risk factor not specified 2582 38 33596 29

Receipt of blood transfusion blood components or tissue 39 1 1546 1Otherrisk factor not reported or identified 2612 39 23894 21

Total 6739 100 114375 100

HispanicInjection drug use 322 18 12892 35Hemophiliacoagulation disorder 4 0 67 0High-risk heterosexual contactb 894 49 17995 49

Sex with injection drug user 166 9 6522 18Sex with bisexual male 32 2 818 2Sex with person with hemophilia 1 0 45 0Sex with HIV-infected transfusion recipient 7 0 141 0Sex with HIV-infected person risk factor not specified 688 38 10469 29

Receipt of blood transfusion blood components or tissue 12 1 619 2Otherrisk factor not reported or identified 592 32 5023 14

Total 1824 100 36596 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 43

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 8 8 125 12Hemophiliacoagulation disorder 0 0 7 1High-risk heterosexual contactb 49 47 574 53

Sex with injection drug user 4 4 114 11Sex with bisexual male 2 2 80 7Sex with person with hemophilia 0 0 4 0Sex with HIV-infected transfusion recipient 1 1 25 2Sex with HIV-infected person risk factor not specified 42 40 351 33

Receipt of blood transfusion blood components or tissue 1 1 93 9Otherrisk factor not reported or identified 46 44 279 26

Total 104 100 1078 100

American IndianAlaska NativeInjection drug use 13 32 280 42Hemophiliacoagulation disorder 0 0 3 0High-risk heterosexual contactb 15 37 277 41

Sex with injection drug user 4 10 107 16Sex with bisexual male 1 2 27 4Sex with person with hemophilia 0 0 2 0Sex with HIV-infected transfusion recipient 0 0 6 1Sex with HIV-infected person risk factor not specified 10 24 135 20

Receipt of blood transfusion blood components or tissue 1 2 17 3Otherrisk factor not reported or identified 12 29 95 14

Total 41 100 672 100

Total casesInjection drug use 1826 17 67693 35Hemophiliacoagulation disorder 11 0 348 0High-risk heterosexual contactb 4839 46 85186 44

Sex with injection drug user 706 7 26073 14Sex with bisexual male 234 2 5162 3Sex with person with hemophilia 11 0 502 0Sex with HIV-infected transfusion recipient 21 0 793 0Sex with HIV-infected person risk factor not specified 3867 37 52656 27

Receipt of blood transfusion blood components or tissue 68 1 4176 2Otherrisk factor not reported or identified 3793 36 34311 18

Total 10537c 100 191714d 100a From the beginning of the epidemic through 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 104 females of unknown race or multiple racesd Includes 1419 females of unknown race or multiple races

44 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 690 26 4260 26Hemophiliacoagulation disorder 3 0 24 0

bHigh-risk heterosexual contact 1132 42 7593 46Sex with injection drug user 205 8 1876 11Sex with bisexual male 98 4 659 4Sex with person with hemophilia 10 0 115 1Sex with HIV-infected transfusion recipient 7 0 64 0Sex with HIV-infected person risk factor not specified 812 30 4879 29

Receipt of blood transfusion blood components or tissue 12 0 146 1Otherrisk factor not reported or identified 850 32 4567 28

Total 2687 100 16590 100

Black not HispanicInjection drug use 1034 13 7105 14Hemophiliacoagulation disorder 1 0 35 0

bHigh-risk heterosexual contact 3451 44 23732 46Sex with injection drug user 313 4 3473 7Sex with bisexual male 155 2 1294 3Sex with person with hemophilia 5 0 71 0Sex with HIV-infected transfusion recipient 14 0 120 0Sex with HIV-infected person risk factor not specified 2964 38 18774 36

Receipt of blood transfusion blood components or tissue 26 0 324 1Otherrisk factor not reported or identified 3370 43 20244 39

Total 7882 100 51440 100

HispanicInjection drug use 339 15 2280 18Hemophiliacoagulation disorder 2 0 11 0

bHigh-risk heterosexual contact 1198 52 6264 50Sex with injection drug user 218 9 1324 11Sex with bisexual male 62 3 266 2Sex with person with hemophilia 1 0 11 0Sex with HIV-infected transfusion recipient 7 0 39 0Sex with HIV-infected person risk factor not specified 910 39 4624 37

Receipt of blood transfusion blood components or tissue 12 1 58 0Otherrisk factor not reported or identified 767 33 3843 31

Total 2318 100 12456 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 45

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 44: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Table 21 Reported AIDS cases for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdashUnited States and dependent areas (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 8 8 125 12Hemophiliacoagulation disorder 0 0 7 1High-risk heterosexual contactb 49 47 574 53

Sex with injection drug user 4 4 114 11Sex with bisexual male 2 2 80 7Sex with person with hemophilia 0 0 4 0Sex with HIV-infected transfusion recipient 1 1 25 2Sex with HIV-infected person risk factor not specified 42 40 351 33

Receipt of blood transfusion blood components or tissue 1 1 93 9Otherrisk factor not reported or identified 46 44 279 26

Total 104 100 1078 100

American IndianAlaska NativeInjection drug use 13 32 280 42Hemophiliacoagulation disorder 0 0 3 0High-risk heterosexual contactb 15 37 277 41

Sex with injection drug user 4 10 107 16Sex with bisexual male 1 2 27 4Sex with person with hemophilia 0 0 2 0Sex with HIV-infected transfusion recipient 0 0 6 1Sex with HIV-infected person risk factor not specified 10 24 135 20

Receipt of blood transfusion blood components or tissue 1 2 17 3Otherrisk factor not reported or identified 12 29 95 14

Total 41 100 672 100

Total casesInjection drug use 1826 17 67693 35Hemophiliacoagulation disorder 11 0 348 0High-risk heterosexual contactb 4839 46 85186 44

Sex with injection drug user 706 7 26073 14Sex with bisexual male 234 2 5162 3Sex with person with hemophilia 11 0 502 0Sex with HIV-infected transfusion recipient 21 0 793 0Sex with HIV-infected person risk factor not specified 3867 37 52656 27

Receipt of blood transfusion blood components or tissue 68 1 4176 2Otherrisk factor not reported or identified 3793 36 34311 18

Total 10537c 100 191714d 100a From the beginning of the epidemic through 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 104 females of unknown race or multiple racesd Includes 1419 females of unknown race or multiple races

44 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 690 26 4260 26Hemophiliacoagulation disorder 3 0 24 0

bHigh-risk heterosexual contact 1132 42 7593 46Sex with injection drug user 205 8 1876 11Sex with bisexual male 98 4 659 4Sex with person with hemophilia 10 0 115 1Sex with HIV-infected transfusion recipient 7 0 64 0Sex with HIV-infected person risk factor not specified 812 30 4879 29

Receipt of blood transfusion blood components or tissue 12 0 146 1Otherrisk factor not reported or identified 850 32 4567 28

Total 2687 100 16590 100

Black not HispanicInjection drug use 1034 13 7105 14Hemophiliacoagulation disorder 1 0 35 0

bHigh-risk heterosexual contact 3451 44 23732 46Sex with injection drug user 313 4 3473 7Sex with bisexual male 155 2 1294 3Sex with person with hemophilia 5 0 71 0Sex with HIV-infected transfusion recipient 14 0 120 0Sex with HIV-infected person risk factor not specified 2964 38 18774 36

Receipt of blood transfusion blood components or tissue 26 0 324 1Otherrisk factor not reported or identified 3370 43 20244 39

Total 7882 100 51440 100

HispanicInjection drug use 339 15 2280 18Hemophiliacoagulation disorder 2 0 11 0

bHigh-risk heterosexual contact 1198 52 6264 50Sex with injection drug user 218 9 1324 11Sex with bisexual male 62 3 266 2Sex with person with hemophilia 1 0 11 0Sex with HIV-infected transfusion recipient 7 0 39 0Sex with HIV-infected person risk factor not specified 910 39 4624 37

Receipt of blood transfusion blood components or tissue 12 1 58 0Otherrisk factor not reported or identified 767 33 3843 31

Total 2318 100 12456 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 45

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 45: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting

Transmission category

2006 Cumulativea

No No

White not HispanicInjection drug use 690 26 4260 26Hemophiliacoagulation disorder 3 0 24 0

bHigh-risk heterosexual contact 1132 42 7593 46Sex with injection drug user 205 8 1876 11Sex with bisexual male 98 4 659 4Sex with person with hemophilia 10 0 115 1Sex with HIV-infected transfusion recipient 7 0 64 0Sex with HIV-infected person risk factor not specified 812 30 4879 29

Receipt of blood transfusion blood components or tissue 12 0 146 1Otherrisk factor not reported or identified 850 32 4567 28

Total 2687 100 16590 100

Black not HispanicInjection drug use 1034 13 7105 14Hemophiliacoagulation disorder 1 0 35 0

bHigh-risk heterosexual contact 3451 44 23732 46Sex with injection drug user 313 4 3473 7Sex with bisexual male 155 2 1294 3Sex with person with hemophilia 5 0 71 0Sex with HIV-infected transfusion recipient 14 0 120 0Sex with HIV-infected person risk factor not specified 2964 38 18774 36

Receipt of blood transfusion blood components or tissue 26 0 324 1Otherrisk factor not reported or identified 3370 43 20244 39

Total 7882 100 51440 100

HispanicInjection drug use 339 15 2280 18Hemophiliacoagulation disorder 2 0 11 0

bHigh-risk heterosexual contact 1198 52 6264 50Sex with injection drug user 218 9 1324 11Sex with bisexual male 62 3 266 2Sex with person with hemophilia 1 0 11 0Sex with HIV-infected transfusion recipient 7 0 39 0Sex with HIV-infected person risk factor not specified 910 39 4624 37

Receipt of blood transfusion blood components or tissue 12 1 58 0Otherrisk factor not reported or identified 767 33 3843 31

Total 2318 100 12456 100

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 45

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 46: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulativemdash45 states and 5 US dependent areas with confidential name-based HIV infection reporting (cont)

Transmission category

2006 Cumulativea

No No

AsianPacific IslanderInjection drug use 10 7 23 5Hemophiliacoagulation disorder 0 0 1 0High-risk heterosexual contactb 57 42 198 42

Sex with injection drug user 7 5 18 4Sex with bisexual male 8 6 15 3Sex with person with hemophilia 0 0 0 0Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 42 31 165 35

Receipt of blood transfusion blood components or tissue 0 0 5 1Otherrisk factor not reported or identified 70 51 239 51

Total 137 100 466 100

American IndianAlaska NativeInjection drug use 29 34 112 28Hemophiliacoagulation disorder 0 0 0 0High-risk heterosexual contactb 38 44 190 48

Sex with injection drug user 8 9 54 14Sex with bisexual male 4 5 17 4Sex with person with hemophilia 0 0 2 1Sex with HIV-infected transfusion recipient 0 0 0 0Sex with HIV-infected person risk factor not specified 26 30 117 29

Receipt of blood transfusion blood components or tissue 0 0 1 0Otherrisk factor not reported or identified 19 22 94 24

Total 86 100 397 100

Total casesInjection drug use 2124 16 13925 17Hemophiliacoagulation disorder 6 0 73 0High-risk heterosexual contactb 5939 45 38315 47

Sex with injection drug user 757 6 6791 8Sex with bisexual male 328 2 2265 3Sex with person with hemophilia 16 0 201 0Sex with HIV-infected transfusion recipient 28 0 223 0Sex with HIV-infected person risk factor not specified 4810 36 28835 35

Receipt of blood transfusion blood components or tissue 50 0 536 1Otherrisk factor not reported or identified 5106 39 29312 36

Total 13225c 100 82161d 100

Note See Table 16 for list of 45 states and 5 US dependent areas with confidential name-based HIV infection reporting as of December 2006a From the beginning of the epidemic through December 2006 b Heterosexual contact with a person known to have or to be at high risk for HIV infectionc Includes 115 females of unknown race or multiple racesd Includes 812 females of unknown race or multiple races

46 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 47: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994ndash2006mdash25 states with confidential name-based HIV infection reporting

Year of report

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Childrsquos raceethnicityWhite not Hispanic 76 72 45 25 27 20 12 17 20 15 10 15 12Black not Hispanic 212 204 160 124 94 77 79 87 66 63 61 67 51Hispanic 32 20 19 14 10 10 15 13 18 9 15 18 8AsianPacific Islander 1 0 0 1 2 0 1 0 0 1 0 2 2American IndianAlaska Native 5 1 0 1 0 1 0 0 1 1 0 1 2

Perinatal transmission categoryMother with documented HIV infection

or 1 of the following risk factorsInjection drug use 121 92 78 49 23 23 25 22 12 9 4 18 7Sex with injection drug user 64 44 41 28 19 21 9 9 12 7 5 8 6Sex with bisexual male 8 11 5 5 2 5 3 5 2 5 4 5 2Sex with person with hemophilia 2 2 0 0 1 1 1 1 0 1 0 0 0Sex with HIV-infected transfusion

recipient 1 0 0 0 0 0 0 0 0 0 0 0 0Sex with HIV-infected person risk

factor not specified 81 88 49 53 47 29 41 49 40 40 35 34 27Receipt of blood transfusion blood

components or tissue 6 4 3 2 2 1 0 2 1 0 0 0 0Has HIV infection risk factor not

specified 45 58 50 31 39 30 28 30 40 32 38 39 36

Childrsquos diagnosisa HIV infection 125 135 119 93 91 70 77 78 72 76 69 86 65AIDS 203 164 107 75 42 40 30 40 35 18 17 18 13

Totalb 328 299 226 168 133 110 107 118 107 94 86 104 78Note Since 1994 the following 25 states have had laws and regulations requiring confidential name-based HIV infection reporting Alabama Arizona Arkansas Colorado Idaho Indiana Louisiana Michigan Minnesota Mississippi Missouri Nevada New Jersey North Carolina North Dakota Ohio Oklahoma South Carolina South Dakota Tennessee Utah Virginia West Virginia Wisconsin and WyomingData include children with a diagnosis of HIV infection (not AIDS) a diagnosis of HIV infection and a later diagnosis of AIDS or concurrent diagnoses of HIV infection and AIDSa In the surveillance system as of June 2007b Includes children of unknown race or multiple races

Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS) 47

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 48: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Technical Notes

SURVEILLANCE OF HIV INFECTION (NOT AIDS)

This report includes data from case reports from 50 areas (see Table 16 for list of areas) that had laws or regulations requiring confidential reporting by name for adults adolescents and children with confirmed HIV infection (not AIDS) in addition to the reporting of persons with AIDS as of December 31 2006 After the removal of personal identifying information data from these reports were submitted to CDC The imple-mentation of HIV reporting has differed from state to state Before 1991 surveillance of HIV infection (not AIDS) was not standardized and the reporting of HIV infection (not AIDS) was based primarily on passive surveillance The information on many of the cases reported before 1991 is not complete Since then CDC has assisted states in conducting active surveillance of HIV infection (not AIDS) by the use of standardized report forms and software

Data on HIV infection (not AIDS) should be inter-preted with caution HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested Many HIV-reporting states offer anonymous HIV test-ing the results of anonymous tests are not reported to the confidential name-based HIV registries of state and local health departments Therefore reports of confi-dential test results may not represent all persons who tested positive for HIV infection Furthermore many factors including the extent to which testing is rou-tinely offered to specific groups and the availability of and access to medical care and testing services may influence testing patterns These data provide a mini-mum estimate of the number of persons known to be HIV infected in states with confidential HIV reporting

As of December 31 2006 5 areas (Hawaii Mary-land Massachusetts Vermont and the District of Columbia) had implemented a code-based system to conduct case surveillance of HIV infection (not AIDS) Montana had implemented a name-to-code system for conducting HIV infection surveillance (in a name-to-code system names are collected and after any necessary public health follow-up names are con-verted to codes) Data on cases of HIV infection (not

48

AIDS) from these areas are not included in the HIV data tables In order to acquire high-quality HIV data CDC recommended in 2005 that all states and US dependent areas adopt confidential name-based public health disease surveillance systems to report cases of HIV infection [1]

For this report we classified cases in adults adoles-cents and children aged 18 months and older by using the 2000 revised HIV surveillance case definition which incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA [2] For children younger than 18 months the pediatric HIV reporting criteria reflect diagnostic advances that permit the diagnosis of HIV infection during the first months of life By the use of HIV nucleic acid detection tests HIV infection can be detected in nearly all infants aged 1 month and older The timing of the HIV serologic and HIV nucleic acid detection tests specified in the definitive and presump-tive criteria for HIV infection is based on the recom-mended practices for diagnosing infection in children younger than 18 months and on evaluations of the per-formance of these tests for children in this age group Children younger than 18 months who were born to an HIV-infected mother are categorized as having been exposed perinatally to HIV infection if the child does not meet the criteria for HIV infection or the criteria for ldquonot infected with HIVrdquo [2 3] Children born before 1994 were considered HIV infected if they met the HIV case definition in the 1987 pediatric classifi-cation system for HIV infection [4]

Because states initiated reporting on different dates the length of time reporting has been in place influ-ences the number of HIV infection cases reported For example data presented for a given year may include cases reported during only part of the year Before implementing statewide HIV reporting some states collected reports of HIV infection (not AIDS) in selected populations Therefore these states have reports that precede the initiation of statewide confi-dential reporting A state with confidential HIV infec-tion reporting also may report persons who tested positive in that state but who were residents of other states Therefore when HIV data are presented by state of residence cases reported before a state initiated

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 49: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

reporting may have been reported from a state that did have confidential HIV infection reporting

Over time HIV infection may progress to AIDS and be reported to surveillance Persons with HIV infection (not AIDS) who are later reported as having AIDS are deleted from the HIV infection (not AIDS) tables and added to the AIDS tables Persons with HIV infection may be tested at any point on the clinical spectrum of disease therefore the time between diagnosis of HIV infection and diagnosis of AIDS differs In addition because surveillance practices differ the reporting and updating of personsrsquo clinical and vital status differ among states The completeness of reporting of HIV infection (not AIDS) is estimated at more than 80 [5]

SURVEILLANCE OF AIDSAll 50 states the District of Columbia and US

dependent areas report AIDS cases to CDC by using a uniform surveillance case definition and case report form The original definition was modified in 1985 and 1987 [6 7] The case definition for adults and adolescents was modified again in 1993 [8 see also 9] The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diag-nostic tests to improve the sensitivity and specificity of the definition The laboratory and diagnostic criteria for the 1987 pediatric case definition [4] were updated in 1994 [10] Effective January 1 2000 the surveil-lance case definition for HIV infection was revised to incorporate new laboratory tests The definition incorporates the reporting criteria for HIV infection and AIDS into a single case definition for adults and children [2]

For persons with laboratory-confirmed HIV infec-tion the 1987 revision incorporated encephalopathy wasting syndrome and other indicator diseases that are diagnosed presumptively (ie without confirmatory laboratory evidence of opportunistic infection) In addition to the 23 clinical conditions in the 1987 defi-nition the 1993 case definition for adults and adoles-cents includes HIV infection among persons with CD4+ T-lymphocyte counts of fewer than 200 cellsmicroL or a CD4+ percentage of less than 14 and a diagnosis of pulmonary tuberculosis recurrent pneumonia or invasive cervical cancer For adults adolescents and children aged 18 months and older the 2000 revised HIV surveillance case definition incorporates positive test results or reports of a detectable quantity of HIV nucleic acid or plasma HIV RNA

Technic

The pediatric case definition incorporates the revised 1994 pediatric classification system for evi-dence of HIV infection Cases in children who tested positive by Western blot or HIV detection tests before October 1994 were categorized according to the 1987 classification system For children of any age (birth to 13 years) with an AIDS-defining condition that requires evidence of HIV infection a single positive HIV virologic test result (ie HIV nucleic acid [DNA or RNA] HIV viral culture HIV p24 antigen) is suffi-cient for a reportable AIDS diagnosis if the diagnosis is documented by a physician

Although the completeness of reporting of AIDS cases to state and local health departments differs by geographic region and patient population studies con-ducted by state and local health departments indicate that the reporting of AIDS cases in most areas of the United States is more than 85 complete (CDC unpublished data 2005) [5 11ndash12] In addition multi-ple routes of exposure opportunistic infections diag-nosed after the initial AIDS case report was submitted to CDC and vital status may not be determined or reported for all cases However for persons reported as having AIDS the reporting of deaths is estimated to be more than 90 complete [13]

Since January 1 1994 CDC has not accepted AIDS case reports that meet only the laboratory-based immunologic criteria of the 1993 expanded surveil-lance case definition [8] if information on sex or raceethnicity is missing A small number of cases previ-ously reported to CDC without those variables have been returned to the health departments for follow-up and have been deleted from the totals

TABULATION AND PRESENTATION OF DATA

Data in this report are provisional This report includes information received by CDC through June 30 2007 This report is organized in 5 sections In Sections 1ndash3 (ie Tables 1ndash12 Figure 1 and Maps 1 and 2) data have been statistically adjusted to correct for delays in the reporting of cases and deaths when transmission categories are presented unreported risk factors have been statistically redistributed to better present the trends in the epidemic and the distribution of risk characteristics among affected populations To assess trends in cases deaths or prevalence it is pref-erable to use adjusted data presented by year of diagnosis instead of year of report Section 4 which presents survival data is discussed later in the

al Notes 49

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 50: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Technical Notes In Section 5 (Tables 14ndash23) HIV and AIDS data are tabulated by date of report to CDC Data for the US dependent areas are included in the table totals unless their exclusion is specified in a foot-note The US dependent areas are American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS

and HIV Infection (Not AIDS)The inclusion of areas with mature (ie since at least

2003) confidential name-based HIV reporting for tabu-lation and presentation of HIVAIDS and HIV infec-tion (not AIDS) data was based on the date of the implementation of HIV reporting in the area Areas must have 4 full calendar years of reporting so that CDC can calculate reporting delays with reasonable precision Adjustment of case counts for reporting delay is required to reliably display trends in the data [14 15] For this report 38 areas (33 states and 5 US dependent areas) with laws or regulations requiring confidential name-based HIV infection reporting since at least 2003 were eligible for inclusion The 38 areas are 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 For Tables 1 2 8 9 and 12 we used data from these 38 areas to describe diagnoses of HIVAIDS For Maps 1 and 2 we also used data from these 38 areas to estimate the numbers of cases of HIV infection (not AIDS)

Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)

Areas included in tabulations of reports of HIV infection (not AIDS) are based on the date of imple-mentation of name-based HIV infection reporting as of December 31 2006 For Tables 16 18 20 and 22 we used data from 50 areas (45 states and 5 US depen-dent areas) to describe reports of cases of HIV infec-tion (not AIDS)

50 Technic

Age GroupsFor Tables 8ndash12 and Maps 1 and 2 age groups of

persons living with HIVAIDS HIV infection (not AIDS) or AIDS are based on the personrsquos age as of December 31 2006 For Table 7 age groups of persons who died with AIDS are based on the personrsquos age at the time of death For all other tables age groups are based on the personrsquos age at the first documented posi-tive HIV-antibody test result for persons with a diagno-sis of HIV infection (not AIDS) and on age at diagnosis of AIDS for persons with a diagnosis of AIDS The age category for adults and adolescents comprises persons aged 13 years and older the age category for children comprises children younger than 13 years

Race and EthnicityIn the Federal Register for October 30 1997 [16]

the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity At a minimum data on the following race categories should be collected

bull American Indian or Alaska Nativebull Asianbull black or African Americanbull Native Hawaiian or Other Pacific Islanderbull whiteAdditionally systems must be able to retain infor-

mation when multiple racial categories are reported Two ethnicity categories should be collected regard-less of race

bull Hispanicbull not HispanicBecause data for this document were compiled from

reports to CDC through June 2007 race and ethnicity information were collected under 2 systems The race and ethnicity categories in the system used through December 2002 are maintained in this document because most case reports were submitted under that system Persons who reported multiple racial catego-ries or whose race was unknown are included in the total numbers in Tables 1ndash5 7ndash11 13 and 19ndash23 Also the number of persons reported as ldquonot Hispanicrdquo may include persons whose ethnicity was not reported

al Notes

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 51: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Tabulation of Cases of HIVAIDS and AIDSIn this report the term HIVAIDS is used to refer to

3 categories of diagnoses collectively (1) a diagnosis of HIV infection (not AIDS) (2) a diagnosis of HIV infection with a later diagnosis of AIDS and (3) con-current diagnoses of HIV infection and AIDS For analyses of HIVAIDS data we used data from 38 areas (ie 33 states and 5 US dependent areas) that have had HIV infection reporting for a sufficient length of time (ie since at least 2003) to allow for stabilization of data collection and for adjustment of the data in order to monitor trends Tables 1 2 8 and 9 summarize cases and prevalence of HIVAIDS For the analyses of AIDS cases we used data from the 50 states the District of Columbia and US dependent areas

Tabulation of Persons Living with HIVAIDS HIV Infection (Not AIDS) and AIDS Tabulations of persons living with HIVAIDS HIV

infection (not AIDS) or with AIDS (Tables 8ndash12 and Maps 1 and 2) do not reflect actual counts of cases reported to the surveillance system Rather the esti-mates are based on numbers of reported cases which have been adjusted for delays in the reporting of cases and deaths

Tabulation of Deaths of Persons with AIDS Tabulations of deaths of persons with AIDS (Table

7) do not reflect actual counts of deaths reported to the surveillance system Rather the estimates are based on numbers of reported deaths which have been adjusted for delays in reporting

Geographic DesignationsRegions of residence included in the report are

defined as followsNortheast Connecticut Maine Massachusetts

New Hampshire New Jersey New York Pennsylvania Rhode Island and Vermont

Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota and Wisconsin

South Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia and West Virginia

West Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington and Wyoming

Technic

US dependent areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

Metropolitan Statistical AreasIn the Federal Register for December 27 2000 the

OMB published revised standards for defining metro-politan statistical areas (MSAs) for use in federal sta-tistical activities [17] These standards which provided for the identification of MSAs in the United States and Puerto Rico replaced the 1990 standards The adop-tion of the new standards was effective as of December 27 2000 On June 6 2003 the OMB announced new MSA definitions based on the new standards and Cen-sus 2000 data [18] Table 15 presents reported AIDS cases by MSA for areas with populations of more than 500000 The MSAs listed in Table 15 are defined according to the OMBrsquos most recent update (February 2005) of statistical areas [19]

Survival AnalysesFor the survival analyses presented in Section 4

(Table 13 and Figures 2ndash4) we used the Kaplan-Meier method to estimate the probability of survival for AIDS case data reported through June 30 2007 Table 13 was limited to AIDS cases diagnosed in 2002 and Figures 2ndash4 were limited to cases diagnosed during 1998ndash2005 Table 13 and the figures were limited to deaths through December 31 2006 this was done to allow at least 6 months for a death to be reported by June 30 2007 and to allow at least 1 month after AIDS diagnosis

Transmission CategoriesTransmission category is the term for the classifica-

tion of cases that summarizes a personrsquos possible HIV risk factors the summary classification results from selecting from the presumed hierarchical order of probability the 1 risk factor most likely to have been responsible for transmission For surveillance pur-poses cases of HIVAIDS HIV infection (not AIDS) and AIDS are counted only once in the hierarchy of transmission categories Persons with more than 1 reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy The exception is men who report sexual contact with other men and injection drug use this group makes up a separate transmission category

al Notes 51

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 52: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Persons whose transmission category is classified as male-to-male sexual contact include men who report sexual contact with other men (ie homosex-ual contact) and men who report sexual contact with both men and women (ie bisexual contact) Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have or to be at high risk for HIV infec-tion (eg an injection drug user)

Adults and adolescents born in or who had sex with someone born in a country where heterosexual trans-mission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern II countries by the World Health Organization) are no longer classified as having heterosexually acquired HIV infection unless they meet the criteria stated in the preceding paragraph Similar to other cases in persons who were reported without information about a behav-ioral or a transfusion risk factor for HIV infection these cases are classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquono risk factor reported or identifiedrdquo [20] Cases in children whose mother was born in or whose mother had sex with someone born in Pattern II countries are now classified (in the absence of other risk factor information that would classify them in another transmission category) as ldquomother with documented HIV infection a risk factor for HIV infection or HIV infection without a specified risk factorrdquo

Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as ldquono risk factor reported or identifiedrdquo No identified risk factor (NIR) cases include cases that have been followed up by local health department officials cases in persons whose exposure history is missing because they died declined to be interviewed or were lost to follow-up and cases in persons who were interviewed or for whom other follow-up information was available but for whom no mode of exposure was identified

As of September 2000 the procedures for investi-gating cases reported without risk factor information changed from ascertaining a risk factor for all reported cases to estimating risk factor distributions from statis-tical models and population-based samples States continue to investigate any report of an unusual expo-sure to HIV and report these cases to CDC CDC will

52 Technic

continue to tabulate the number of documented unusual exposures to HIV reported by the states

Because recently reported cases of HIV infection or AIDS are more likely to be reported without sufficient risk factor information recent AIDS incidence in some transmission categories will be underestimated unless an adjustment is made For tables and figures showing the estimated cases of HIV infection (not AIDS) HIVAIDS and AIDS the adjustment of cases among adults and adolescents without risk factor information is based on the redistribution of transmis-sion category by specific sex race and region of cases that were diagnosed 3 to 10 years earlier and ini-tially classified as NIR but that were later reclassified [21 22] Similar adjustments of such cases among children are based on transmission-category redistri-bution of all cases diagnosed during that period and later reclassified

Reporting DelaysReporting delays (time between diagnosis of HIV

infection or AIDS and report to CDC) may differ among exposure geographic racialethnic age sex and vital status categories for some AIDS cases delays have been as long as several years Adjustments of the estimated data on HIV infection (not AIDS) and on AIDS to account for reporting delays are calculated by a maximum likelihood statistical procedure This procedure takes into account the differences in report-ing delays in exposure geographic racialethnic age sex and vital status categories and is based on the assumption that reporting delays in these categories have not changed over time [14 15 23]

RatesRates per 100000 population were calculated for

the numbers of HIVAIDS or AIDS cases (Tables 5a 5b 14 and 15) in 2006 as well as for persons living with HIV infection (not AIDS) or AIDS (Maps 1 and 2) at the end of 2006 The population denominators used to compute these rates for the 50 states and the District of Columbia were based on official postcensus estimates for 2006 from the US Census Bureau [24] and bridged-race estimates for 2006 obtained from the National Center for Health Statistics [25] The bridged estimates are based on the Census 2000 counts and produced under a collaborative agreement with the US Census Bureau These estimates result from bridging the 31 race categories used in Census 2000 as

al Notes

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 53: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

specified in the 1997 OMB standards [16] for the classification of data on race and ethnicity to the 4 race categories specified in the 1977 standards The population denominators for US dependent areas were based on official postcensus estimates and Census 2000 counts from the US Census Bureaursquos International Database Each rate is calculated by dividing the number of cases reported during the 12 months in 2006 (or the number of persons living with HIV infection or with AIDS at the end of 2006) by the 2006 population multiplied by 100000 The denomi-nators used for calculating age- sex- and raceethnicity-specific rates are computed by applying the age sex and raceethnicity proportions from the bridged-race population estimates for 2000 to the 2006 postcensus estimates of the total population for each state When bridged-race population denominators for the US dependent areas were not available propor-tions from the US Census Bureaursquos International Database for 2000 were used to estimate the age- and sex-specific subpopulations [26]

REFERENCES1 CDC Dear colleague letter CDC recommends that

all states and territories adopt confidential name-based surveillance systems to report HIV infections httpwwwcdcgovhivpubs070505_ dearcolleague_gerberdingpdf Published July 5 2005 Accessed March 11 2008

2 CDC Guidelines for national human immuno-deficiency virus case surveillance including moni-toring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 199948(RR-13)29ndash31

3 CDC Guidelines for the use of antiretroviral agents in pediatric HIV infection MMWR 199847(RR-4)1ndash43

4 CDC Current trends classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age MMWR 1987 36225ndash230 235

5 Hall HI Song R Gerstle JE III Lee LM on behalf of the HIVAIDS Reporting System Evaluation Group Assessing the completeness of reporting of human immunodeficiency virus diagnoses in 2002ndash2003 capture-recapture methods Am J Epidemiol 2006164391ndash397

Technic

6 CDC Current trends revision of the case definition of acquired immunodeficiency syndrome for national reportingmdashUnited States MMWR 1985 34373ndash375

7 CDC Revision of the CDC surveillance case defini-tion for acquired immunodeficiency syndrome MMWR 198736(SS-1)1Sndash15S

8 CDC 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults MMWR 199241(RR-17)1ndash19

9 CDC Current trends update acquired immuno-deficiency syndromemdashUnited States 1994 MMWR 19954464ndash67

10 CDC 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age official authorized addenda human immunodeficiency virus infection codes and official guidelines for coding and reporting ICD-9-CM MMWR 199443(RR-12)1ndash19

11 Schwarcz SK Hsu LC Parisi MK Katz MH The impact of the 1993 AIDS case definition on the com-pleteness and timeliness of AIDS surveillance AIDS 1999131109ndash1114

12 Klevens RM Fleming PL Li J The completeness validity and timeliness of AIDS surveillance data Ann Epidemiol 200111443ndash449

13 Karon JM Rosenberg PS McQuillan G Khare M Gwinn M Petersen LR Prevalence of HIV infection in the United States 1984 to 1992 JAMA 1996276126ndash131

14 Green TA Using surveillance data to monitor trends in the AIDS epidemic Stat Med 199817143ndash154

15 Song R Hall HI Frey R Uncertainties associated with incidence estimates of HIVAIDS diagnoses adjusted for reporting delay and risk redistribution Stat Med 200524453ndash464

16 Office of Management and Budget Revisions to the standards for the classification of federal data on race and ethnicity Federal Register 19976258781ndash58790 httpwwwwhitehousegovombfedregombdir15html Accessed March 13 2008

17 Office of Management and Budget Standards for defining metropolitan and micropolitan statistical areas Federal Register 20006582228ndash82238 httpwwwwhitehousegovombfedregmetroareas122700pdf Accessed March 13 2008

al Notes 53

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 54: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

18 Office of Management and Budget Revised defini-tions of metropolitan statistical areas new defini-tions of micropolitan statistical areas and combined statistical areas and guidance on uses of the statisti-cal definitions of these areas OMB Bulletin 03-04 httpwwwwhitehousegovombbulletinsb03-04html Published June 6 2003 Accessed March 13 2008

19 Office of Management and Budget Update of statis-tical area definitions and guidance on their uses OMB Bulletin 05-02 httpwwwwhitehousegovombbulletinsfy05b05-02html Published Febru-ary 22 2005 Accessed March 13 2008

20 CDC Current trends heterosexually acquired AIDSmdashUnited States 1993 MMWR 1994 43155ndash160

21 Green TA Karon JM Nwanyanwu OC Changes in AIDS incidence trends in the United States J Acquir Immune Defic Syndr 19925547ndash555

22 Neal JJ Fleming PL Green TA Ward JW Trends in heterosexually acquired AIDS in the United States 1988 through 1995 J Acquir Immune Defic Syndr Hum Retrovirol 199714465ndash474

23 Karon JM Devine OJ Morgan WM Predicting AIDS incidence by extrapolating from recent trends In Castillo-Chavez C ed Mathematical and Statis-tical Approaches to AIDS Epidemiology Berlin Springer-Verlag 19898358ndash88 Lecture Notes in Biomathematics

24 US Census Bureau Population estimates [specific files entire data set no longer available] httpwww censusgovpopestarchives2000svintage_2006 Published July 1 2006 Accessed March 17 2008

25 National Center for Health Statistics Bridged-race vintage 2006 postcensal population estimates for July 1 2000ndashJuly 1 2006 by year county single-year of age bridged-race Hispanic origin and sex httpwwwcdcgovnchsaboutmajordvspopbridgedatadochtmvintage2006 Accessed March 13 2008

26 US Census Bureau Census 2000 the island areas httpwwwcensusgovpopulationwwwcen2000islandareashtml Accessed March 13 2008

54 Technic

al Notes

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance
Page 55: HIV AIDS Surveillance Report 2006 · The HIV/AIDS design element on the cover is used with the permission of the American Red Cross. Federal Recycling Program Printed on recycled

Web Addresses for Reports of State or Local HIV and AIDS SurveillanceAlabama httpwwwadphorgaidsDefaultaspid=984Alaska httpwwwepihssstateakusbulletinsdocsrr2007_02pdfArizona httpwwwazdhsgovphshivhiv_epihtmArkansas httpwwwhealthyarkansascomstatshiv_aids093007_reportpdfCalifornia httpwwwcdphcagovdatastatisticsPagesOAHIVAIDSStatsLandingaspxChicago httpwwwaidschicagoorgpdf2006fact_cdph_winterpdfColorado httpwwwcdphestatecousdcHIVandSTDsurveillancehtmlConnecticut httpwwwctgovdphcwpviewaspa=3135ampq=393048Delaware httpwwwdhssdelawaregovdhssdphepidisstatshivhtmlDistrict of Columbia httpdohdcgovdohcwpviewA1371Q603431aspFlorida httpwwwdohstateflusDisease_ctrlaidstrendstrendshtmlGeorgia httphealthstategausprogramsstdhivindexaspHawaii httphawaiigovhealthhealthy-lifestylesstd-aidsdata-statisticsindexhtmlHouston httpwwwhoustontxgovhealthHIV-STDIdaho httpwwwhealthandwelfareidahogovDesktopModulesArticlesSortable

ArticlesSrtViewaspxtabID=0ampItemID=1299ampmid=11117ampwversion=StagingIllinois httpwwwidphstateilusaidsstatshtmIndiana httpwwwingovisdhprogramshivstdquarterlyquarterlyhtmIowa httpwwwidphstateiausadperhiv_aids_programsaspsurveillanceKansas httpwwwkdheksgovhivsurveillancehtmlKentucky httpchfskygovdphepiHIV-AIDS+Reporting+and+StatisticshtmLos Angeles httplapublichealthorgphcommonpublicreportsrptspubdisplaycfmunit=hivampou=phampprog=haeLouisiana httpwwwdhhlouisianagovofficespageaspid=264ampdetail=7930Maine httpwwwmainegovdhhsbohddcdata_statistics_surveillancehtmMaryland httpwwwdhmhstatemdusAIDSDataampStatisticsstatisticshtmMassachusetts httpwwwstatemausdphcdcaidsaidsproghtmMichigan httpwwwmichigangovhivstdMinnesota httpwwwhealthstatemnusdivsidepcdiseaseshivhivstatisticshtmlMississippi httpwwwmsdhstatemsusmsdhsiteindexcfm141185150htmlMississippiMissouri httpwwwdhssmogovHIV_STD_AIDSDatahtmlMontana httpwwwdphhsmtgovPHSDSTD-HIVstd-hiv-indexshtmlNebraska httpwwwdhhsnegovdpcpdfsAIDSSurv06pdfNevada httphealthnvgovindexphpoption=com_contentamptask=viewampid=601ampItemid=1277New Hampshire httpwwwdhhsnhgovDHHSCDCSLIBRARYData-Statistical+Reporthiv-aids-reporthtmNew Jersey httpwwwstatenjushealthaidsaidsqtrhtmNew Mexico httpwwwhealthstatenmushiv-aidshtmlNew York httpwwwhealthstatenyusdiseasesaidsstatisticsindexhtmNew York City httpwwwnycgovhtmldohhtmldireshivepishtmlNorth Carolina httpwwwepistatencusepihivsurveillancehtmlNorth Dakota httpwwwndhivcomresourcesOhio httpwwwodhohiogovhealthStatsdiseasehivcovaspxOklahoma httpwwwhealthstateokusprogramhivstdepistatshtmOregon httporegongovDHSphhstindexshtmlPennsylvania httpwwwhealthstatepaushiv-epiextranet11indexhtmPhiladelphia httpwwwphilagovhealthunitsaacoHIV_AIDShtmlRhode Island httpwwwhealthrigovhivdataphpSan Francisco httpwwwdphsfcausphpHIVEpiSecthtmSouth Carolina httpwwwdhecscgovhealthdiseasestdhivsurveillancehtmSouth Dakota httpdohsdgovDiseasestatisticsaspxTennessee httpwwwcoetenncomIndexTNHIVdatahtmTexas httpwwwdshsstatetxushivstddefaultshtmUtah httphealthutahgovcdcsphtmVermont httphealthvermontgovpreventaidsquarterreportsaspxVirginia httpwwwvdhstatevausstddatahome2aspWashington httpwwwdohwagovcfhHIV_AIDSPrev_EduStatisticshtmWest Virginia httpwwwwvdhhrorgidepaidsaspWisconsin httpdhfswisconsingovaids-hivStatsindexhtmWyoming httpwdhfsstatewyusphsdhivsurveillanceIndexhtml

Note Electronic reports of local HIV and AIDS surveillance were not available for the following areas American Samoa Guam the Northern Mariana Islands Puerto Rico and the US Virgin Islands

55

  • Cover13
  • Suggested citation
  • Contents13
  • Commentary13
    • Highlights of Analyses
      • Cases of HIVAIDS and Cases of AIDS
        • Cases of HIVAIDS
        • Cases of AIDS
          • Deaths
          • Persons Living with HIVAIDS HIV Infection (Not AIDS) or AIDS
            • Persons living with HIVAIDS
            • Prevalence rates of HIV infection (not AIDS)
            • Persons living with AIDS
            • AIDS prevalence rates
              • Survival after AIDS Diagnosis
              • Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                • Reports of cases of HIV infection (not AIDS)
                • Reports of AIDS cases
                    • Additional Resources
                    • Suggested Readings
                      • Section 1 Cases of HIVAIDS and AIDS
                        • Table 1 Estimated numbers of cases of HIVAIDS by year of diagnosis and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 2 Time to an AIDS diagnosis after a diagnosis of HIV infection by selected characteristics 2005-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                        • Table 3 Estimated numbers of AIDS cases by year of diagnosis and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                        • Table 4 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis and selected characteristics 2002-2006 and cumulative-50 states and the District of Columbia
                        • Figure 1 Estimated numbers of AIDS cases in children lt13 years of age by year of diagnosis 1992-2006-50 states and the District of Columbia
                        • Table 5a Estimated numbers of cases and rates (per 100000 population) of AIDS by raceethnicity age category and sex 2006-50 states and the District of Columbia
                        • Table 5b Estimated numbers of cases and rates (per 100000 population) of HIVAIDS by raceethnicity age category and sex 2006-33 states with confidential name-based HIV infection reporting
                        • Table 6 Estimated numbers of AIDS cases in adult and adolescent Hispanics by transmission category and place of birth 2006-United States and dependent areas
                          • Section 2 Deaths
                            • Table 7 Estimated numbers of deaths of persons with AIDS by year of death and selected characteristics 2002-2006 and cumulative-United States and dependent areas
                              • Section 3 Persons Living with HIVAIDS AIDS or HIV Infection (Not AIDS)
                                • Table 8 Estimated numbers of persons living with HIVAIDS by year and selected characteristics 2003-2006-33 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                • Table 9 Estimated numbers of persons living with HIVAIDS at the end of 2006 by raceethnicity sex and transmission category-33 states with confidential name-based HIV infection reporting
                                • Map 1 Estimated rates (per 10000 population) for adults and adolescents living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Map 2 Estimated rates (per 100000 population) for children lt13 years of age living with HIV infection (not AIDS) or with AIDS 2006-United States and dependent areas
                                • Table 10 Estimated numbers of persons living with AIDS by year and selected characteristics 2002-2006- United States and dependent areas
                                • Table 11 Estimated numbers of persons living with AIDS at the end of 2006 by raceethnicity sex and transmission category-50 states and the District of Columbia
                                • Table 12 Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2006 by area of residence and age category-United States and dependent areas
                                  • Section 4 Survival after AIDS Diagnosis
                                    • Table 13 Proportion of persons surviving for more than 12 24 and 36 months after an AIDS diagnosis in 2002 by selected characteristics-United States and dependent areas
                                    • Figure 2 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by year of diagnosis-United States and dependent areas
                                    • Figure 3 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by age group-United States and dependent areas
                                    • Figure 4 Proportion of persons surviving by months after AIDS diagnosis during 1998-2005 and by race ethnicity-United States and dependent areas
                                      • Section 5 Reports of Cases of HIVAIDS AIDS and HIV Infection (Not AIDS)
                                        • Table 14 Reported AIDS cases and annual rates (per 100000 population) by area of residence 2005 2006 and cumulative-United States and dependent areas
                                        • Table 15 Reported AIDS cases and annual rates (per 100000 population) by metropolitan statistical area of residence 2005 2006 and cumulative-United States and Puerto Rico
                                        • Table 16 Reported cases of HIV infection (not AIDS) by area of residence 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 17 Reported AIDS cases by age category transmission category and sex 2006 and cumulative-United States and dependent areas
                                        • Table 18 Reported cases of HIV infection (not AIDS) by age category transmission category and sex 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 19 Reported AIDS cases for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 20 Reported cases of HIV infection (not AIDS) for male adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 21 Reported AIDS cases for female adults and adolescents by transmission category and race ethnicity 2006 and cumulative-United States and dependent areas
                                        • Table 22 Reported cases of HIV infection (not AIDS) for female adults and adolescents by transmission category and raceethnicity 2006 and cumulative-45 states and 5 US dependent areas with confidential name-based HIV infection reporting
                                        • Table 23 Reported cases of HIVAIDS in infants born to HIV-infected mothers by year of report and selected characteristics 1994-2006-25 states with confidential name-based HIV infection reporting
                                          • Technical Notes13
                                            • Surveillance of HIV Infection (Not AIDS)
                                            • Surveillance of AIDS
                                            • Tabulation and Presentation of Data
                                              • Selection of Areas with Mature HIV Reporting Systems for Analysis of Cases of HIVAIDS and HIV Infection (Not AIDS)
                                              • Selection of Areas for Analyses of Reports of HIV Infection (Not AIDS)
                                              • Age Groups
                                              • Race and Ethnicity
                                              • Tabulation of Cases of HIVAIDS and AIDS
                                              • Tabulation of Persons Living with HIV AIDS HIV Infection (Not AIDS) and AIDS
                                              • Tabulation of Deaths of Persons with AIDS
                                              • Geographic Designations
                                              • Metropolitan Statistical Areas
                                              • Survival Analyses
                                              • Transmission Categories
                                              • Reporting Delays
                                              • Rates
                                                • References
                                                  • Web Addresses for Reports of State or Local HIV and AIDS Surveillance