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United States: HIV Epidemic Vijay Kandula, MD MPH AAHIVS Adjunct Assistant Professor Division of Public Health, Department of Family and Preventive Medicine University of Utah, Salt Lake City 2013 HIV Info Everyone Should Know • What are the four fluids that can transmit HIV? • What are four fluids that cannot transmit HIV? • What is the window period with regards to HIV testing? Common Acronyms • • • • • MSM IDU CSW PLWHA HAART • ~80% of HIV was among males • 20% among females. What % of the transmission occurred due to heterosexual contact? What are the other transmission routes? High Risk Groups for HIV • Individuals with multiple sex partners – Individual’s partner has multiple sex partners • Injecting Drug Users (IDUs) – Sex partners of IDUs • People who exchange sex for drugs or money (such as commercial sex workers) • Sex partners of HIV infected individuals • CDC: HIV in the United States, 2010 http://www.cdc.gov/hiv/resources/factsheets/us.htm#ref2 Trends in Infection • • • • • Younger People (25 and under) Women, especially among African Americans People in Prison MSM and Injection Drug Users, crystal meth Low Socioeconomic Status / Marginalized Populations Trends in Infection – cont. • Youth (often defined as 13-24) – In 2004, an estimated 4,883 young people received a diagnosis of HIV infection or AIDS, representing about 13% of the persons given a diagnosis during that year. – Early age at sexual initiation. According to CDC’s Youth Risk Behavioral Survey (YRBS), 47% of high school students have had sexual intercourse, and 7.4% of them reported first sexual intercourse before age 13. Trends in Infection • • • • • Younger People Women, especially among African Americans People in Prison MSM and Injection Drug Users, crystal meth Low Socioeconomic Status / Marginalized Populations Trends in Infection – cont. • African Americans – At the end of 2007, blacks accounted for almost half (46%) of people living with a diagnosis of HIV infection • Women – AIDS is a common killer, second only to cancer and heart disease for women. • African American Women – In 2006, the rate of new HIV infection for black women was nearly 15 times as high as that of white women and nearly 4 times that of Hispanic/Latina women. Trends in Infection – cont. • MSM and Injection Drug Users – In 2006, MSM accounted for more than half (53%) of all new HIV infections in the United States, and MSM with a history of injection drug use (MSM-IDU) accounted for an additional 4% of new infections. – Sex parties with crystal meth “Party and Play” are high risk for HIV transmission Summary • > 1.1 m are living with HIV infection – ~ 1 in 5 (20%) are unaware of their infection • Gay, bisexual, and other MSM – particularly young black/African American MSM, most seriously affected by HIV. • By race, blacks/African Americans face the most severe burden of HIV. Thank You Vijay Kandula, MD MPH AAHIVS Adjunct Assistant Professor Division of Public Health, Department of Family and Preventive Medicine University of Utah, Salt Lake City 2013