HIV and AIDS—United States, 1981-2000

doi:10.1001/jama.285.24.3083-jwr0627-2-1

Abstract

The acquired immunodeficiency syndrome (AIDS) epidemic has had a substantial impact on the health and economy of many nations. Since the first AIDS cases were reported in the United States in June 1981, the number of cases and deaths among persons with AIDS increased rapidly during the 1980s followed by substantial declines in new cases and deaths in the late 1990s. This report describes the changes in the characteristics of persons with AIDS since 1981. The greatest impact of the epidemic is among men who have sex with men (MSM) and among racial/ethnic minorities, with increases in the number of cases among women and of cases attributed to heterosexual transmission. The number of persons living with AIDS has increased as deaths have declined. Controlling the epidemic requires sustained prevention programs in all of these affected communities, particularly programs targeting MSM, women, and injection drug users.

Highlights

Infection and acquired immunodeficiency syndrome (AIDS) are pandemic and pose one of the greatest challenges to global public health
As a bloodborne and sexually transmitted infection, HUMAN IMMUNODEFICIENCY VIRUS (HIV) has variable patterns of transmission and impact among world regions and has disproportionately affected disadvantaged or marginalized persons such as commercial sex workers, injection drug users, men who have sex with men (MSM), and persons living in poverty
In 2000, an estimated 25.3 million persons in Sub-Saharan Africa (SSA) were infected with HIV, and the average national prevalence of HIV infection among persons aged 15-49 years was 8.8%

Summary

AND PREVENTION

Infection and acquired immunodeficiency syndrome (AIDS) are pandemic and pose one of the greatest challenges to global public health. In Botswana, the country with the highest prevalence, 36% of the adult population is infected with HIV. Despite these trends, intensive and aggressive prevention programs for behavior change, condom promotion, voluntary HIV counseling and testing, and blood transfusion safety have lowered prevalence or slowed HIV transmission in several SSA countries. 20-24 years decreased from 20.9% during 1989-1990 to 13.8% during 19961997.5 in Lusaka, Zambia, which had an early and severe epidemic, HIV prevalence declined among females aged 15-19 years attending prenatal clinics from 27% in 1993 to 17% in. An exception to countries with increasing prevalence is Thailand, where the epidemic began in the mid-1980s among injection drug users and commercial sex workers and their clients and spread rapidly to the wider population through heterosexual transmis-. The resulting decline in STD and HIV transmission was reflected in a decrease in STD rates and HIV prevalence in military recruits and women attending prenatal clinics

Eastern Europe and Central Asia

In Western Europe and the United

Latin America and the Caribbean

HIV infection in many cultures combined with difficulties in providing

Findings

AIDS cases were reported in the United