New HIV Incidence Estimates Underscore the Need for a National Commitment to Prevention

Abstract

Kimberly Carbaugh, BA, MAT, is Director of Policy, Association of Nurses in AIDS Care, Akron, Ohio. On August 3, 2008, the Centers for Disease Control and Prevention (CDC) announced revised estimates of annual HIV incidence rates in the United States (CDC, 2008). In an article published in the Journal of the American Medical Association, Hall et al. (2008) concluded that in 2006 there were an estimated 56,300 new HIV infections in the United States. This incidence rate represents a 40% increase over the previous estimate of 40,000 new HIV infections reported each year in the United States. The CDC (2008) emphasized that the revised estimate, although it did show that the U.S. HIV epidemic is worse than previously thought, did not represent an actual increase in the number of new cases. Rather, the annual new infection rate of 40,000 was shown to be incorrect; the actual rate has been between 55,000 and 58,500 since the late 1990s (Hall et al., 2008). The CDC has developed several fact sheets to explain the increased estimates, which are attributed to a more precise HIV surveillance system and improved methodology. The new HIV surveillance system uses the serologic testing algorithm for recent HIV seroconversion (STARHS), a technology that enables the CDC to distinguish between new and longstanding HIV infections. As a result, the CDC can more accurately determine annual HIV incidence rates. A separate historical trend analysis called extended back-calculation was used by researchers to confirm the STARHS data (CDC, 2008). The increased number of new infections, even if attributable to newer and better technology, is alarming, especially in light of the status of federal funding for domestic HIV prevention programs. Holtgrave and Curran (2006) determined that federal funding