Epidemiology of HIV in the United States
ABSTRACT The United States has a comprehensive system of HIV surveillance, including case reporting and disease staging, estimates of incidence, behavioral, and clinical indicators and monitoring of HIV-related mortality. These data are used to monitor the epidemic and to better design, implement, and evaluate public health programs.
We describe HIV-related surveillance systems and review recent data.
There are more than 1.1 million people living with HIV in the United States, and approximately 56,000 new HIV infections annually. Risk behavior data show that 47% of men who have sex with men engaged in unprotected anal intercourse in the past year, and 33% of injection drug users had shared syringes. One third (32%) of people diagnosed with HIV in 2008 were diagnosed with AIDS within 12 months, indicating missed opportunities for care and prevention. An estimated 72% of HIV-diagnosed persons received HIV medical care within 4 months of initial diagnosis.
Conducting accurate and comprehensive HIV surveillance is critical for measuring progress toward the goals of the 2010 National HIV/AIDS Strategy: reduced HIV incidence, increased access to care, and improvements in health equity.
- SourceAvailable from: Corey S. Davis
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- "The burden of bloodborne disease in the United States falls disproportionately on those living in the South (Lansky et al., 2010; Qian et al., 2006), which has higher HIV and hepatitis C (HCV) incidence rates and more people living with HIV than any other region (Centers for Disease Control and Prevention, 2013a,b,c,d; Zou et al., 2010). In 2011, North Carolina had the country's 8th highest HIV incidence rate, the 12th highest number of cumulative AIDS cases, and an HCV incidence rate 50% greater than the national average (Centers for Disease Control and Prevention, 2013a,b,c,d; North Carolina Division of Public Health, 2013). "
ABSTRACT: BACKGROUND: North Carolina, like much of the U.S. South, is disproportionately affected by HIV and hepatitis. This persistently high disease burden may be driven in part by laws that criminalize the possession and distribution of syringes for illicit drug use. Legal change to decriminalize syringes may reduce infection rates in the state, but is unlikely absent support from law enforcement actors. METHODS: We analyzed the responses of 350 North Carolina law enforcement officers to a confidential, anonymous survey. The survey instrument collected data regarding self-reported needle-stick injury (NSI), blood borne disease risk perception and attitudes toward syringe decriminalization. RESULTS: 82% of respondents reported that contracting HIV was a "big concern" for them. 3.8% of respondents reported ever receiving a job-related NSI, a rate of 36 NSI per 10,000 officer-years. Majorities of respondents reported positive views regarding syringe decriminalization, with approximately 63% agreeing that it would be "good for the community" and 60% agreeing that it would be "good for law enforcement." Black and female officers were significantly less likely to agree that on-the-job NSI was a "big concern" and significantly more likely to agree that it would be good for law enforcement. CONCLUSIONS: These findings suggest that many North Carolina LEOs understand the public health benefits of syringe access programs and may be inclined to support syringe decriminalization legislation. Further research is indicated to determine the causes of observed differences in perceptions of bloodborne disease risk and attitudes toward syringe decriminalization by race and sex.Drug and Alcohol Dependence 08/2014; 144. DOI:10.1016/j.drugalcdep.2014.08.007 · 3.28 Impact Factor
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- "Intravenous drug use remains a significant risk factor for HIV infection (Lansky et al., 2010). As such, methadone is commonly given for the treatment of opioid dependence in combination with antiretroviral drugs. "
ABSTRACT: Dolutegravir (DTG) is an investigational integrase inhibitor for treatment of HIV infection. As intravenous drug use is a common risk factor for HIV, this study evaluated the effect of DTG on the pharmacokinetics (PK) of methadone. This was an open-label, 2-period study in adult, opioid-dependent, HIV-seronegative subjects. Subjects received their current individual methadone doses once daily for 3 days (Period 1) followed by DTG 50mg twice daily (BID) for 5 days while continuing their stable methadone therapy (Period 2). Serial PK samples for R- and S-methadone were collected after each Period. Pharmacodynamic (PD) measures and safety assessments were obtained throughout the study. Non-compartmental PK analysis was performed, and geometric least-squares mean ratios and 90% confidence intervals were generated. Plasma exposures of total, R-, and S-methadone were not affected by co-administration of DTG. Mean ratios for AUC were 0.98, 0.95, and 1.01 for total, R-, and S-methadone, respectively, alone compared with in combination with DTG. No statistically significant differences were noted between the 2 treatment periods in methadone PD measures. The combination of DTG and methadone was well tolerated. No deaths, serious adverse events, or grade 3/4 adverse events occurred. No clinically significant changes in laboratory values, vital signs, or electrocardiograms were observed. Co-administration of methadone with repeat doses of DTG 50mg BID had no effect on total, R-, and S-methadone PK or on methadone-induced PD markers. No dose adjustment in methadone is required when given in combination with DTG.Drug and alcohol dependence 08/2013; 133(2). DOI:10.1016/j.drugalcdep.2013.08.009 · 3.28 Impact Factor
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- "Kirk and Goetz, 2009) and should be examined further in future research. Findings are from a largely African American urban sample and represent all sexual orientations, and are representative of those who are currently most infected and affected by HIV/AIDS in the United States (Lansky et al., 2010). This study provides direction to clinicians currently treating individuals living with HIV by demonstrating the importance of assessing for the usage of these non-conventional practices and openness to usage. "
ABSTRACT: to examine the relationships among non-conventional practices, adherence and immune functioning in individuals with HIV. 92 participants completed an interview on non-conventional practices (complementary and alternative medicines (CAM), psychosocial therapies, and religious practice). They also completed the Psychiatric Symptom Index and the AIDS Clinical Trials Group Adherence Follow-up Questionnaire. Medical chart reviews determined CD4 count and viral load. Hierarchical logistic regressions revealed religious practice was associated with adherence and CAM was associated with viral load. Participation in non-conventional practices in HIV populations may lead to positive health and health behaviors. Clinical implications are discussed.Journal of Health Psychology 05/2011; 16(8):1241-50. DOI:10.1177/1359105311405350 · 1.88 Impact Factor