with high HIV incidence—including Washington, D.C., New York, Chicago, and Los Angeles—have a much higher risk of HIV exposure from new sexual partners than people in other parts of the United States, according to Dr. Jonathan Mermin, director of CDC’s Division of HIV/AIDS Prevention. Approximately two percent of 8,500 poor heterosexuals living in 12 major cities tested positive for HIV and almost half (45 percent) of those diagnosed reported they had never been tested for HIV before. Eighteen percent of HIV-infected people in the overall U.S. population do not know they are infected.
Researchers analyzed 2010 data from 8,500 heterosexuals in neighborhoods with high HIV incidence in 21 U.S. cities. The research focused on people with no more than a high school education or with income less than the poverty level ($11,490); more than 70 percent of study participants were African American. Of those tested, 197 (2.3 percent) tested positive for HIV.
The highest HIV rates were among blacks, and those who report using crack cocaine or trading sex for drugs. Having less than a high school education, and having a household income lower than $10,000 also increased risk. More than a quarter of participants (25.8 percent) had never been tested for HIV. About two thirds of those diagnosed had seen a health care provider within the last six months, but they had not received HIV tests.
U.S. Preventive Services Task Force guidelines recommend routine HIV screening for all people aged 15 to 65. The Affordable Care Act requires insurers to cover HIV testing. Other barriers to care include lack of transportation and housing.
The full report, “HIV Infection Among Heterosexuals at Increased Risk—United States, 2010,” was published online March 15, 2013, in the Morbidity and Mortality Weekly Report at URL: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6210a2.htm?s_cid=mm6210a2_w.