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CDC HIV/AIDS/Viral Hepatitis/STD/TB Prevention News Update
Trends in HIV Incidence Among Young Adults in the United
Rosenberg, Philip S.; Biggar, Robert J.
June 16, 1998
Journal of the American Medical Association (06/17/98) Vol.

Researchers from the National Cancer Institute analyzed AIDS surveillance data and back-calculated the HIV incidence among 20- and 25-year-olds in the United States in 1988, comparing the results with HIV rates among the same age group in 1993. As of January 1993, homosexual contact was the primary cause of HIV infection among young men and heterosexual contact was the leading cause among young women. There were about 22,002 HIV-positive men and 11,000 HIV-positive women aged 18-to-22 years at the time. Between 1988 and 1993, the researchers found a 57 percent reduction in HIV cases among 20-year-old white men and a 75 percent reduction in 25-year-old homosexual white men. They also observed an approximate 50 percent reduction in HIV incidence due to intravenous drug use among white, Hispanic, and African-American men. HIV prevalence decreased by about 50 percent among white men, but remained stable in African-American and Hispanic men. HIV prevalence in women aged 20 years increased 36 percent over the same time period, while 25-year-old women had an increase of 45 percent. Among young women, heterosexual HIV transmission increased; African-American women had the highest heterosexual transmission rates among any group. The researchers also noticed that younger cohorts, when compared to the group born between 1960 and 1964, became infected as teenagers more frequently. Overall, the HIV prevalence among people aged 20 and 25 years fell 14 percent between 1988 and 1993. The authors concluded that while decreases were seen among white homosexual men and intravenous drug users, increasing rates of heterosexual transmission, particularly in minorities, offset the declines. However, they note that there were three potential sources of bias that could affect the calculated results: heterosexual transmission could have become increasingly recognized over time, the Centers for Disease Control and Prevention data for AIDS opportunistic illnesses in 1987 are estimates and could be imprecise, and AIDS progression rates could be different from estimated rates.