New cases of HIV infection are increasingly occurring among women who acquire the disease from their heterosexual partners, and black women are the hardest hit of all, the Centers for Disease Control and Prevention said Thursday.
In an analysis of all new HIV diagnoses that occurred in 29 states between 1999 and 2002, the agency found that more than one-third of new HIV diagnoses --- 35 percent --- resulted from heterosexual sex. Almost two-thirds --- 64 percent --- of infections from heterosexual sex were in women. And almost three-fourths of the infections from heterosexual sex --- 74 percent --- occurred among black people.
"The findings are unfortunately not surprising: We have been seeing a rise in heterosexually acquired HIV for quite some time," said Dr. Gina Wingood, a co-director of the Center for AIDS Research at Emory University. "But they are extremely concerning because we have seen them before. That indicates that prevention messages and educational programs are not being disseminated, or are not being understood, or are not effective."
The 29 states were chosen because their data was presumed to be reliable: They have several years' experience tracking HIV infections and AIDS cases by patients' names, which is the CDC's preferred method. However, the states did not include those with the highest rates of HIV and AIDS, such as New York and California. Overall, the CDC said, the 29 states account for two-fifths of U.S. AIDS cases. Georgia was not included in the study because it did not begin tracking HIV infections until the end of 2003. It now tracks newly diagnosed patients by name.
The study, published in the CDC's weekly bulletin, included both patients who are HIV-positive but have no other symptoms, and those who have progressed to cases of AIDS. During the four years of the study, there were 101,877 new diagnoses of HIV. Almost 7,400 of the infections --- one-fifth of those acquired heterosexually --- were discovered at the same time that an AIDS diagnosis was made, suggesting that those who were infected did not know they had been exposed.
The data indicates that, in the states where cases were tracked, HIV is increasingly a disease of minorities and women. Fifty-five percent of all new infections were among blacks, compared to 31 percent among whites and 11 percent among Hispanics. Twenty-nine percent of new infections were among women.
Within the category of infections acquired through heterosexual contact --- as opposed to same-sex contact, injection-drug use, or transfusions or use of other blood products --- women fared worse than men. Seventy percent of white women, 64 percent of black women and 56 percent of Hispanic women were infected through heterosexual contact.
Among young women ages 13 to 19 years old, 89 percent of infections came through heterosexual sex.
"Males have more power and direct control over condom use because they are the ones who wear condoms. Females have to negotiate," Wingood said. "And if you are 14 and asking a 20-year-old, that is a hard thing to do." > ON THE WEB: For more information about this topic: www.cdc.gov/mmwr
Copyright 2004 The Atlanta Journal-Constitution