HIV prevalence remains steady; infection rate higher in men, blacks

Results from the 2007-2012 National Health and Nutrition Examination Survey showed a nonsignificant reduction in HIV infection among U.S. adults and a higher prevalence among men and black participants, according to a recent CDC report.

“Monitoring national trends of HIV prevalence and HIV risk factors remain important national health surveillance activities to better understand the health behaviors and characteristics influencing these trends,” Joseph Woodring, DO, MPH, MTMH, and colleagues from the National Center for Health Statistics wrote.

The analysis included 10,466 respondents who participated in the survey from 2007 to 2012. During the first two years, researchers used an enzyme-linked immunosorbent assay to measure HIV antibodies in patients aged 18 to 49 years. The cohort was expanded in 2009 to include patients aged 50 to 59 years. The participants responded to questions related to sexual behavior and drug use through a computer-assisted, self-interviewing system at a mobile examination center. Other demographics, including age, sex, race, poverty index ratio, education and health insurance coverage, were assessed during household interviews. The participants also reported ART use.

The researchers weighed the results to reflect the cohort expansion in 2009. A sensitivity analysis showed the overall data may be slightly greater than the true estimate among participants aged 50 to 59.

In comparing the periods of 1999 to 2006 with 2007 to 2012, the researchers observed a nonsignificant decline in HIV infection from 0.47% (95% CI, 0.33%-0.64%) to 0.31% (95% CI, 0.19%-0.47%) for participants aged 18 to 49 years. The prevalence of infection increased with age, with 0.24% among participants aged 18 to 39 and 0.64% among those aged 50 to 59, though the difference was not significant.

Black participants were more likely to have HIV compared with all other races combined, including Hispanic subgroups (1.6% vs. 0.23%; P < .001). In addition, men were more than three times as likely to have HIV infection compared with women (0.61% vs. 0.16%; P < .01).

HIV infection increased with the number of lifetime sexual partners. Those with 10 or more partners had a 0.68% prevalence rate vs. 0.14% among participants with four or fewer partners.

HIV prevalence also was greater among participants with a self-reported history of sexually transmitted infection (1.8% vs. 0.23%; P < .05), participants (aged 18 to 49) with herpes simplex virus type 2 infection (1.2% vs. 0.11%; P < .01); and men who had sex with men (7.7% vs. 0.17%; P < .01). Those who were included in at least one high-risk group (aged 18 to 49 years) were associated with a greater HIV prevalence compared with the rest of the population (0.56% vs. 0.05%; P < .001).

The researchers estimated that 86.1% of participants with HIV were tested outside of blood donations, and half (51.9%; 95% CI, 32.5%-70.9%) of HIV-positive participants used ART in the past month. ART use appeared to increase with age (80.1% in those aged 50 to 59 vs. 22.9% in those aged 18 to 39) and was higher in non-Hispanic white participants vs. non-Hispanic black participants (88.4% vs. 30.7%); men vs. women (61.5% vs. 16.7%); and those with health insurance coverage vs. those without coverage (58.7% vs. 16.2%). – by Stephanie Viguers

Reference:

Woodring J, et al. HIV Infection in U.S. Household Population Aged 18-59: Data from the National Health and Nutrition Examination Survey, 2007-2012. National Health Statistics Reports. 83:Sept. 24, 2015.

Disclosure: The researchers report no relevant financial disclosures.