HIV Infection Rate Among Blacks Doubles - Rate for Ages 18 to 59 Is 13 Times That of Whites
/- Originally published in The Washington Post February 26, 2005
By David Brown, Washington Post Staff Writer
The prevalence of HIV infection in blacks doubled in the last decade while remaining stable among whites, according to the federal government's most detailed, ongoing survey of the U.S. population's health.
The findings, presented to a gathering of AIDS researchers here Friday, is further evidence the nation's AIDS epidemic is becoming a scourge disproportionately suffered by African Americans.
The prevalence of HIV infection in blacks ages 18 to 59 in 1991 was 1.1 percent, about five times higher than what was found in whites. In 2001, it was 2.14 percent, and the gap had increased to 13 times that seen in whites. The hardest-hit group was black men ages 40 to 49, 3.6 percent of whom were infected with HIV when contacted through the National Health and Nutrition Examination Survey.
"It is a disturbing trend," said Geraldine McQuillan, a researcher from the National Center for Health Statistics who described the findings at the 12th Conference on Retroviruses and Opportunistic Infections, the annual midwinter AIDS meeting in the United States.
She said, in fact, that "if anything, the findings are an underestimate" of the lopsided racial profile of the AIDS epidemic.
The survey's interviewers ask a sample of American households to answer an extensive questionnaire, give blood samples, and undergo a modified physical exam. The survey does not include people in the military or in jails, prisons and hospitals.
In the 2001 survey, out of about 5,500 people examined, 32 were HIV-positive. Of that group, 23 were African American. The overall prevalence of HIV was 0.43 percent, up slightly from 0.33 percent a decade earlier.
Although the later survey showed a marked increase in HIV prevalence in blacks overall, it found no change over 10 years in the 18-to-39 age group. That finding is at odds with numerous other studies showing the AIDS epidemic growing with unusual speed in young black homosexuals (many of whom do not consider themselves to be gay), and in women who are their sex partners or the sex partners of intravenous drug users.
Nationwide, for example, black women make up 72 percent of new cases of HIV infection among American women. Most of those new infections in African Americans would be expected to occur in people in the 18-to-39 age group that the survey found to have stable HIV rates.
"We're not capturing that high-risk category," McQuillan acknowledged, adding that the survey "tells you the background picture . . . not the total picture" of what is happening in the country.
In a related study presented here Friday, researchers from the Centers for Disease Control and Prevention estimated that 56 percent of people eligible for antiretroviral treatment on clinical grounds were getting it in 2003.
Of those who were not getting treatment, 42 percent were unaware they were infected. The rest knew they were HIV-positive, but were either not under medical care or were in care but did not want, or could not get, antiretroviral therapy.
In other research news from the conference, scientists from the CDC and Johns Hopkins University reported the discovery of two new viruses in Central African men with heavy exposure to the blood and tissue of monkeys and apes.
The finding suggests that the sort of cross-species infection that first put the AIDS virus into human beings continues today and probably is not rare.
The two new microbes are retroviruses like the AIDS virus, and specifically fall into the group known as human T-cell lymphotrophic viruses. That family's two previously known members, HTLV-1 and HTLV-2, infect about 22 million people worldwide and can be passed person-to-person through sex, birth and body fluids.
About 5 percent of HTLV-infected people eventually develop illness, usually decades after infection. Whether that is true for the new microbes -- which together double the size of the HTLV family -- is unknown.
"It is possible they may cause disease," said Walid Heneine, the chief of CDC's retrovirus surveillance laboratory. "We need to follow these people. We need to reach the contacts of the hunters and look for human-to-human transmission."
One of the new microbes, named HTLV-3, resembles a simian, or monkey-derived, virus called STLV-3. The other, HTLV-4, does not have a known primate equivalent, although one presumably exists.
The viruses were found in a survey of 930 people living in 12 villages in the central African nation of Cameroon.
All reported contact with primate "bush meat," usually as hunters or butchers. The species included chimpanzees, mandrills and several types of monkeys. The two new viruses were carried by one person each, and the other 11 people all had HTLV-1 strains.
HTLV-1 can cause leukemia and a spinal-cord disease known as "tropical spastic paraparesis." For reasons that are unclear, it is most common in southern Japan, the Caribbean and South America. HTLV-2 causes illness much less frequently.
