Burden of Disease

In 2007, about 37,000 people in the United States were diagnosed with acquired immunodeficiency syndrome (AIDS), raising the total to more than 1 million diagnosed cases since the recognition of AIDS in 1981. In 2006, more than 450,000 people in the United States were living with AIDS, and an additional 56,300 people were newly infected with HIV. From 2003 to 2007, the total number of new AIDS cases has remained relatively stable, but the proportion of HIV/ AIDS cases has continued to increase steadily (CDC, 2009). With approximately 12,000 deaths in 2007, AIDS is not in the top 15 causes of death in the United States (Heron et al., 2009).

Those at increased risk for HIV infection include men who have had sex with men after 1975; men and women having unprotected sex with multiple partners; past or present injection drug users; men and women who exchange sex for money or drugs or have sex partners who do; individuals whose past or present sex partners were HIV infected, bisexual, or injection drug users; persons being treated for STIs; and persons with a history of blood transfusion between 1978 and 1985. Persons who request an HIV test despite reporting no individual risk factors may also be considered at increased risk, because this group is likely to include individuals not willing to disclose high-risk behaviors. A higher prevalence is seen in high-risk settings, such as STI clinics, correctional facilities, homeless shelters, tuberculosis clinics, clinics serving men who have sex with men, and adolescent health clinics with a high prevalence of STIs (Chou et al., 2005).

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