Study: AIDS hitting blacks the hardest
David Brown,  Washington Post
February 27, 2005

http://www.startribune.com/stories/484/5261894.html

BOSTON -- 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 men who have homosexual
sex (many of whom do not consider themselves to be gay), and in women who
are their sex partners or are 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 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 Minnesota, the trend in HIV among blacks is the reverse of the national
trend. The rate has been declining since 1994, said Tracy Sides, an HIV
epidemiologist with the Minnesota Department of Health. In 2003 there were
53 HIV cases for every 100,000 African Americans, she said, down from 81 in
1994.

But that decline masks an increasing rate of infection among African-born
Minnesotans. Minnesota has more African immigrants than most other states.
In 2003, 55 of the 266 new cases of HIV infection in Minnesota were among
African-born immigrants, compared to six among that group in 1994, she said.

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."