Introduction
AIDS was first identified in the USA in 1981. The epidemic has now spread to every part of the USA and to all sectors of
society.
It is thought that more than one million people are living with HIV in the USA and that more than half a million have died after developing AIDS.
American HIV surveillance data are not comprehensive so many statistics must be based on reports of AIDS diagnoses. In
interpreting such AIDS statistics, it is important to remember that they do not correspond to new HIV infections. Most people
live with HIV for several years before developing AIDS.
AIDS statistics
People living with AIDS
At the end of 2005, the CDC estimates that 437,982 people were living with AIDS in the USA.1
The chart below shows the ethnicities of these people, revealing that black Americans have been disproportionately affected.
The charts below show how adults and adolescents2 living with AIDS most likely became infected with HIV. Around
77% of adults and adolescents living with AIDS are men.
An estimated 1,411 children aged under 13 were living with AIDS at the end of 2005. The vast
majority of these children acquired HIV from their mothers during pregnancy, labour, delivery or breastfeeding.
People with AIDS are surviving longer and are contributing to a steady increase in the number of people living with AIDS.
This trend will continue as long as the number of new diagnoses exceeds the number of people dying each year.
AIDS diagnoses and deaths
In June 1981, the first cases of what is now known as AIDS were reported in the USA. During the 1980s, there were rapid
increases in the number of AIDS cases and deaths of people with AIDS. Cases peaked with the 1993 expansion of the case definition3,
and then declined. The most dramatic drops in both cases and deaths began in 1996, with the widespread use of combination
antiretroviral therapy.
The rate of decrease in AIDS diagnoses slowed in the late 1990s. After reaching a plateau, the estimated number of diagnoses
increased slightly each year from 2001 to 2005, reaching 45,669 in the last year. In total, an
estimated 988,376 people have been diagnosed with AIDS.
The number of deaths among people with AIDS has remained relatively stable since 1999; there were an estimated 17,011
deaths in 2005. Since the beginning of the epidemic, an estimated 550,394 people with AIDS have
died in the USA.
Who is affected by AIDS?
During the 1990s, the epidemic shifted steadily toward a growing proportion of AIDS cases among black people and Hispanics
and in women, and toward a decreasing proportion in MSM, although this group remains the largest single exposure group. Black
people and Hispanics have been disproportionately affected since the early years of the epidemic. In absolute numbers, blacks
have outnumbered whites in new AIDS diagnoses and deaths since 1996, and in the number of people living with AIDS since 1998.
From 2000 to 2005, the estimated number of new AIDS cases increased in all racial/ethnic groups. Over the same period,
the estimated number of new AIDS diagnoses increased by 17% among women and by 16%
among men. The number of new cases probably due to heterosexual contact grew by 42%; cases probably due to sex between men
grew by 24%; and the number among injecting drug users fell by less than 1%.
During 2005 there were an estimated 58 paediatric AIDS diagnoses, compared to 187 in 1999 and
799 in 1994. The decline in paediatric AIDS incidence is associated with more HIV testing of pregnant women and the use of
zidovudine (AZT) by HIV-infected pregnant women and their newborn infants.
The age group 35-44 years accounted for 38% of all AIDS cases diagnosed in 2005. Nearly three-quarters
of all people who have died with AIDS did not live to the age of 45.
HIV statistics
At the end of 2005, the CDC estimates that there were 476,749 people living with HIV/AIDS in the 37 areas that have a history
of confidential name-based HIV reporting, based on reported diagnoses and deaths4. However, the total number of
people living in the USA with HIV/AIDS is thought to be between 1,039,000 and 1,185,0005.
The discrepancy between these figures is due to several factors including:
- confidential name-based reporting of HIV diagnoses has not yet been implemented in all states6
- anonymous tests, including home tests, are excluded from case reports
- one in every four people living with HIV has not even had their infection diagnosed, let alone reported.7
During 2005, an estimated 38,133 new diagnoses of HIV infection were reported from the 37 areas
with a history of confidential name-based reporting, a number that has remained relatively stable since 2001. Of these cases,
74% were among adult or adolescent males, 26% were among adult or adolescent females, and less than 1% were among children
under 13 years of age. Recent HIV reports represent a mixture of people with recent infection and others who may have been
infected in the past but are only now being diagnosed.
Interpreting HIV & AIDS statistics for the USA
In order to monitor the spread of the American epidemic and to assess the need for services and resources, there is a need
for accurate surveillance. In the USA, statistics on both HIV and AIDS are collected by the Centers for Disease Control and
Prevention (CDC) and published in an annual report. The latest report was published in November 2006, and contains data up
to the end of 2005.
The CDC surveillance report includes data on the number of people diagnosed with AIDS, the number living with AIDS and
the number of people with AIDS who have died. Such AIDS statistics include not only the 50 states and the District of Columbia
but also Puerto Rico, Guam, the US Pacific Islands and the US Virgin Islands. However, around 97.5% of the total number of
people living with AIDS reside within the 50 states or the District of Columbia.
In recent years, the use of antiretroviral therapy has slowed the progression of HIV in many infected persons and hence
contributed to a decline in AIDS incidence. This means that AIDS surveillance data are less able to represent trends in the
incidence of HIV infection or the impact of the epidemic on the health-care system. In response, more states are now implementing
HIV case reporting. This enables state and local areas to better estimate the size of the population living with HIV/AIDS
and to predict the services and resources needed.
The CDC reports HIV diagnoses and the number of people living with HIV, using only data collected through confidential
name-based reporting. By the end of 2005, confidential name-based reporting of adult and child HIV cases had been implemented
by 38 states plus Puerto Rico, Guam, American Samoa, the Northern Mariana Islands and the US Virgin Islands. Of these 43 areas,
only 37 have been reporting since at least 2001.
Estimates and reporting delays
There is often a delay between the time of diagnosis of HIV or AIDS, or the time of death, and the time at which the event
is reported. Moreover, this delay may differ among different categories of people. For this reason the CDC estimates the number
of diagnoses, deaths and people living with HIV or AIDS by adjusting for reporting delays, taking into account the differences
between categories. The CDC also redistributes cases into exposure categories if none was initially reported. No adjustment
is made for incomplete reporting. On this page, all numbers are CDC estimates unless stated otherwise.
More information
AVERT.org has a collection of USA statistics pages which look at different aspects of the American epidemic, including statistics by state.
We also have a more general page about HIV & AIDS in the USA, describing the history of the epidemic and how the nation has responded.
Last updated April 25, 2007
