February 3, 2011
During 2005-2008, blacks/African Americans accounted for 13.6% of the population in the 37 states and 50.3% of the 156,812 diagnoses of HIV infection during that period ... HIV transmissions in black/African American males were classified most frequently as male-to-male sexual contact (61.1%), followed by heterosexual contact (23.1%), injection drug use (IDU) (11.9%), and both male-to-male sexual contact and IDU (3.6%). ... Among females, blacks/African Americans accounted for the largest percentage of diagnoses of HIV infection (65.9%) during 2005-2008. Most black/African American females diagnosed with HIV were exposed through heterosexual contact (85.2%), and the next greatest percentage by IDU (14.0%).
Some additional findings in this report:
The authors of this report comment that "the higher rates of diagnoses among blacks/African Americans suggest that adolescents and adults from this population who are at higher risk for HIV infection might benefit [emphasis mine] from more frequent testing to facilitate earlier diagnosis."
As usual, this is an outstanding report from the kind folks from Atlanta (who must feel this year like they've been tricked into living in New England).
But one of the things I've learned to recognize over the years of reading MMWR and other CDC reports, is that when they bring out the word "might" -- a classic word from the CDC Manual of Style -- what they really mean is: "We think you should do this but something is keeping us from stating it so bluntly."
So let me be so bold: More frequent HIV testing is recommended for people at high risk for HIV -- and the risk is high in certain black/African American communities, regardless of "risk factors", as my colleague Kim Smith has wisely stated. Clinicians should be aware of the data presented here so that they can implement these recommendations appropriately.
Paul Sax is Clinical Director of Infectious Diseases at Brigham and Women's Hospital. His blog HIV and ID Observations is part of Journal Watch, where he is Editor-in-Chief of Journal Watch AIDS Clinical Care.
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