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September 11, 2008
A new method of estimating new HIV infections released by the Centers for Disease Control and Prevention (CDC) in August revealed that an estimated 56,300 people were infected with HIV in the United States in 2006. Michigan was among the 22 states and cities that contributed data for the estimate, and our rate was the lowest at 10 per 100,000 Michiganians newly infected in 2006 - less than half the national rate of 23 per 100,000. The sex, race, age and risk breakdowns of the national estimate are being released this week in the Sept. 12, 2008 CDC publication, Morbidity and Mortality Weekly Report.
Michigan has long tracked the number of people newly diagnosed each year. Until now, there has not been a way to distinguish recent infections from those that occurred years earlier. The CDC developed a lab test that is able to distinguish between recent and long-term infection, allowing the first national and state estimates of recent HIV infection. The sample of people recently infected with HIV as indicated by the test is used to approximate recent HIV infection among the general population.
"This new technology gives us a clearer picture of recent HIV infections in the country and helps us understand where HIV is spreading now and how to focus our prevention efforts," said Janet Olszewski, MDCH director. "While Michigan's rate of infection is the lowest of the group whose data contributed to the national estimate, this new data reinforces the fact that HIV remains a very serious public health issue that requires our utmost vigilance."
The most highly impacted groups in Michigan tend to mirror what is seen nationally. In Michigan, 80% of new infections in 2006 occurred in males; 55% in African Americans; 43% among males who have sex with other males (MSM); and 29% in persons under age 29.
Nationally, infection rates per 100,000 demonstrate significant racial/ethnic disparities. Similarly in Michigan, African Americans bear a disproportionate burden of HIV infection. The rate of new HIV infections in 2006 among African Americans was nearly eight times the rate of all other racial/ethnic groups that year: 42.3 per 100,000 versus 5.4 per 100,000. In other words, while African Americans comprise 14% of Michigan's population, they accounted for 55% of new HIV infections in 2006.
These numbers highlight the populations at greatest risk of HIV infection and help focus our prevention strategies. "We know science-based prevention interventions and testing help prevent the spread of HIV," said Debra Szwejda, Manager, HIV/AIDS Prevention and Intervention Section. "However, our prevention and surveillance efforts must be adequately funded and vigorously applied. We have lost nearly one million dollars in our federal prevention funding since 2001."
"We have seen great success in nearly eliminating perinatal HIV transmission, and trends among injecting drug users show significant declines. However, it is troubling that we continue to see increases in rates of new diagnoses among African Americans, particularly among young African American men who have sex with other men, as shown by previous trend analyses," Szwejda said.
MDCH is utilizing programs that are effective in reaching at-risk individuals. In 2007 over 100,000 people received highly targeted outreach and education programs - the majority African Americans and under the age of 24.
MDCH also funds a number of testing initiatives to reach at-risk populations. Routine HIV testing has been implemented in selected clinical settings focusing on African Americans in areas with higher rates of HIV. MDCH also supports HIV testing, counseling and prevention services in local public health and community based organizations, resulting in approximately 55,000 Michiganians annually learning their HIV status.
This is the first year the CDC has provided estimates based on its new method. In the coming years, MDCH expects to be able to track Michigan and national trends and adapt prevention strategies as warranted.
For additional data, see the report U.S. and Michigan 2006 HIV Incidence Estimates online at www.michigan.gov/hivstd, click ‘HIV/AIDS', then click ‘Statistics and Reports'.