Fast Facts
- HIV and AIDS are generally
concentrated in urban areas in the
United States.
- In 2009, the number of adults and
adolescents living with an AIDS
diagnosis was highest in the South.
- In 2010, blacks accounted for the
largest proportion of AIDS diagnoses in
the South, the Northeast, and the
Midwest.
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In the United States, the HIV and
AIDS epidemic is not evenly distributed
across states and regions. Generally,
HIV and AIDS are concentrated in urban
areas, so states reporting higher rates
of persons living with a diagnosis of
HIV infection or AIDS usually contain
major metropolitan areas where their
epidemics are focused. However, some
generalities about the epidemic can be
understood by considering regional
aspects. For example, at the end of
2009, the rate (which takes into
account the size of the population by
noting the number of cases per 100,000
people) of persons living with an AIDS
diagnosis was highest in the Northeast,
followed by the South, the West, and the
Midwest,1
even though the estimated number
of adults and adolescents living with an
AIDS diagnosis was highest in the South.
In 2010, blacks accounted for the
largest proportion of AIDS diagnoses in
all regions except the West, where
whites accounted for the highest
proportion of diagnoses. Understanding
the places and populations that are most
affected by HIV and AIDS allows the federal
government to allocate its resources in such
a way that they are matched to the
geographic areas where they are needed most,
while still supporting a basic level of HIV
education and prevention for everyone across
the country.
HIV in the United States
The following map shows the ranges of
rates of persons living with a diagnosis of
HIV infection at the end of 2008, by state;
predominantly, states in the South and the
Northeast report the highest rates. In 2008,
the overall total rate for persons living
with a diagnosis of HIV infection in the
United States was 417.5/100,000 population.
Rates of Persons Aged 18–64 Years Living with a
Diagnosis of HIV Infection, Year-End 2008—United States2
AIDS in the United States
New AIDS diagnoses: At the end of
2010, the South accounted for 45% of the
estimated 33,015 new AIDS diagnoses in the
50 states and the District of Columbia,
followed by the Northeast (24%), the West
(19%), and the Midwest (13%).
In 2010, the Northeast reported the
highest rate of new AIDS diagnoses
(14.2/100,000), followed by the South
(13.0/100,000), the West (8.8/100,000), and
the Midwest (6.3/100,000).
Living with an AIDS diagnosis: In
2009, the South accounted for 40% of the
estimated 476,732 persons living with an
AIDS diagnosis in the 50 states and the
District of Columbia, followed by the
Northeast (29%), the West (20%), and the
Midwest (11%).
In 2009, the Northeast reported the
highest rate of persons per 100,000
population living with an AIDS diagnosis
(248.7/100,000), followed by the South
(169.5/100,000), the West (133.6/100,000),
and the Midwest (77.2/100,000).
AIDS deaths: In 2009, the South
accounted for 48% of the 17,774 persons with
a diagnosis of AIDS who died in the 50
states and the District of Columbia,
followed by the Northeast (24%), the West
(17%), and the Midwest (11%).
That same year, the Northeast reported
the highest rate of deaths of persons with
AIDS (7.7/100,000), followed by the South
(7.6/100,000), the West (4.2/100,000), and
the Midwest (2.8/100,000).
Deaths of persons with an AIDS diagnosis
may be due to any cause.
AIDS in the United States, by
Race/Ethnicity
Most people receiving an AIDS diagnosis
in 2010 or living with an AIDS diagnosis at
the end of 2009 were black, white, or
Latino, reflecting the majority population
groups of the United States.
Race/Ethnicity of
Persons Diagnosed with AIDS in 2010
in the 50 States and District of Columbia,
by Region of Residence
However, HIV and AIDS strongly affect some
of the smaller population groups in the
United States, an effect that may not always
be noted because of the relatively small
number of cases among these groups. For
example, by year-end 2009, American
Indians/Alaska Natives living in the
Northeast had almost the same rate of
persons living with an AIDS diagnosis
(86.8/100,000 people) as whites in this
region (87.6/100,000).
What CDC Is Doing
Because the HIV epidemic is not evenly
distributed across the country, CDC uses a
strategy called High-Impact Prevention
that invests its HIV prevention resources in
the places and populations most affected by
HIV and encourages the use of programs that
will be most effective in those
jurisdictions.
Examples of CDC’s targeted approach to
HIV prevention follow:
- The Enhanced Comprehensive HIV
Prevention Planning Project (ECHPP)
is a 3-year demonstration project
intended to maximize the impact of HIV
prevention in the 12 metropolitan
statistical areas with the highest AIDS
prevalence in the United States.3
The flexibility of ECHPP allows each
site to create HIV prevention plans
using HIV interventions that should be
most effective in their specific
jurisdictions. CDC maintains an
ECHPP website with a project
overview and descriptions of each
jurisdiction’s activities.
- The Expanded Testing Initiative
(ETI) is a large-scale HIV testing
program intended for populations
disproportionately affected by HIV.
During the first 3 years of the program,
CDC invested more than $100 million in
ETI to test 2.7 million persons for HIV,
resulting in 0.7% with newly identified
HIV diagnoses and averting an estimated
3,381 new HIV infections. Importantly,
ETI achieved a return of $1.95 for every
dollar invested—showing that an
investment in HIV testing can save money
over time. Research shows that once
people learn of their HIV infection,
they are likely to take steps to protect
their partners from becoming infected.
- Funding for state and local
health departments is CDC’s most
significant HIV investment. CDC
allocates its HIV and AIDS funding for
health departments to closely align with
the geographic areas and populations
most affected by the epidemic. These
programs channel more resources to the
areas that need them the most, while
still ensuring that all persons in the
United States have a basic understanding
of HIV, know how to protect themselves
from becoming infected, know where to
get an HIV test, and understand the
importance of treatment. Therefore, all
states receive a basic level of HIV
funding to achieve these goals.
CDC is guided in its efforts to end
the HIV epidemic in the United States by the
2010
National HIV/AIDS Strategy, which calls
for reducing HIV incidence, increasing
access to care and optimizing health
outcomes, and reducing HIV-related health
disparities.
1 Northeast: CT, ME, MA, NH, NJ, NY, PA, RI, VT
Midwest: IL, IN, IA, KS, MI, MN, MO, NE, ND, OH, SD, WI
South: AL, AR, DE, DC, FL, GA, KY, LA, MD, MS, NC, OK, SC, TN, TX, VA, WV
West: AK, AZ, CA, CO, HI, ID, MT, NV, NM, OR, UT, WA, WY
2 To provide population rates of persons living
with a diagnosis of HIV for every state, this map uses unadjusted data from
CDC’s National HIV Surveillance System.
3 Atlanta; Baltimore; Chicago; Dallas; Houston; Los
Angeles; Miami; New York; Philadelphia; Washington, DC; San Francisco; San Juan,
PR
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