Document:US HIV Prevalence Source Data

From AIDS Wiki

NOTWITHSTANDING ANY OTHER NOTICE ON THIS PAGE, the material on this page is NOT available under the GNU Free Documentation License; in accordance with Title 17 U.S.C. section 107, it is posted in the manner of bulletin boards in schools and workplaces, to encourage public education and citizen awareness, without profit or payment, for persons and entities engaging in non-profit research and educational activities and purposes only.

23 April 2007
[revised 30 April 2007, 18 October 2008]

By their words ye shall know them.

1986: 1,000,000-1,500,000, Confronting AIDS, Institute of Medicine, 1986. "Summary and Recommendations", p. 5. The exact text states, "as of September 1986...between 1 million and 1.5 million people in the United States are probably infected with the virus that causes AIDS."; "Prevalence of HIV Infection", p. 69. The exact text states, "...the Public Health Service estimated as of mid-1986 that this number [HIV prevalence] is somewhere between 1 million and 1.5 million (Appendix G)"; "Projections by the Public Health Service", p. 85. The exact text states "There are 1 million to 1.5 million Americans currently infected with HIV."; "Mandatory Screening", p. 120. The exact text states, "The number of seropositive persons in the United States in mid-1986 is estimated to be between 1 million and 1.5 million". This is acknowledged to be an overestimate in the 1988 update, see Confronting AIDS (1988 update), Institute of Medicine, 1988, "Prevalence and Incidence of Infection in the United States", p. 4. The exact text states, "CDC has scaled back somewhat its estimate of the number of infected people in the United States. In 1986 the estimate was 1 to 1.5 million; in late 1987 it was 945,000 to 1.4 million."; "National Estimates of HIV Infection", p. 50. The exact text states, "In 1986...CDC calculated from these estimates [of HIV prevalence for risk groups] that 1 to 1.5 million people in the United States were currently infected with HIV... In retrospect, the 1986 estimates made by CDC appear to have been too high. CDC now estimates that between 945,000 and 1.4 million Americans currently are infected with HIV", as well as "Changing Estimates of HIV-1 Seroprevalence in the United States", Sten H. Vermund, Journal of NIH Research, July 1991, pp. 77-81. The exact text states, "Consequently, the Coolfont conference guess that there were 1 million to 1.5 million infected Americans in 1986 was an overestimate."

1986: 1,250,000, Confronting AIDS, Institute of Medicine, 1986. "Prevalence of HIV Infection", pp. 69-70. This estimate is based on the infamous Curran et al paper "The epidemiology of AIDS: current status and future prospects" frequently cited by HIV apologists as being misrepresented ["choosing the highest estimate of 1,000,000"] by Duesberg et al. It is interesting to note that in 1986, the authors of Confronting AIDS did not appear to agree with those currently accusing Duesberg of misrepresentation. The exact text of Confronting AIDS states: "Using this method [of using "estimated prevalence of infection and estimates of the size of these risk groups"], the Public Health Service estimated as of mid-1986 that this number [HIV prevalence] is somewhere between 1 million and 1.5 million (Appendix G). The estimate corresponds reasonably well with the estimate (approximately 1.25 million) derived using an infected-to-AIDS-case ratio of 50 to 1 (Curran et al., 1985)" [my emphasis].

1986: 750,000, CDC, "HIV prevalence estimates and AIDS case projections for the United States: report based upon a workshop", MMWR 39, (RR16) 1, (1990). The exact text states, "CDC estimates that approximately 750,000 persons in the United States were infected with AIDS [sic] at the beginning of 1986 and that approximately 1,000,000 Americans are currently infected with HIV".

1987: 945,000-1,400,000, Confronting AIDS (1988 update), Institute of Medicine, 1988. "Prevalence and Incidence of Infection in the United States", p. 4. The exact text states, "...in late 1987 it [HIV prevalence] was 945,000 to 1.4 million".; "National Estimates of HIV Infection", p. 50. The exact text states, "CDC now estimates that between 945,000 and 1.4 million Americans currently are infected with HIV".

1987: 936,000-1,144,000, "Changing Estimates of HIV-1 Seroprevalence in the United States", Sten H. Vermund, Journal of NIH Research, July 1991, pp. 77-81. The exact text states, "The Johns Hopkins group's estimated number of HIV-infected Americans as of July 1, 1987, is 1,040,000 ± 104,000 (standard deviation)".

1987: 707,000-1,376,000, "Backcalculation of the number with human immunodeficiency virus infection in the United States", Rosenberg PS, Biggar RJ, Goedert JJ, Gail MH, Am J Epidemiol. 1991 Feb 1;133(3): 276-85. The exact text states, "Plausible estimates for the total number infected by July 1987 ranged from 707,000 to 1,376,000, with the most likely estimate equal to 992,000".

1988-89: 1,000,000, "Changing Estimates of HIV-1 Seroprevalence in the United States", Sten H. Vermund, Journal of NIH Research, July 1991, pp. 77-81. The exact text states, "The official Public Health Service (PHS) estimates are about 1 million HIV-infected Americans in 1988-1989".

1989: 800,000-1,200,000, CDC, "Current trends estimates of HIV prevalence and projected AIDS cases: Summary of a workshop, October 31-November 1, 1989", (1990). MMWR, 39(7), 110-112, 117-119. The exact text states, "Preliminary HIV seroprevalence survey data provided estimates most consistent with between 800,000 and 1.2 million HIV infections. Although based on independent data sources and subject to different biases, both methods provide estimates that overlap and center around the 1 million estimate."

1990: 1,000,000, CDC, "HIV prevalence estimates and AIDS case projections for the United States: report based upon a workshop", MMWR 39, (RR16) 1, (1990). The exact text states, "CDC estimates...that approximately 1,000,000 Americans are currently infected with HIV."

1992: 1,000,000, "The second 100,000 cases of Acquired Immunodeficiency Syndrome – United States, June 1981-December 1991", MMWR 41: 28-29. The exact text states, "Of the estimated 1 million HIV-infected persons in the United States, approximately 20% have developed AIDS".

1992: 650,000-900,000, "Prevalence of HIV infection in the United States, 1984 to 1992" J. M. Karon, P. S. Rosenberg, G. McQuillan, M. Khare, M. Gwinn and L. R. Petersen Division of HIV/AIDS Prevention Centers for Disease Control and Prevention, Atlanta, GA 30333, USA, JAMA Vol. 276 No. 2, July 10, 1996. The exact text states, "RESULTS – Approximately 0.3% of US residents (650,000-900,000 persons) were infected with HIV in 1992".

1993: 630,000-897,000, "Scope of the AIDS epidemic in the United States", Rosenberg PS, Science. 1995 Nov;270(5240): 1372-5. The exact text states, "This approach suggests that 630,000 to 897,000 adults and adolescents in the United States were living with HIV infection as of January 1993".

1993: 1,000,000, "Letter from Harold Jaffe to Peter Duesberg ", 5 March 1993. Jaffe was then the current "Acting Director of the Division of HIV/AIDS, National Center for Infectious Disease". The exact text states, "The CDC estimates that approximately one million Americans are now infected with HIV..."

1996: 700,000, "The estimated prevalence and incidence of HIV in 96 large US metropolitan areas", Holmberg SD. Am J Public Health. 1996 May;86(5): 642-54. The exact text states, "This implies about 700,000 prevalent and 41,000 new HIV infections yearly in the United States".

1998: 800,000-900,000, "HIV Prevalence in the United States, 2000" P. L. Fleming, R. H. Byers, P. A. Sweeney, D. Daniels, J. M. Karon, and R. S. Janssen CDC, Atlanta, GA Session 5 Oral Abstract Session Epidemiology and Infection Control Session Time: Monday, 10 am - 12:30 pm Room 6C, 9th Conference on Retroviruses and Opportunistic Infections. The exact text states, "In 1998, the HIV prevalence estimate was 800,000-900,000".

2000: 850,000-950,000, "Estimated HIV prevalence in the United States at the end of 2003". National HIV Prevention Conference, June 2005, Atlanta. The exact text states, "Previous estimates stated 850,000-950,000 persons were living with HIV at the end of 2000".; "HIV Prevalence in the United States, 2000" P. L. Fleming, R. H. Byers, P. A. Sweeney, D. Daniels, J. M. Karon, and R. S. Janssen CDC, Atlanta, GA Session 5 Oral Abstract Session Epidemiology and Infection Control Session Time: Monday, 10 am - 12:30 pm Room 6C, 9th Conference on Retroviruses and Opportunistic Infections. The exact text states, "During 1999 and 2000, respectively, AIDS incidence was 40,800 and 40,200 and AIDS deaths were 17,200 and 15,300. Assuming stable HIV incidence, the number of persons living with HIV/AIDS increased about 50,000 and prevalence increased to 850,000-950,000".

2001: 720,000, "Epidemiology of HIV/AIDS in the United States", HIV InSite Knowledge Base, March 2003 Dennis H. Osmond, PhD, University of California San Francisco. The exact text states, "A lower estimate is obtained if the 650,000 estimate for 1991 (midyear of sample collection) from the adjusted NHANES III data is projected forward to 2002 by the difference between annual AIDS deaths and the estimate of 40,000 new HIV infections each year. That calculation gives a prevalence of approximately 720,000 by the beginning of 2002."

2002: 788,000, Table 12, Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2002, by state or area of residence and age category – United States, CDC HIV/AIDS Surveillance Report, Volume 14, 2002. The number of HIV-infected (non-AIDS) is estimated as (144,000)(304/145)(4/3) = 403,000 plus 385,000 AIDS cases gives 788,000 for HIV prevalence. The factor of (304/145) is to account for states which are not represented in the HIV infection column because they did not have confidential name-based HIV infection reporting. The factor of (4/3) is to account for the fact that "the reported case counts have been adjusted for reporting delays, but not for incomplete reporting" and that "approximately 25% of [persons living with HIV in the US] did not know they were infected [at the end of 2000]". (Presumably, people diagnosed as "AIDS cases" know they are "infected".) *

2003: 775,000, Table 12, Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2003, by state or area of residence and age category – United States, CDC HIV/AIDS Surveillance Report, Volume 15, 2003. The number of HIV-infected (non-AIDS) is estimated as (175,000)(304/172)(4/3) = 369,000 plus 406,000 AIDS cases gives 775,000 for HIV prevalence. The factor of (304/172) is to account for states which are not represented in the HIV infection column because they did not have confidential name-based HIV infection reporting. The factor of (4/3) is to account for the fact that "the reported case counts have been adjusted for reporting delays, but not for incomplete reporting" and that "approximately 25% of [persons living with HIV in the US] did not know they were infected [at the end of 2000]". (Presumably, people diagnosed as "AIDS cases" know they are "infected".) *

2003: 994,000, "HIV Prevalence Estimates — United States, 2006", MMWR 57(39);1073-1076. The exact text states, "The 2006 estimate is based on a data set that 1) includes HIV diagnoses from 10 states that were not reporting in 2003 and 2) has been refined by an improved ability to identify and remove duplicate HIV case data that reflect reports by more than one state. Using the refined data set, CDC now estimates the HIV prevalence for 2003 to have been 994,000..."

2003: 925,000-1,025,000, "Estimated HIV prevalence in the United States at the end of 2003", National HIV Prevention Conference; June 2005, Abstract 595. The exact text states, "RESULTS: From method A, there were an estimated 925,000-1,025,000 persons living with HIV/AIDS at the end of 2003 in the U.S.... In method B, overall HIV estimated prevalence was 1,039,000-1,185,000.... CONCLUSIONS: Using either estimation method, there were approximately one million persons living with HIV/AIDS in the U.S. at the end of 2003."

2003: 1,039,000-1,185,000, "Estimated HIV prevalence in the United States at the end of 2003", National HIV Prevention Conference; June 2005, Abstract 595. The exact text states, "RESULTS: From method A, there were an estimated 925,000-1,025,000 persons living with HIV/AIDS at the end of 2003 in the U.S.... In method B, overall HIV estimated prevalence was 1,039,000-1,185,000.... CONCLUSIONS: Using either estimation method, there were approximately one million persons living with HIV/AIDS in the U.S. at the end of 2003."

2004: 864,000, Table 12, Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2004, by area of residence and age category – United States, CDC HIV/AIDS Surveillance Report, Volume 16, 2004. The number of HIV-infected (non-AIDS) is estimated as (213,000)(304/192)(4/3) = 449,000 plus 415,000 AIDS cases gives 864,000 for HIV prevalence. The factor of (304/192) is to account for states which are not represented in the HIV infection column because they did not have confidential name-based HIV infection reporting. The factor of (4/3) is to account for the fact that "the reported case counts have been adjusted for reporting delays, but not for incomplete reporting" and that "approximately 25% of [persons living with HIV in the US] did not know they were infected [at the end of 2000]". (Presumably, people diagnosed as "AIDS cases" know they are "infected".) *

2005: 891,000, Table 12, Estimated numbers of persons living with HIV infection (not AIDS) or with AIDS at the end of 2005, by area of residence and age category – United States, CDC HIV/AIDS Surveillance Report, Volume 17, 2005. The number of HIV-infected (non-AIDS) is estimated as (215,000)(304/192)(4/3) = 453,000, plus 438,000 AIDS cases gives 891,000 for HIV prevalence. The factor of (304/192) is to account for states which are not represented in the HIV infection column because they did not have confidential name-based HIV infection reporting. The factor of (4/3) is to account for the fact that "the reported case counts have been adjusted for reporting delays, but not for incomplete reporting" and that "approximately 25% of [persons living with HIV in the US] did not know they were infected [at the end of 2000]". (Presumably, people diagnosed as "AIDS cases" know they are "infected".) *

2006: 1,100,000, "HIV Prevalence Estimates — United States, 2006", MMWR 57(39);1073-1076. The exact text states, "CDC now estimates that 1.1 million adults and adolescents (prevalence rate: 447.8 per 100,000 population) were living with diagnosed or undiagnosed HIV infection in the United States at the end of 2006."

* NOTE ON CDC NUMBERS: It is very difficult to determine exactly the meaning of the numbers in the various tables of the annual CDC HIV/AIDS surveillance reports: which are actual numbers, which are estimates, and in the latter case, how the estimates were obtained: what original raw data and specific algorithms or statistical methods were used. For example, Table 12 of the CDC surveillance reports from 2002-2005 contains the following baffling note: "These numbers do not represent actual cases in persons living with HIV infection (not AIDS) or with AIDS. Rather, these numbers are point estimates of persons living with HIV infection or AIDS that have been adjusted for reporting delays. The estimates have not been adjusted for incomplete reporting." Yet nowhere are the raw data for "actual cases in persons living with HIV infection (not AIDS) or with AIDS" given, nor are we given any indication what specific algorithms or statistical methods were employed to arrive at estimates "adjusted for reporting delays" but "not adjusted for incomplete reporting". Table 12 and similar tables are typical of the "chaotic mess " emanating from the CDC regarding reliable HIV/AIDS statistics. The arithmetic factors employed above represent my very best attempt to make any sense at all of this chaotic mess as manifested in Tables 12.

© 2007 by Darin Brown
Originally published at "You Bet Your Life"