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U.S. Survey Indicates Blacks Hardest Hit by HIV Infection

In 2001, Rate for Those Ages 18 to 59 Is 13 Times That of Whites

By David Brown
Washington Post Staff Writer
Saturday, February 26, 2005; Page A03

BOSTON, Feb. 25 -- The prevalence of HIV infection in blacks doubled in the last decade while remaining stable among whites, according to the federal government's most detailed, ongoing survey of the U.S. population's health.

The findings, presented to a gathering of AIDS researchers here Friday, is further evidence the nation's AIDS epidemic is becoming a scourge disproportionately suffered by African Americans.

The prevalence of HIV infection in blacks ages 18 to 59 in 1991 was 1.1 percent, about five times higher than what was found in whites. In 2001, it was 2.14 percent, and the gap had increased to 13 times that seen in whites. The hardest-hit group was black men ages 40 to 49, 3.6 percent of whom were infected with HIV when contacted through the National Health and Nutrition Examination Survey.

"It is a disturbing trend," said Geraldine McQuillan, a researcher from the National Center for Health Statistics who described the findings at the 12th Conference on Retroviruses and Opportunistic Infections, the annual midwinter AIDS meeting in the United States.

She said, in fact, that "if anything, the findings are an underestimate" of the lopsided racial profile of the AIDS epidemic.

The survey's interviewers ask a sample of American households to answer an extensive questionnaire, give blood samples, and undergo a modified physical exam. The survey does not include people in the military or in jails, prisons and hospitals.

In the 2001 survey, out of about 5,500 people examined, 32 were HIV-positive. Of that group, 23 were African American. The overall prevalence of HIV was 0.43 percent, up slightly from 0.33 percent a decade earlier.

Although the later survey showed a marked increase in HIV prevalence in blacks overall, it found no change over 10 years in the 18-to-39 age group. That finding is at odds with numerous other studies showing the AIDS epidemic growing with unusual speed in young black homosexuals (many of whom do not consider themselves to be gay), and in women who are their sex partners or the sex partners of intravenous drug users.

Nationwide, for example, black women make up 72 percent of new cases of HIV infection among American women. Most of those new infections in African Americans would be expected to occur in people in the 18-to-39 age group that the survey found to have stable HIV rates.

"We're not capturing that high-risk category," McQuillan acknowledged, adding that the survey "tells you the background picture . . . not the total picture" of what is happening in the country.

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