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HIV/AIDS Surveillance Report Thursday October 29, 1992 Suggested Citation: Centers for Disease Control. HIV/AIDS Surveillance Report, October, 1992 Report Description The U.S. AIDS case data presented below are extracted from the "HIV/AIDS Surveillance Report", published each quarter by the Division of HIV/AIDS, Center for Infectious Diseases, Centers for Disease Control, Atlanta, GA 30333 In addition to the data presented here, the printed report contains maps, figures, and technical notes. Single copies of the printed report are available free from: CDC National AIDS Clearinghouse P.O. Box 6003 Rockville, MD 20849-6003 Table 1. AIDS cases and annual incidence rates per 100,000 population, by state, reported October 1990 through September 1991, October 1991 through September 1992; and cumulative totals, by state and age group, through September 1992 Oct. 1990- Oct. 1991- Sept 1991 Sept 1992 STATE OF RESIDENCE No. Rate No. Rate Alabama 310 7.6 462 11.4 Alaska 17 3.0 17 2.9 Arizona 242 6.4 410 10.6 Arkansas 187 7.9 235 9.9 California 7,539 24.8 8,386 27.1 Colorado 422 12.7 418 12.4 Connecticut 520 15.7 541 16.3 Delaware 79 11.7 131 19.2 District of Columbia 699 115.8 701 116.7 Florida 4,993 37.7 5,038 37.1 Georgia 1,415 21.5 1,307 19.6 Hawaii 164 14.6 176 15.5 Idaho 27 2.7 36 3.5 Illinois 1,412 12.4 1,839 16.1 Indiana 273 4.9 376 6.8 Iowa 97 3.5 85 3.1 Kansas 91 3.7 189 7.6 Kentucky 174 4.7 207 5.6 Louisiana 711 16.8 768 18.2 Maine 54 4.4 50 4.0 Maryland 926 19.1 1,100 22.5 Massachusetts 955 15.8 776 12.8 Michigan 545 5.9 766 8.2 Minnesota 208 4.7 237 5.3 Mississippi 193 7.5 231 8.9 Missouri 600 11.7 651 12.6 Montana 30 3.7 22 2.7 Nebraska 56 3.5 68 4.3 Nevada 243 19.6 237 18.5 New Hampshire 48 4.3 46 4.0 New Jersey 2,300 29.6 2,063 26.4 New Mexico 122 7.9 90 5.8 New York 8,076 44.8 8,283 45.8 North Carolina 521 7.8 647 9.5 North Dakota 5 0.8 8 1.3 Ohio 632 5.8 649 6.0 Oklahoma 201 6.4 226 7.1 Oregon 302 10.5 283 9.8 Pennsylvania 1,164 9.8 1,345 11.3 Rhode Island 87 8.6 102 10.1 South Carolina 297 8.4 339 9.5 South Dakota 9 1.3 7 1.0 Tennessee 315 6.4 446 9.0 Texas 3,098 17.9 2,957 16.9 Utah 101 5.8 146 8.2 Vermont 24 4.2 26 4.5 Virginia 698 11.1 609 9.6 Washington 574 11.6 567 11.3 West Virginia 48 2.7 60 3.4 Wisconsin 192 3.9 224 4.5 Wyoming 17 3.8 4 0.9 U.S. TOTAL 42,013 16.7 44,587 17.6 Guam 2 1.5 1 0.7 Pacific Islands, U.S. - 0.0 - 0.0 Puerto Rico 1,777 50.0 1,817 50.7 Virgin Islands, U.S. 14 13.7 18 18.8 TOTAL 43,806 17.2 46,423 18.0 Table 1. AIDS cases and annual incidence rates per 100,000 population, by state, reported October 1990 through September 1991, October 1991 through September 1992; and cumulative totals, by state and age group, through September 1992 (Continued) Cumulative totals Adults/ Children STATE OF RESIDENCE adolescents <13 years old Total Alabama 1,570 37 1,607 Alaska 128 3 131 Arizona 1,872 12 1,884 Arkansas 822 15 837 California 44,635 300 44,935 Colorado 2,329 16 2,345 Connecticut 2,749 81 2,830 Delaware 495 6 501 District of Columbia 3,882 56 3,938 Florida 22,619 609 23,228 Georgia 6,684 71 6,755 Hawaii 930 7 937 Idaho 132 2 134 Illinois 7,540 114 7,654 Indiana 1,622 13 1,635 Iowa 383 3 386 Kansas 699 4 703 Kentucky 833 12 845 Louisiana 3,585 59 3,644 Maine 303 2 305 Maryland 4,887 109 4,996 Massachusetts 4,757 100 4,857 Michigan 3,140 56 3,196 Minnesota 1,207 11 1,218 Mississippi 1,024 20 1,044 Missouri 2,958 28 2,986 Montana 100 1 101 Nebraska 292 2 294 Nevada 1,047 11 1,058 New Hampshire 268 5 273 New Jersey 13,785 388 14,173 New Mexico 525 2 527 New York 48,057 1,097 49,154 North Carolina 2,688 63 2,751 North Dakota 32 - 32 Ohio 3,407 51 3,458 Oklahoma 1,079 15 1,094 Oregon 1,504 8 1,512 Pennsylvania 6,577 104 6,681 Rhode Island 538 9 547 South Carolina 1,619 30 1,649 South Dakota 34 1 35 Tennessee 1,777 20 1,797 Texas 16,534 175 16,709 Utah 555 15 570 Vermont 116 2 118 Virginia 3,150 62 3,212 Washington 3,252 16 3,268 West Virginia 281 4 285 Wisconsin 1,012 11 1,023 Wyoming 55 - 55 U.S. TOTAL 230,069 3,838 233,907 Guam 11 - 11 Pacific Islands, U.S. 2 - 2 Puerto Rico 7,909 208 8,117 Virgin Islands, U.S. 104 5 109 TOTAL 238,095 4,051 242,146 Table 2. AIDS cases and annual incidence rates per 100,000 population, by metropolitan area with 500,000 or more population, reported October 1990 through September 1991, October 1991 through September 1992; and cumulative totals, by area and age group, through September 1992 Oct. 1990- Oct. 1991- METROPOLITAN Sept 1991 Sept 1992 AREA OF RESIDENCE No. Rate No. Rate Akron, Ohio 30 4.6 36 5.5 Albany-Schenectady, N.Y. 86 9.8 112 12.7 Allentown, Pa. 38 5.5 35 5.0 Anaheim, Calif. 309 12.6 567 22.6 Atlanta, Ga. 1,082 37.3 918 30.9 Austin, Tex. 205 25.4 224 27.0 Bakersfield, Calif. 56 10.0 51 8.9 Baltimore, Md. 561 23.4 672 27.8 Baton Rouge, La. 66 12.4 93 17.4 Bergen-Passaic, N.J. 248 19.4 262 20.5 Birmingham, Ala. 89 9.8 115 12.6 Boston, Mass. 648 17.1 547 14.4 Bridgeport, Conn. 141 17.0 157 18.9 Buffalo, N.Y. 95 9.9 63 6.6 Charleston, S.C. 59 11.5 65 12.4 Charlotte, N.C. 74 6.3 119 9.9 Chicago, Ill. 1,139 18.8 1,522 25.1 Cincinnati, Ohio 99 6.8 108 7.4 Cleveland, Ohio 186 10.2 172 9.5 Columbus, Ohio 119 8.6 149 10.6 Dallas, Tex. 681 26.1 763 28.5 Dayton, Ohio 67 7.0 62 6.5 Denver, Colo. 360 21.9 336 20.2 Detroit, Mich. 376 8.6 592 13.6 El Paso, Tex. 43 7.1 46 7.5 Fort Lauderdale, Fla. 866 67.7 855 65.6 Fort Worth, Tex. 201 14.7 158 11.3 Fresno, Calif. 61 8.9 96 13.8 Gary, Ind. 28 4.7 49 8.2 Grand Rapids, Mich. 37 5.3 35 5.0 Greensboro, N.C. 89 9.4 119 12.4 Greenville, S.C. 41 6.3 55 8.4 Harrisburg, Pa. 42 7.1 46 7.7 Hartford, Conn. 165 14.6 168 14.8 Honolulu, Hawaii 117 13.9 124 14.6 Houston, Tex. 1,285 38.3 1,039 30.4 Indianapolis, Ind. 127 10.1 160 12.6 Jacksonville, Fla. 236 25.5 332 35.2 Jersey City, N.J. 405 73.3 314 56.9 Kansas City, Mo. 212 13.4 313 19.7 Knoxville, Tenn. 28 4.6 38 6.2 Lake County, Ill. 34 6.5 29 5.5 Las Vegas, Nev. 182 23.7 178 22.3 Little Rock, Ark. 70 13.5 81 15.6 Los Angeles, Calif. 2,693 29.9 3,007 32.9 Louisville, Ky. 70 7.4 90 9.5 Memphis, Tenn. 96 9.7 171 17.2 Miami, Fla. 1,775 90.2 1,323 66.2 Middlesex, N.J. 197 19.1 216 20.6 Milwaukee, Wis. 85 5.9 127 8.8 Minneapolis-Saint Paul, Minn. 176 7.0 204 8.1 Monmouth-Ocean City, N.J. 184 18.4 113 11.1 Nashville, Tenn. 114 11.4 128 12.6 Nassau-Suffolk, N.Y. 345 13.2 372 14.3 New Bedford, Mass. 73 14.3 45 8.8 New Haven, Conn. 181 22.4 164 20.2 New Orleans, La. 425 34.4 422 34.2 New York, N.Y. 6,902 80.5 7,195 83.7 Newark, N.J. 891 49.0 837 46.2 Norfolk, Va. 174 12.3 104 7.2 Oakland, Calif. 422 20.0 570 26.5 Oklahoma City, Okla. 97 10.0 114 11.7 Omaha, Neb. 42 6.8 49 7.8 Orlando, Fla. 365 32.9 304 26.5 Oxnard-Ventura, Calif. 37 5.4 71 10.2 Philadelphia, Pa. 904 18.6 1,002 20.5 Phoenix, Ariz. 185 8.5 289 12.9 Pittsburgh, Pa. 113 5.5 144 7.1 Portland, Oreg. 239 19.1 229 18.1 Providence, R.I. 83 9.0 96 10.4 Raleigh-Durham, N.C. 107 14.2 117 15.2 Richmond, Va. 127 14.5 141 15.9 Riverside-San Bernardino, Calif. 356 13.2 432 15.5 Rochester, N.Y. 98 9.7 76 7.5 Sacramento, Calif. 199 13.1 296 19.0 Saint Louis, Mo. 333 13.6 290 11.8 Salt Lake City, Utah 89 8.2 129 11.7 San Antonio, Tex. 214 16.1 213 15.8 San Diego, Calif. 598 23.3 641 24.4 San Francisco, Calif. 2,070 128.2 1,920 118.0 San Jose, Calif. 162 10.7 182 11.8 San Juan, P.R. 1,116 65.4 1,053 61.0 Scranton, Pa. 39 5.3 44 6.0 Seattle, Wash. 393 19.6 415 20.3 Springfield, Mass. 103 17.0 93 15.3 Stockton, Calif. 54 10.9 36 7.1 Syracuse, N.Y. 41 6.2 65 9.8 Tacoma, Wash. 54 9.1 36 5.9 Tampa-Saint Petersburg, Fla. 470 22.2 541 25.1 Toledo, Ohio 35 5.7 31 5.1 Tucson, Ariz. 40 5.9 95 13.7 Tulsa, Okla. 59 8.3 69 9.6 Washington, D.C. 1,259 31.5 1,306 32.2 West Palm Beach, Fla. 358 40.1 532 57.8 Wilmington, Del. 61 10.4 109 18.5 Worcester, Mass. 80 11.2 50 6.9 METROPOLITAN AREAS WITH 500,000 OR MORE POPULATION 36,466 24.4 38,273 25.4 METROPOLITAN AREAS WITH 50,000 TO 500,000 POPULATION 4,605 9.5 4,976 10.1 NON-METROPOLITAN AREAS 2,564 4.5 2,980 5.2 TOTAL* 43,806 17.2 46,423 18.0 * Totals include 846 patients whose area of residence is unknown. Table 2. AIDS cases and annual incidence rates per 100,000 population, by metropolitan area with 500,000 or more population, reported October 1990 through September 1991, October 1991 through September 1992; and cumulative totals, by area and age group, through September 1992 (Continued) Cumulative totals METROPOLITAN Adults/ Children AREA OF RESIDENCE adolescents <13 years old Total Akron, Ohio 168 - 168 Albany-Schenectady, N.Y. 495 11 506 Allentown, Pa. 218 6 224 Anaheim, Calif. 2,127 15 2,142 Atlanta, Ga. 5,048 37 5,085 Austin, Tex. 1,092 12 1,104 Bakersfield, Calif. 206 2 208 Baltimore, Md. 2,954 84 3,038 Baton Rouge, La. 338 4 342 Bergen-Passaic, N.J. 1,751 42 1,793 Birmingham, Ala. 468 8 476 Boston, Mass. 3,585 72 3,657 Bridgeport, Conn. 803 25 828 Buffalo, N.Y. 396 3 399 Charleston, S.C. 349 3 352 Charlotte, N.C. 504 9 513 Chicago, Ill. 6,280 94 6,374 Cincinnati, Ohio 533 9 542 Cleveland, Ohio 890 15 905 Columbus, Ohio 739 6 745 Dallas, Tex. 4,054 24 4,078 Dayton, Ohio 341 7 348 Denver, Colo. 1,912 11 1,923 Detroit, Mich. 2,252 40 2,292 El Paso, Tex. 187 1 188 Fort Lauderdale, Fla. 3,995 87 4,082 Fort Worth, Tex. 943 12 955 Fresno, Calif. 334 2 336 Gary, Ind. 164 1 165 Grand Rapids, Mich. 163 2 165 Greensboro, N.C. 446 11 457 Greenville, S.C. 219 - 219 Harrisburg, Pa. 236 5 241 Hartford, Conn. 837 16 853 Honolulu, Hawaii 692 4 696 Houston, Tex. 6,705 69 6,774 Indianapolis, Ind. 747 4 751 Jacksonville, Fla. 1,239 42 1,281 Jersey City, N.J. 2,317 67 2,384 Kansas City, Mo. 1,464 6 1,470 Knoxville, Tenn. 170 1 171 Lake County, Ill. 133 3 136 Las Vegas, Nev. 778 11 789 Little Rock, Ark. 315 7 322 Los Angeles, Calif. 15,852 130 15,982 Louisville, Ky. 348 6 354 Memphis, Tenn. 594 6 600 Miami, Fla. 6,919 215 7,134 Middlesex, N.J. 1,164 28 1,192 Milwaukee, Wis. 557 7 564 Minneapolis-Saint Paul, Minn. 1,067 8 1,075 Monmouth-Ocean City, N.J. 894 31 925 Nashville, Tenn. 577 9 586 Nassau-Suffolk, N.Y. 2,214 54 2,268 New Bedford, Mass. 252 5 257 New Haven, Conn. 885 38 923 New Orleans, La. 2,193 33 2,226 New York, N.Y. 41,750 987 42,737 Newark, N.J. 5,681 173 5,854 Norfolk, Va. 676 17 693 Oakland, Calif. 2,939 21 2,960 Oklahoma City, Okla. 547 1 548 Omaha, Neb. 205 1 206 Orlando, Fla. 1,341 20 1,361 Oxnard-Ventura, Calif. 245 - 245 Philadelphia, Pa. 4,969 74 5,043 Phoenix, Ariz. 1,368 8 1,376 Pittsburgh, Pa. 775 4 779 Portland, Oreg. 1,186 5 1,191 Providence, R.I. 507 8 515 Raleigh-Durham, N.C. 559 13 572 Richmond, Va. 623 12 635 Riverside-San Bernardino, Calif. 1,695 23 1,718 Rochester, N.Y. 496 7 503 Sacramento, Calif. 1,087 13 1,100 Saint Louis, Mo. 1,378 20 1,398 Salt Lake City, Utah 490 11 501 San Antonio, Tex. 1,168 12 1,180 San Diego, Calif. 3,442 23 3,465 San Francisco, Calif. 12,864 22 12,886 San Jose, Calif. 1,016 8 1,024 San Juan, P.R. 4,872 130 5,002 Scranton, Pa. 196 4 200 Seattle, Wash. 2,437 10 2,447 Springfield, Mass. 364 15 379 Stockton, Calif. 197 8 205 Syracuse, N.Y. 250 6 256 Tacoma, Wash. 219 6 225 Tampa-Saint Petersburg, Fla. 2,392 46 2,438 Toledo, Ohio 180 3 183 Tucson, Ariz. 366 3 369 Tulsa, Okla. 312 5 317 Washington, D.C. 6,775 92 6,867 West Palm Beach, Fla. 2,150 93 2,243 Wilmington, Del. 408 5 413 Worcester, Mass. 276 4 280 METROPOLITAN AREAS WITH 500,000 OR MORE POPULATION 201,504 3,373 204,877 METROPOLITAN AREAS WITH 50,000 TO 500,000 POPULATION 22,686 396 23,082 NON-METROPOLITAN AREAS 13,078 263 13,341 TOTAL* 238,095 4,051 242,146 * Totals include 846 patients whose area of residence is unknown. Table 3. AIDS cases by age group, exposure category, and sex, reported October 1990 through September 1991, October 1991 through September 1992; and cumulative totals, by age group and exposure category, through September 1992, United States Males Oct. 1990- Oct. 1991- ADULT/ADOLESCENT Sept 1991 Sept 1992 EXPOSURE CATEGORY No. (%) No. (%) Men who have sex with men 23,555 (62) 23,745 (60) Injecting drug use 8,083 (21) 8,517 (22) Men who have sex with men and inject drugs 2,492 (7) 2,324 (6) Hemophilia/coagulation disorder 295 (1) 324 (1) Heterosexual contact: 1,215 (3) 1,587 (4) Sex with injecting drug user 531 703 Sex with bisexual male - - Sex with person with hemophilia 4 3 Born in Pattern-II* country 311 281 Sex with person born in Pattern-II country 22 11 Sex with transfusion recipient with HIV infection 30 18 Sex with person with HIV infection, risk not specified 317 571 Receipt of blood transfusion, blood components, or tissue** 451 (1) 401 (1) Other/undetermined*** 1,646 (4) 2,666 (7) Adult/adolescent subtotal 37,737 (100) 39,564 (100) PEDIATRIC (<13 years old) EXPOSURE CATEGORY Hemophilia/coagulation disorder 25 (7) 23 (6) Mother with/at risk for HIV infection: 330 (86) 319 (86) Injecting drug use 152 113 Sex with injecting drug user 63 53 Sex with bisexual male 4 7 Sex with person with hemophilia 2 5 Born in Pattern-II country 22 18 Sex with person born in Pattern-II country - 3 Sex with transfusion recipient with HIV infection - 1 Sex with person with HIV infection, risk not specified 22 26 Receipt of blood transfusion, blood components, or tissue 7 11 Has HIV infection, risk not specified 58 82 Receipt of blood transfusion, blood components, or tissue 22 (6) 13 (4) Other/undetermined 7 (2) 14 (4) Pediatric subtotal 384 (100) 369 (100) TOTAL 38,121 39,933 * See technical notes (available only in the printed version of this report) ** Nineteen adults/adolescents and 2 children developed AIDS after receiving blood screened negative for HIV antibody. Five additional adults develope AIDS after receiving tissue or organs from HIV-infected donors. Two of th 5 received tissue or organs from a donor who was negative for HIV antibody at the time of donation. *** "Other" refers to 7 health-care workers who developed AIDS after occupa- tional exposure to HIV-infected blood, as documented by evidence of seroconversion; and to 2 patients who developed AIDS after exposure to HIV within the health-care setting, as documented by laboratory studies. "Undetermined" refers to patients whose mode of exposure to HIV is unknown This includes patients under investigation; patients who died, were lost t follow-up, or refused interview; and patients whose mode of exposure to HI remains undetermined after investigation. Table 3. AIDS cases by age group, exposure category, and sex, reported October 1990 through September 1991, October 1991 through September 1992; and cumulative totals, by age group and exposure category, through September 1992, United States (Continued) Females Oct. 1990- Oct. 1991- ADULT/ADOLESCENT Sept 1991 Sept 1992 EXPOSURE CATEGORY No. (%) No. (%) Men who have sex with men - (0) - (0) Injecting drug use 2,659 (50) 2,711 (44) Men who have sex with men and inject drugs - (0) - (0) Hemophilia/coagulation disorder 6 (0) 6 (0) Heterosexual contact: 1,987 (37) 2,435 (40) Sex with injecting drug user 1,183 1,397 Sex with bisexual male 161 149 Sex with person with hemophilia 20 19 Born in Pattern-II* country 149 166 Sex with person born in Pattern-II country 27 11 Sex with transfusion recipient with HIV infection 53 47 Sex with person with HIV infection, risk not specified 394 646 Receipt of blood transfusion, blood components, or tissue** 252 (5) 271 (4) Other/undetermined*** 458 (9) 711 (12) Adult/adolescent subtotal 5,362 (100) 6,134 (100) PEDIATRIC (<13 years old) EXPOSURE CATEGORY Hemophilia/coagulation disorder 1 (0) - (0) Mother with/at risk for HIV infection: 294 (91) 333 (94) Injecting drug use 124 135 Sex with injecting drug user 65 60 Sex with bisexual male 7 6 Sex with person with hemophilia - 2 Born in Pattern-II country 12 13 Sex with person born in Pattern-II country 2 2 Sex with transfusion recipient with HIV infection 1 3 Sex with person with HIV infection, risk not specified 14 20 Receipt of blood transfusion, blood components, or tissue 6 10 Has HIV infection, risk not specified 63 82 Receipt of blood transfusion, blood components, or tissue 19 (6) 6 (2) Other/undetermined 9 (3) 17 (5) Pediatric subtotal 323 (100) 356 (100) TOTAL 5,685 6,490 * See technical notes (available only in the printed version of this report) ** Nineteen adults/adolescents and 2 children developed AIDS after receiving blood screened negative for HIV antibody. Five additional adults develope AIDS after receiving tissue or organs from HIV-infected donors. Two of th 5 received tissue or organs from a donor who was negative for HIV antibody at the time of donation. *** "Other" refers to 7 health-care workers who developed AIDS after occupa- tional exposure to HIV-infected blood, as documented by evidence of seroconversion; and to 2 patients who developed AIDS after exposure to HIV within the health-care setting, as documented by laboratory studies. "Undetermined" refers to patients whose mode of exposure to HIV is unknown This includes patients under investigation; patients who died, were lost t follow-up, or refused interview; and patients whose mode of exposure to HI remains undetermined after investigation. Table 3. AIDS cases by age group, exposure category, and sex, reported October 1990 through September 1991, October 1991 through September 1992; and cumulative totals, by age group and exposure category, through September 1992, United States (Continued) Totals Oct. 1990- Oct. 1991- Cumulative ADULT/ADOLESCENT Sept 1991 Sept 1992 Total**** EXPOSURE CATEGORY No. (%) No. (%) No. (%) Men who have sex with men 23,555 (55) 23,745 (52) 136,912 (58) Injecting drug use 10,742 (25) 11,228 (25) 54,475 (23) Men who have sex with men and inject drugs 2,492 (6) 2,324 (5) 15,203 (6) Hemophilia/coagulation disorder 301 (1) 330 (1) 1,953 (1) Heterosexual contact: 3,202 (7) 4,022 (9) 15,221 (6) Sex with injecting drug user 1,714 2,100 8,060 Sex with bisexual male 161 149 789 Sex with person with hemophilia 24 22 122 Born in Pattern-II* country 460 447 2,844 Sex with person born in Pattern-II country 49 22 195 Sex with transfusion recipient with HIV infection 83 65 290 Sex with person with HIV infection, risk not specified 711 1,217 2,921 Receipt of blood transfusion, blood components, or tissue** 703 (2) 672 (1) 4,833 (2) Other/undetermined*** 2,104 (5) 3,377 (7) 9,498 (4) Adult/adolescent subtotal 43,099 (100) 45,698 (100) 238,095 (100) PEDIATRIC (<13 years old) EXPOSURE CATEGORY Hemophilia/coagulation disorder 26 (4) 23 (3) 183 (5) Mother with/at risk for HIV infection: 624 (88) 652 (90) 3,480 (86) Injecting drug use 276 248 1,634 Sex with injecting drug user 128 113 704 Sex with bisexual male 11 13 77 Sex with person with hemophilia 2 7 18 Born in Pattern-II country 34 31 271 Sex with person born in Pattern-II country 2 5 17 Sex with transfusion recipient with HIV infection 1 4 17 Sex with person with HIV infection, risk not specified 36 46 176 Receipt of blood transfusion, blood components, or tissue 13 21 75 Has HIV infection, risk not specified 121 164 491 Receipt of blood transfusion, blood components, or tissue 41 (6) 19 (3) 303 (7) Other/undetermined 16 (2) 31 (4) 85 (2) Pediatric subtotal 707 (100) 725 (100) 4,051 (100) TOTAL 43,806 46,423 242,146 * See technical notes (available only in the printed version of this report ** Nineteen adults/adolescents and 2 children developed AIDS after receiving blood screened negative for HIV antibody. Five additional adults develop AIDS after receiving tissue or organs from HIV-infected donors. Two of t 5 received tissue or organs from a donor who was negative for HIV antibod at the time of donation. *** "Other" refers to 6 health-care workers who developed AIDS after occupa- tional exposure to HIV-infected blood, as documented by evidence of seroconversion; and to 2 patients who developed AIDS after exposure to HI within the health-care setting, as documented by laboratory studies. "Undetermined" refers to patients whose mode of exposure to HIV is unknow This includes patients under investigation; patients who died, were lost follow-up, or refused interview; and patients whose mode of exposure to H remains undetermined after investigation. **** Includes 6 patients known to be infected with human immunodeficiency virus type 2 (HIV-2). See "Human Immunodeficiency Virus Type 2 Infection in the United States." O'Brien TR, George JR, Holmberg SD. JAMA, May 27, 1992, Vol. 267, No. 20 pp. 2775-2779. Table 4. AIDS cases by age group, exposure category, and race/ethnicity, reported through September 1992, United States White, not Black, not ADULT/ADOLESCENT Hispanic Hispanic Hispanic EXPOSURE CATEGORY No. (%) No. (%) No. (%) Men who have sex with men 95,317 (75) 24,287 (35) 15,671 (40) Injecting drug use 11,110 (9) 27,410 (39) 15,704 (40) Men who have sex with men and inject drugs 8,666 (7) 4,198 (6) 2,233 (6) Hemophilia/coagulation disorder 1,592 (1) 160 (0) 161 (0) Heterosexual contact: 3,172 (3) 9,008 (13) 2,938 (7) Sex with injecting drug user 1,669 4,275 2,066 Sex with bisexual male 405 268 97 Sex with person with hemophilia 97 15 8 Born in Pattern-II* country 13 2,805 17 Sex with person born in Pattern-II country 53 127 13 Sex with transfusion recipient with HIV infection 173 57 55 Sex with person with HIV infection, risk not specified 762 1,461 682 Receipt of blood transfusion, blood components, or tissue** 3,295 (3) 876 (1) 549 (1) Other/undetermined*** 3,329 (3) 3,853 (6) 2,113 (5) Adult/adolescent subtotal 126,481 (100) 69,792 (100) 39,369 (100) PEDIATRIC (<13 years old) EXPOSURE CATEGORY Hemophilia/coagulation disorder 126 (15) 25 (1) 28 (3) Mother with/at risk for HIV infection: 535 (64) 2,050 (94) 868 (88) Injecting drug use 248 967 409 Sex with injecting drug user 103 320 276 Sex with bisexual male 32 27 17 Sex with person with hemophilia 11 5 2 Born in Pattern-II country 2 266 3 Sex with person born in Pattern-II country - 15 1 Sex with transfusion recipient with HIV infection 5 5 7 Sex with person with HIV infection, risk not specified 37 87 48 Receipt of blood transfusion, blood components, or tissue 23 33 19 Has HIV infection, risk not specified 74 325 86 Receipt of blood transfusion, blood components, or tissue 157 (19) 67 (3) 71 (7) Other/undetermined 18 (2) 50 (2) 17 (2) Pediatric subtotal 836 (100) 2,192 (100) 984 (100) TOTAL 127,317 71,984 40,353 * See technical notes (available only in the printed version of this report) ** Nineteen adults/adolescents and 2 children developed AIDS after receiving blood screened negative for HIV antibody. Five additional adults develope AIDS after receiving tissue or organs from HIV-infected donors. Two of th 5 received tissue or organs from a donor who was negative for HIV antibody at the time of donation. *** "Other" refers to 7 health-care workers who developed AIDS after occupa- tional exposure to HIV-infected blood, as documented by evidence of seroconversion; and to 2 patients who developed AIDS after exposure to HIV within the health-care setting, as documented by laboratory studies. "Undetermined" refers to patients whose mode of exposure to HIV is unknown This includes patients under investigation; patients who died, were lost t follow-up, or refused interview; and patients whose mode of exposure to HI remains undetermined after investigation. Table 4. AIDS cases by age group, exposure category, and race/ethnicity, reported through September 1992, United States (Continued) American Asian/ Indian/ Pacific Alaska ADULT/ADOLESCENT Islander Native Total**** EXPOSURE CATEGORY No. (%) No. (%) No. (%) Men who have sex with men 1,112 (74) 222 (55) 136,912 (58) Injecting drug use 65 (4) 73 (18) 54,475 (23) Men who have sex with men and inject drugs 34 (2) 56 (14) 15,203 (6) Hemophilia/coagulation disorder 23 (2) 9 (2) 1,953 (1) Heterosexual contact: 59 (4) 15 (4) 15,221 (6) Sex with injecting drug user 22 11 8,060 Sex with bisexual male 15 2 789 Sex with person with hemophilia 2 - 122 Born in Pattern-II* country 3 - 2,844 Sex with person born in Pattern-II country 1 - 195 Sex with transfusion recipient with HIV infection 3 - 290 Sex with person with HIV infection, risk not specified 13 2 2,921 Receipt of blood transfusion, blood components, or tissue** 99 (7) 7 (2) 4,833 (2) Other/undetermined*** 114 (8) 22 (5) 9,498 (4) Adult/adolescent subtotal 1,506 (100) 404 (100) 238,095 (100) PEDIATRIC (<13 years old) EXPOSURE CATEGORY Hemophilia/coagulation disorder 3 (16) 1 (8) 183 (5) Mother with/at risk for HIV infection: 9 (47) 11 (92) 3,480 (86) Injecting drug use 3 4 1,634 Sex with injecting drug user 2 1 704 Sex with bisexual male 1 - 77 Sex with person with hemophilia - - 18 Born in Pattern-II country - - 271 Sex with person born in Pattern-II country - - 17 Sex with transfusion recipient with HIV infection - - 17 Sex with person with HIV infection, risk not specified 1 2 176 Receipt of blood transfusion, blood components, or tissue - - 75 Has HIV infection, risk not specified 2 4 491 Receipt of blood transfusion, blood components, or tissue 7 (37) - (0) 303 (7) Other/undetermined - (0) - (0) 85 (2) Pediatric subtotal 19 (100) 12 (100) 4,051 (100) TOTAL 1,525 416 242,146 * See technical notes (available only in the printed version of this report ** Nineteen adults/adolescents and 2 children developed AIDS after receiving blood screened negative for HIV antibody. Five additional adults develop AIDS after receiving tissue or organs from HIV-infected donors. Two of t 5 received tissue or organs from a donor who was negative for HIV antibod at the time of donation. *** "Other" refers to 6 health-care workers who developed AIDS after occupa- tional exposure to HIV-infected blood, as documented by evidence of seroconversion; and to 2 patients who developed AIDS after exposure to HI within the health-care setting, as documented by laboratory studies. "Undetermined" refers to patients whose mode of exposure to HIV is unknow This includes patients under investigation; patients who died, were lost follow-up, or refused interview; and patients whose mode of exposure to H remains undetermined after investigation. **** Includes 551 persons whose race/ethnicity is unknown. Table 5. Adult/adolescent AIDS cases by sex, exposure category, and race/ethnicity, reported through September 1992, United States White, not Black, not MALE Hispanic Hispanic Hispanic EXPOSURE CATEGORY No. (%) No. (%) No. (%) Men who have sex with men 95,317 (79) 24,287 (43) 15,671 (46) Injecting drug use 8,383 (7) 20,000 (36) 13,077 (39) Men who have sex with men and inject drugs 8,666 (7) 4,198 (7) 2,233 (7) Hemophilia/coagulation disorder 1,560 (1) 152 (0) 158 (0) Heterosexual contact: 1,036 (1) 4,138 (7) 786 (2) Sex with injecting drug user 585 1,438 416 Sex with person with hemophilia 7 3 2 Born in Pattern-II* country 9 1,975 10 Sex with person born in Pattern-II country 42 52 10 Sex with transfusion recipient with HIV infection 47 24 22 Sex with person with HIV infection, risk not specified 346 646 326 Receipt of blood transfusion, blood components, or tissue** 2,121 (2) 476 (1) 293 (1) Other/undetermined*** 2,826 (2) 2,830 (5) 1,732 (5) Male subtotal 119,909 (100) 56,081 (100) 33,950 (100) FEMALE EXPOSURE CATEGORY Injecting drug use 2,727 (41) 7,410 (54) 2,627 (48) Hemophilia/coagulation disorder 32 (0) 8 (0) 3 (0) Heterosexual contact: 2,136 (33) 4,870 (36) 2,152 (40) Sex with injecting drug user 1,084 2,837 1,650 Sex with bisexual male 405 268 97 Sex with person with hemophilia 90 12 6 Born in Pattern-II country 4 830 7 Sex with person born in Pattern-II country 11 75 3 Sex with transfusion recipient with HIV infection 126 33 33 Sex with person with HIV infection, risk not specified 416 815 356 Receipt of blood transfusion, blood components, or tissue 1,174 (18) 400 (3) 256 (5) Other/undetermined 503 (8) 1,023 (7) 381 (7) Female subtotal 6,572 (100) 13,711 (100) 5,419 (100) TOTAL 126,481 69,792 39,369 * See technical notes (available only in the printed version of this report) ** Nineteen adults/adolescents and 2 children developed AIDS after receiving blood screened negative for HIV antibody. Five additional adults develope AIDS after receiving tissue or organs from HIV-infected donors. Two of th 5 received tissue or organs from a donor who was negative for HIV antibody at the time of donation. *** "Other" refers to 7 health-care workers who developed AIDS after occupa- tional exposure to HIV-infected blood, as documented by evidence of seroconversion; and to 2 patients who developed AIDS after exposure to HIV within the health-care setting, as documented by laboratory studies. "Undetermined" refers to patients whose mode of exposure to HIV is unknown This includes patients under investigation; patients who died, were lost t follow-up, or refused interview; and patients whose mode of exposure to HI remains undetermined after investigation. Table 5. Adult/adolescent AIDS cases by sex, exposure category, and race/ethnicity, reported through September 1992, United States (Continued) American Asian/ Indian/ Pacific Alaska MALE Islander Native Total**** EXPOSURE CATEGORY No. (%) No. (%) No. (%) Men who have sex with men 1,112 (81) 222 (64) 136,912 (65) Injecting drug use 47 (3) 39 (11) 41,631 (20) Men who have sex with men and inject drugs 34 (2) 56 (16) 15,203 (7) Hemophilia/coagulation disorder 23 (2) 9 (3) 1,910 (1) Heterosexual contact: 12 (1) 4 (1) 5,983 (3) Sex with injecting drug user 6 3 2,448 Sex with person with hemophilia - - 12 Born in Pattern-II* country 3 - 2,003 Sex with person born in Pattern-II country 1 - 105 Sex with transfusion recipient with HIV infection - - 94 Sex with person with HIV infection, risk not specified 2 1 1,321 Receipt of blood transfusion, blood components, or tissue** 59 (4) 2 (1) 2,956 (1) Other/undetermined*** 91 (7) 14 (4) 7,553 (4) Male subtotal 1,378 (100) 346 (100) 212,148 (100) FEMALE EXPOSURE CATEGORY Injecting drug use 18 (14) 34 (59) 12,844 (50) Hemophilia/coagulation disorder - (0) - (0) 43 (0) Heterosexual contact: 47 (37) 11 (19) 9,238 (36) Sex with injecting drug user 16 8 5,612 Sex with bisexual male 15 2 789 Sex with person with hemophilia 2 - 110 Born in Pattern-II country - - 841 Sex with person born in Pattern-II country - - 90 Sex with transfusion recipient with HIV infection 3 - 196 Sex with person with HIV infection, risk not specified 11 1 1,600 Receipt of blood transfusion, blood components, or tissue 40 (31) 5 (9) 1,877 (7) Other/undetermined 23 (18) 8 (14) 1,945 (7) Female subtotal 128 (100) 58 (100) 25,947 (100) TOTAL 1,506 404 238,095 * See technical notes (available only in the printed version of this report ** Nineteen adults/adolescents and 2 children developed AIDS after receiving blood screened negative for HIV antibody. Five additional adults develop AIDS after receiving tissue or organs from HIV-infected donors. Two of t 5 received tissue or organs from a donor who was negative for HIV antibod at the time of donation. *** "Other" refers to 6 health-care workers who developed AIDS after occupa- tional exposure to HIV-infected blood, as documented by evidence of seroconversion; and to 2 patients who developed AIDS after exposure to HI within the health-care setting, as documented by laboratory studies. "Undetermined" refers to patients whose mode of exposure to HIV is unknow This includes patients under investigation; patients who died, were lost follow-up, or refused interview; and patients whose mode of exposure to H remains undetermined after investigation. **** Includes 484 males and 59 females whose race/ethnicity is unknown. Table 6. AIDS cases in adolescents and adults under age 25, by exposure category, reported October 1990 through September 1991, October 1991 through September 1992, and cumulative totals through September 1992, United States 13-19 years old Oct. 1990- Oct. 1991- Cumulative Sept 1991 Sept 1992 Total EXPOSURE CATEGORY No. (%) No. (%) No. (%) Men who have sex with men 33 (20) 32 (20) 222 (24) Injecting drug use 26 (15) 15 (9) 116 (13) Men who have sex with men and inject drugs 6 (4) 5 (3) 38 (4) Hemophilia/coagulation disorder 46 (27) 49 (30) 273 (30) Heterosexual contact: 29 (17) 34 (21) 139 (15) Sex with injecting drug user 22 18 90 Sex with bisexual male - 1 4 Sex with person with hemophilia 2 2 5 Born in Pattern-II* country 1 1 14 Sex with person born in Pattern-II country 2 - 2 Sex with transfusion recipient with HIV infection - - 1 Sex with person with HIV infection, risk not specified 2 12 23 Receipt of blood transfusion, blood components, or tissue 8 (5) 4 (2) 55 (6) Undetermined** 20 (12) 22 (14) 69 (8) TOTAL 168 (100) 161 (100) 912 (100) * See technical notes (available only in the printed version of this report) ** "Undetermined" refers to patients whose mode of exposure to HIV is unknown. This includes patients under investigation; patients who died, were lost to follow-up, or refused interview; and patients whose mode of exposure to HIV remains undetermined after investigation. Table 6. AIDS cases in adolescents and adults under age 25, by exposure category, reported October 1990 through September 1991, October 1991 through September 1992, and cumulative totals through September 1992, United States (Continued) 20-24 years old Oct. 1990- Oct. 1991- Cumulative Sept 1991 Sept 1992 Total EXPOSURE CATEGORY No. (%) No. (%) No. (%) Men who have sex with men 700 (48) 668 (46) 4,986 (54) Injecting drug use 291 (20) 265 (18) 1,598 (17) Men who have sex with men and inject drugs 108 (7) 88 (6) 810 (9) Hemophilia/coagulation disorder 35 (2) 44 (3) 241 (3) Heterosexual contact: 212 (14) 247 (17) 1,072 (12) Sex with injecting drug user 131 128 604 Sex with bisexual male 10 16 74 Sex with person with hemophilia 3 2 19 Born in Pattern-II* country 13 15 136 Sex with person born in Pattern-II country 3 - 11 Sex with transfusion recipient with HIV infection 4 1 11 Sex with person with HIV infection, risk not specified 48 85 217 Receipt of blood transfusion, blood components, or tissue 18 (1) 16 (1) 124 (1) Undetermined** 105 (7) 138 (9) 439 (5) TOTAL 1,469 (100) 1,466 (100) 9,270 (100) * See technical notes (available only in the printed version of this report). ** "Undetermined" refers to patients whose mode of exposure to HIV is unknown. This includes patients under investigation; patients who died, were lost to follow-up, or refused interview; and patients whose mode of exposure to HIV remains undetermined after investigation. Table 7. AIDS cases by sex, age at diagnosis, and race/ethnicity, reported through September 1992, United States White, not Black, not MALE Hispanic Hispanic Hispanic AGE AT DIAGNOSIS (YEARS) No. (%) No. (%) No. (%) Under 5 285 (0) 964 (2) 416 (1) 5-12 215 (0) 147 (0) 116 (0) 13-19 301 (0) 200 (0) 136 (0) 20-24 3,694 (3) 2,350 (4) 1,456 (4) 25-29 17,719 (15) 8,573 (15) 5,639 (16) 30-34 28,028 (23) 13,644 (24) 8,532 (25) 35-39 26,643 (22) 13,315 (23) 7,641 (22) 40-44 18,772 (16) 8,315 (15) 4,918 (14) 45-49 11,089 (9) 4,447 (8) 2,607 (8) 50-54 6,018 (5) 2,465 (4) 1,441 (4) 55-59 3,636 (3) 1,438 (3) 866 (3) 60-64 2,161 (2) 772 (1) 420 (1) 65 or older 1,848 (2) 562 (1) 294 (1) Male subtotal 120,409 (100) 57,192 (100) 34,482(100) FEMALES AGE AT DIAGNOSIS (YEARS) Under 5 269 (4) 939 (6) 370 (6) 5-12 67 (1) 142 (1) 82 (1) 13-19 70 (1) 146 (1) 44 (1) 20-24 420 (6) 850 (6) 404 (7) 25-29 1,219 (18) 2,526 (17) 1,166 (20) 30-34 1,519 (22) 3,698 (25) 1,406 (24) 35-39 1,103 (16) 3,134 (21) 1,125 (19) 40-44 651 (9) 1,659 (11) 602 (10) 45-49 349 (5) 708 (5) 280 (5) 50-54 243 (4) 425 (3) 174 (3) 55-59 254 (4) 241 (2) 98 (2) 60-64 207 (3) 152 (1) 55 (1) 65 or older 537 (8) 172 (1) 65 (1) Female subtotal 6,908 (100) 14,792 (100) 5,871(100) TOTAL 127,317 71,984 40,353 Table 7. AIDS cases by sex, age at diagnosis, and race/ethnicity, reported through September 1992, United States (Continued) American Asian/ Indian/ Pacific Alaska MALE Islander Native Total* AGE AT DIAGNOSIS (YEARS) No. (%) No. (%) No. (%) Under 5 7 (1) 8 (2) 1,682 (1) 5-12 6 (0) 1 (0) 485 (0) 13-19 7 (1) 6 (2) 650 (0) 20-24 49 (4) 17 (5) 7,578 (4) 25-29 189 (14) 73 (21) 32,262 (15) 30-34 280 (20) 94 (26) 50,685 (24) 35-39 302 (22) 69 (19) 48,085 (22) 40-44 230 (17) 44 (12) 32,364 (15) 45-49 155 (11) 21 (6) 18,362 (9) 50-54 72 (5) 8 (2) 10,031 (5) 55-59 46 (3) 6 (2) 6,010 (3) 60-64 15 (1) 7 (2) 3,380 (2) 65 or older 33 (2) 1 (0) 2,741 (1) Male subtotal 1,391 (100) 355 (100) 214,315 (100) FEMALES AGE AT DIAGNOSIS (YEARS) Under 5 - (0) 3 (5) 1,586 (6) 5-12 6 (4) - (0) 298 (1) 13-19 1 (1) 1 (2) 262 (1) 20-24 7 (5) 5 (8) 1,692 (6) 25-29 10 (7) 12 (20) 4,944 (18) 30-34 25 (19) 17 (28) 6,681 (24) 35-39 16 (12) 7 (11) 5,398 (19) 40-44 28 (21) 8 (13) 2,953 (11) 45-49 13 (10) 4 (7) 1,359 (5) 50-54 7 (5) 1 (2) 851 (3) 55-59 6 (4) - (0) 600 (2) 60-64 9 (7) 2 (3) 425 (2) 65 or older 6 (4) 1 (2) 782 (3) Female subtotal 134 (100) 61 (100) 27,831 (100) TOTAL 1,525 416 242,146 * Includes 551 persons whose race/ethnicity is unknown. Table 8. AIDS cases, case-fatality rates, and deaths by half-year and age group, through September 1992, United States Adults/adolescents Cases diagnosed Case-fatality Deaths occuring HALF-YEAR during interval rate during interval Before 1981 81 86.4 30 1981 Jan.-June 92 91.3 39 July-Dec. 205 91.7 87 1982 Jan.-June 399 92.5 153 July-Dec. 696 91.2 289 1983 Jan.-June 1,288 93.6 524 July-Dec. 1,645 93.0 931 1984 Jan.-June 2,569 92.0 1,401 July-Dec. 3,386 92.6 1,963 1985 Jan.-June 4,891 92.1 2,821 July-Dec. 6,319 91.0 3,868 1986 Jan.-June 8,315 89.8 5,086 July-Dec. 9,940 87.4 6,542 1987 Jan.-June 12,928 87.8 7,571 July-Dec. 14,358 84.1 7,947 1988 Jan.-June 16,480 81.2 9,327 July-Dec. 16,961 79.8 10,667 1989 Jan.-June 19,181 74.4 12,381 July-Dec. 19,190 71.4 14,150 1990 Jan.-June 20,375 63.5 13,687 July-Dec. 19,494 56.4 14,467 1991 Jan.-June 20,924 46.0 14,757 July-Dec. 19,600 34.7 15,326 1992 Jan.-June 16,197 20.4 11,788 July-Sep. 2,581 9.9 2,231 TOTAL* 238,095 66.5 158,243 * Death totals include 210 adults/adolescents and 4 children known to have died, but whose dates of death are unknown. Table 8. AIDS cases, case-fatality rates, and deaths by half-year and age group, through September 1992, United States (Continued) Children <13 years old Cases diagnosed Case-fatality Deaths occuring HALF-YEAR during interval rate during interval Before 1981 6 66.7 1 1981 Jan.-June 10 80.0 2 July-Dec. 5 100.0 7 1982 Jan.-June 14 78.6 8 July-Dec. 15 80.0 5 1983 Jan.-June 33 100.0 13 July-Dec. 42 88.1 16 1984 Jan.-June 49 85.7 26 July-Dec. 62 85.5 23 1985 Jan.-June 97 76.3 44 July-Dec. 130 80.0 70 1986 Jan.-June 135 80.0 64 July-Dec. 187 70.1 92 1987 Jan.-June 223 70.4 118 July-Dec. 260 64.2 167 1988 Jan.-June 250 60.4 134 July-Dec. 336 56.8 169 1989 Jan.-June 339 56.3 167 July-Dec. 326 49.7 182 1990 Jan.-June 341 44.3 188 July-Dec. 351 36.2 186 1991 Jan.-June 317 32.2 152 July-Dec. 257 24.5 157 1992 Jan.-June 241 17.4 113 July-Sep. 25 12.0 21 Total1 4,051 52.6 2,129 * Death totals include 210 adults/adolescents and 4 children known to have died, but whose dates of death are unknown. Table 9. AIDS cases by year of diagnosis and definition category, diagnosed through September 1992, United States Year of diagnosis Before Oct. 1988- Oct. 1989 Oct. 1988 Sept 1989 Sept 1990 DEFINITION CATEGORY* No. (%) No. (%) No. (%) Pre-1987 definition 78,623 (84) 26,657 (70) 27,161 (67) 1987 definition: 15,084 (16) 11,377 (30) 13,235 (33) Specific disease presumptively diagnosed 8,340 6,537 8,170 Specific disease definitively diagnosed 1,390 750 838 HIV encephalopathy 1,857 1,347 1,370 HIV wasting syndrome 3,497 2,743 2,857 TOTAL 93,707 (100) 38,034 (100) 40,396 (100) * Persons who meet the criteria for more than one definition category are classified in the definition category listed first. Table 9. AIDS cases by year of diagnosis and definition category, diagnosed through September 1992, United States (Continued) Year of diagnosis Oct. 1990- Oct. 1991- Cumulative Sept 1991 Sept 1992 total DEFINITION CATEGORY* No. (%) No. (%) No. (%) Pre-1987 definition 26,326 (64) 17,345 (60) 176,112 (73) 1987 definition: 15,008 (36) 11,330 (40) 66,034 (27) Specific disease presumptively diagnosed 9,308 6,752 39,107 Specific disease definitively diagnosed 906 625 4,509 HIV encephalopathy 1,425 1,013 7,012 HIV wasting syndrome 3,369 2,940 15,406 TOTAL 41,334 (100) 28,675 (100) 242,146 (100) * Persons who meet the criteria for more than one definition category are classified in the definition category listed first. Table 10. Health-care workers with HIV infection and/or AIDS, with documented and possible occupationally acquired HIV infection, by occupation, reported through June 1992, United States* Documented Possible occupational occupational transmission** transmission*** Occupation No. No. Dental worker, including dentist - 6 Embalmer/morgue technician - 3 Emergency medical technician/paramedic - 7 Health aide/attendant 1 5 Housekeeper/maintenance worker 1 5 Laboratory technician, clinical 11 10 Laboratory technician, nonclinical 1 1 Nurse 12 12 Physician, nonsurgical 4 7 Physician, surgical - 2 Respiratory therapist 1 1 Surgical technician - 1 Technician/therapist, other than those listed above - 3 Other health care occupations - 2 Total 31 65 * Health-care workers are defined as those persons, including students and trainees, who have worked in a health-care, clinical, or HIV laboratory setting at any time since 1978. ** Health-care workers who had documented HIV seroconversion after occupation exposure: 26 had percutaneous exposure, 4 had mucocutaneous exposure, 1 ha both percutaneous and mucocutaneous exposures. Twenty-nine exposures were to HIV-infected blood, 1 to an unspecified fluid and 1 to concentrated virus in a laboratory. Six have developed AIDS. *** These health-care workers have been investigated and are without identifiable behavioral or transfusion risks; each reported percutaneous o mucocutaneous occupational exposures to blood or body fluids, or laborator specimens containing HIV, but HIV seroconversion was not documented. Table 11. Adult/adolescent AIDS cases by single and multiple exposure categories reported through September 1992, United States AIDS cases EXPOSURE CATEGORY No. (%) Men who have sex with men 131,839 (55) Injecting drug use 46,354 (19) Hemophilia/coagulation disorder 1,318 (1) Heterosexual contact 14,643 (6) Receipt of blood transfusion, blood component, or tissue* 4,833 (2) Other/undetermined** 9,498 (4) SINGLE MODE OF EXPOSURE SUBTOTAL 208,485 (88) MULTIPLE MODES OF EXPOSURE Men who have sex with men; injecting drug use 13,620 (6) Men who have sex with men; hemophilia 57 (0) Men who have sex with men; heterosexual contact 2,777 (1) Men who have sex with men; receipt of transfusion 2,080 (1) Injecting drug use; hemophilia 57 (0) Injecting drug use; heterosexual contact 6,833 (3) Injecting drug use; receipt of transfusion 901 (0) Hemophilia; heterosexual contact 10 (0) Hemophilia; receipt of transfusion 612 (0) Heterosexual contact; receipt of transfusion 578 (0) Men who have sex with men; injecting drug use; hemophilia 16 (0) Men who have sex with men; injecting drug use; heterosexual contact 1,192 (1) Men who have sex with men; injecting drug use; receipt of transfusion 320 (0) Men who have sex with men; hemophilia; heterosexual contact 4 (0) Men who have sex with men; hemophilia; receipt of transfusion 25 (0) Men who have sex with men; heterosexual contact; receipt of transfusion 130 (0) Injecting drug use; hemophilia; heterosexual contact 12 (0) Injecting drug use; hemophilia; receipt of transfusion 23 (0) Injecting drug use; heterosexual contact; receipt of transfusion 287 (0) Hemophilia; heterosexual contact; receipt of transfusion 13 (0) Men who have sex with men; injecting drug use; hemophilia; heterosexual contact 2 (0) Men who have sex with men; injecting drug use; heterosexual contact; receipt of transfusion 5 (0) Injecting drug use; hemophilia; heterosexual contact; receipt of transfusion 48 (0) MULTIPLE MODES of EXPOSURE SUBTOTAL 29,610 ( 12) TOTAL 238,095 (100) * Nineteen adults/adolescents and 2 children developed AIDS after receiving blood screened negative for HIV antibody. Five additional adults develope AIDS after receiving tissue or organs from HIV-infected donors. Two of th 5 received tissue or organs from a donor who was negative for HIV antibody at the time of donation. ** "Other" refers to 7 health-care workers who developed AIDS after occupa- tional exposure to HIV-infected blood, as documented by evidence of seroconversion; and to 2 patients who developed AIDS after exposure to HIV within the health-care setting, as documented by laboratory studies. "Undetermined" refers to patients whose mode of exposure to HIV is unknown This includes patients under investigation; patients who died, were lost t follow-up, or refused interview; and patients whose mode of exposure to HI remains undetermined after investigation. TECHNICAL NOTES: HIV/AIDS SURVEILLANCE REPORT Surveillance and Reporting of AIDS All 50 states, the District of Columbia, U.S dependencies and possessions, and independent nations in free association with the U.S. (1) report AIDS cases to CDC using a uniform case definition and case report form. The original definition was modified in 1985 (MMWR 1985;34:373-5) and again in 1987 (MMWR 1987;36 [suppl. no. 1S]:1S-15S). The revisions incorporated a broader range of AIDS indicator diseases and conditions and used human immunodeficiency virus (HIV) diagnostic tests to improve the sensitivity and specificity of the definition. For persons with laboratory- confirmed HIV infection, the 1987 revision incorporated HIV encephalopathy, wasting syndrome, and other indicator diseases that are diagnosed presumptively (i.e., without confirmatory laboratory evidence of the opportunistic disease). AIDS cases that meet the criteria of both the pre- 1987 and 1987 definitions are classified in the pre-1987 definition category. Compared with patients who meet the pre-1987 case definition, a higher proportion of patients who meet only the 1987 case definition were female, black, or Hispanic, or were intravenous drug users (MMWR 1989;38:229- 36). Each issue of this update includes information received and tabulated by CDC through the last day of the previous month. Data are tabulated by date of report to CDC unless otherwise noted. Data for U.S. dependencies and possessions and for associated independent nations are included in the totals. Age group tabulations are based on the person's age at diagnosis of AIDS: adult/adolescent cases include persons 13 years of age and older; pediatric cases include children under 13 years of age. Age group tabulations in Table 13 (only included in the year-end edition) are based on age at death. Metropolitan areas are defined as the Metropolitan Statistical Areas (MSA) for all areas except the 6 New England states. For these states, the New England County Metropolitan Areas (NECMA) are used. Metropolitan areas are named for a central city in the MSA or NECMA, may include several cities and counties, and may cross state boundaries. For example, AIDS cases and annual rates presented for the District of Columbia in Table 1 include only persons residing within the geographic boundaries of the District. AIDS cases and annual rates for Washington, D.C., in Table 2 include persons residing within several counties in the metropolitan area. State or metropolitan data tabulations are based on the person's residence at diagnosis of the first AIDS-indicator disease(s). The cities and counties which comprise each metropolitan area in Table 2 are listed in the Bureau of Census publication, "State and Metropolitan Area Data Book, 1986." Data in this report are provisional. Fifty percent of patients are reported to CDC within 3 months of diagnosis. However, reporting delays vary widely and have been as long as several years for some cases. The median delay in reporting appears to have increased, from about 2 months in 1982 to about 3 months in 1988; however, recent analyses suggests that reporting delay may be decreasing. Completeness of reporting of diagnosed cases to state and local health departments varies by geographic region and patient population; however, mortality studies suggest that 70 to 90 percent of HIV-related deaths in men 25-44 years old are identified through national surveillance of AIDS (MMWR 1989;38:561-3). In addition, multiple routes of exposure, opportunistic diseases diagnosed after the initial case report was submitted to CDC, and vital status may not be determined or reported for all cases. Caution should be used in interpreting case-fatality rates because reporting of deaths is known to be incomplete. Exposure Categories For surveillance purposes, AIDS cases are counted only once in a hierarchy of exposure categories. Persons with more than one reported mode of exposure to HIV are classified in the exposure category listed first in the hierarchy, except for persons with a history of both homosexual/bisexual contact and intravenous drug use. They make up a separate exposure category. "Homosexual/bisexual contact" cases include men who report sexual contact with other men. "Heterosexual contact" cases include persons who report either specific heterosexual contact with a person with, or at increased risk for, HIV infection (e.g., an intravenous drug user), or persons presumed to have acquired HIV infection through heterosexual contact because they were born in countries with a distinctive pattern of transmission termed "Pattern II" by the World Health Organization (MMWR 1988;37:286-8, 293-5). Pattern II transmission is observed in areas of sub-Saharan Africa and in some Caribbean countries. In these countries, most of the reported cases occur in heterosexuals and the male-to-female ratio is approximately 1:1. Intravenous drug use and homosexual transmission either do not occur or occur at a low level. "Undetermined" cases are persons with no reported history of exposure to HIV through any of the routes listed in the hierarchy of exposure categories. Undetermined cases include persons who are currently under investigation by local health department officials; persons whose exposure history is incomplete because of death, refusal to be interviewed, or loss to follow-up; and persons who were interviewed or for whom follow-up information was available and no exposure mode was identified. Persons who have an exposure mode identified at the time of follow-up are reclassified into the appropriate exposure category. Rates Rates are on an annual basis per 100,000 population. The denominator for computing rates in Table 1 and Table 2 are extrapolations based on U.S. Bureau of Census data from the 1980 census and from 1988 post-census estimates. Each 12-month rate is the number of cases for a 12 month period divided by the 1989 or 1990 extrapolation, multiplied by 100,000. The denominators for computing race-specific rates (Table 9, included only in the year-end edition) are based on 1990 census projections published in U.S. Bureau of Census publications, "Projections of the Population of the United States, by Age, Sex, and Race, 1988 to 2080," and "Projections of the Hispanic Population, 1983 to 2080." Race-specific rates are the number of cases reported for a particular race/ethnicity during the preceding 12- month period divided by the 1990 census projection for that race/ethnicity, multiplied by 100,000. Case-fatality rates are on a semiannual basis by date of diagnosis. Each 6- month case-fatality rate is the number of fatal cases reported, divided by the number of total cases, diagnosed in that period, multiplied by 100. Trends in AIDS Incidence Tabulations of AIDS cases by date of report give a general description of AIDS cases, but analyses by date of diagnosis give a more accurate description of trends. Delays in reporting, however, can have a substantial impact on tabulated numbers of cases diagnosed in recent time periods. About half of all cases are reported within 3 months of diagnosis, but about 15% are reported more than 1 year after diagnosis. Delays are substantially longer for pediatric cases and for transfusion-associated cases in adults. Figure 5 (included only in the year-end edition report) shows trends in AIDS incidence by month of diagnosis. The points on the plot show the estimated numbers of cases diagnosed, after adjusting for estimated reporting delays. The smooth curve is computed using the Lowess procedure (J.M. Chaber, W.S. Cleveland, B. Kleiner, and P.A. Tukey. "Graphical Methods for Data Analysis." Duxbury Press, Boston, 1983, Chapter 4). Reporting delays were estimated by a maximum likelihood statistical procedure for each HIV exposure category (J.M. Karon, O.J. Devine, and W.M. Morgan "Predicting AIDS incidence by extrapolating from recent trends." In: C. Castillo-Chavex, ed. "Mathematical and Statistical Approaches to AIDS Epidemiology. Lecture Notes in Biomathematics," vol. 83, Springer Verlag, Berlin, 1989). The adjusted incidence used in Figure 5 is the sum of the adjusted incidences for each HIV exposure group. The Lowess procedure makes no assumption about the overall trends in the data. A fitted value is computed for each month by weighted least squares regression using only the adjusted number of cases diagnosed during an interval about the month (in Figure 5, the 30% of months closest to the chosen month); the weights decrease for times further from the chosen month. The procedure assumes that incidence during the interval about each month is approximately a linear function of time. Lowess tends to produce a curve that is linear at each end, as observed in the figure; predictions of future numbers of cases should not be made by extrapolating the Lowest curve. The Lowess curve should be considered a description of the overall trend in AIDS cases. This curve emphasizes that the rate of increase in incidence slowed during the middle of 1987. See MMWR 1990:39:81-86. (1) Included among the dependencies, possessions, and independent nations are Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, the Republic of Palau, the Republic of the Marshall Islands, the Commonwealth of the Northern Mariana Islands, and the Federated States of Micronesia. The latter 5 comprise the category "Pacific Islands, U.S." listed in Table 1. ======================================================================== NixPix Windy City (NixPix Net HQ) 708 564 1754 NixPix Central (the original Nick) 303 920 1263 NixPix Sweden 011 46 40 110590 NixPix Austria 011 43 7719 8871 NixPix Finland 011 358 0 298 3390 Remember -- fun and communication is what we're all about! ==========================================================================