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HIV/AIDS Surveillance Report Monday November 1, 1993 Suggested Citation: Centers for Disease Control and Prevention. HIV/AIDS Surveillance Report, November 1993 Report Description The U.S. AIDS case data presented below are extracted from the "HIV/AIDS/ Survillance Report", published each quarter by the Division of HIV/AIDS, Center for Infectious Diseases, Centers for Disease Control and Prevention, 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 from: CDC National AIDS Clearinghouse P.O. Box 6003 Rockville, MD 20849-6003 Table 1. AIDS cases and annual rates per 100,000 population, by state, reported October 1991 through September 1992, October 1992 through September 1993;(1) and cumulative totals, by state and age group, through September 1993,(2) United States Oct. 1991- Oct. 1992- Sept. 1992 Sep. 1993 State of residence No. Rate No. Rate Alabama 465 11.4 705 17.0 Alaska 18 3.2 60 10.2 Arizona 408 10.9 1,202 31.3 Arkansas 237 10.0 420 17.5 California 8,641 28.4 17,474 56.4 Colorado 415 12.3 1,193 34.5 Connecticut 538 16.3 1,693 51.4 Delaware 126 18.5 346 49.9 District of Columbia 724 121.0 1,370 232.3 Florida 5,007 37.7 9,613 70.6 Georgia 1,348 20.4 2,597 38.4 Hawaii 175 15.4 324 27.9 Idaho 36 3.5 71 6.6 Illinois 1,842 16.0 3,005 25.8 Indiana 370 6.6 831 14.6 Iowa 86 3.1 196 7.0 Kansas 188 7.5 335 13.3 Kentucky 207 5.6 316 8.4 Louisiana 829 19.5 1,172 27.4 Maine 50 4.0 126 10.2 Maryland 1,096 22.6 2,353 47.6 Massachusetts 767 12.8 2,532 42.4 Michigan 784 8.4 1,752 18.6 Minnesota 237 5.3 624 13.9 Mississippi 231 8.9 468 17.9 Missouri 650 12.6 1,679 32.3 Montana 22 2.7 35 4.3 Nebraska 68 4.3 179 11.1 Nevada 235 18.3 601 44.0 New Hampshire 48 4.3 99 9.0 New Jersey 2,051 26.4 4,390 56.3 New Mexico 90 5.8 307 19.4 New York 8,232 45.6 16,031 88.4 North Carolina 648 9.6 1,059 15.5 North Dakota 4 0.6 4 0.6 Ohio 696 6.4 1,490 13.5 Oklahoma 228 7.2 716 22.3 Oregon 283 9.7 732 24.4 Pennsylvania 1,338 11.2 2,556 21.2 Rhode Island 102 10.2 305 30.3 South Carolina 347 9.7 1,395 38.4 South Dakota 8 1.1 23 3.2 Tennessee 442 8.9 967 19.2 Texas 2,944 17.0 7,164 40.4 Utah 145 8.2 270 14.9 Vermont 26 4.6 60 10.5 Virginia 606 9.6 1,590 24.9 Washington 573 11.4 1,459 28.2 West Virginia 61 3.4 78 4.3 Wisconsin 224 4.5 700 13.9 Wyoming 4 0.9 36 7.7 Subtotal 44,900 17.8 94,703 37.0 Guam 1 0.7 2 1.5 Pacific Islands, U.S. - - - - Puerto Rico 1,796 50.5 2,621 73.1 Virgin Islands, U.S. 19 18.6 42 40.8 Total 46,716 18.2 97,368 37.5 Cumulative totals Adults/ Children adolescents < 13 years old Total Alabama 2,275 43 2,318 Alaska 154 2 156 Arizona 3,059 14 3,073 Arkansas 1,239 21 1,260 California 62,201 356 62,557 Colorado 3,516 18 3,534 Connecticu 4,415 98 4,513 Delaware 830 7 837 District of Columbia 5,231 78 5,309 Florida 32,008 751 32,759 Georgia 9,255 87 9,342 Hawaii 1,250 10 1,260 Idaho 203 2 205 Illinois 10,522 140 10,662 Indiana 2,443 17 2,460 Iowa 577 6 583 Kansas 1,031 5 1,036 Kentucky 1,148 13 1,161 Louisiana 4,811 67 4,878 Maine 427 4 431 Maryland 7,187 152 7,339 Massachusetts 7,238 132 7,370 Michigan 4,904 62 4,966 Minnesota 1,829 13 1,842 Mississippi 1,483 20 1,503 Missouri 4,626 33 4,659 Montana 134 2 136 Nebraska 469 4 473 Nevada 1,641 15 1,656 New Hampshire 368 6 374 New Jersey 18,106 423 18,529 New Mexico 831 2 833 New York 63,660 1,321 64,981 North Carolina 3,735 75 3,810 North Dakota 32 - 32 Ohio 4,944 68 5,012 Oklahoma 1,795 15 1,810 Oregon 2,233 9 2,242 Pennsylvania 9,086 120 9,206 Rhode Island 842 9 851 South Carolina 3,022 38 3,060 South Dakota 57 2 59 Tennessee 2,734 26 2,760 Texas 23,572 213 23,785 Utah 818 20 838 Vermont 176 2 178 Virginia 4,710 82 4,792 Washington 4,765 18 4,783 West Virginia 359 5 364 Wisconsin 1,705 19 1,724 Wyoming 91 - 91 Subtotal 323,747 4,645 328,392 Guam 12 - 12 Pacific Islands, U.S 2 - 2 Puerto Rico 10,436 256 10,692 Virgin Islands, U.S. 147 5 152 Total 334,344 4,906 339,250 (1) Includes 9 months of data collected under the 1993 AIDS surveillance case definition for adults and adolescents. (2) During the third quarter of 1993, CDC received reports of 23,664 cases and 9,951 deaths among adults/adolescents and 196 cases and 105 deaths among children. Table 2. AIDS cases and annual rates per 100,000 population, by metropolitan area with 500,000 or more population, reported October 1991 through September 1992, October 1992 through September 1993;1) and cumulative totals, by area and age group, through September 1993, United States Oct. 1991- Oct. 1992- Sept. 1992 Sept. 1993 Metropolitan area of residence(2) No. Rate No. Rate Akron, Ohio 36 5.4 46 6.9 Albany-Schenectady, N.Y. 106 12.2 217 24.7 Albuquerque, N.M. 58 9.6 186 30.2 Allentown, Pa. 32 5.3 122 20.0 Ann Arbor, Mich. 29 5.8 63 12.4 Atlanta, Ga. 956 31.3 1,773 56.4 Austin, Tex. 241 27.6 586 65.0 Bakersfield, Calif. 50 8.8 161 27.3 Baltimore, Md. 669 27.7 1,628 66.6 Baton Rouge, La. 92 17.1 135 24.7 Bergen-Passaic, N.J. 267 20.9 677 52.8 Birmingham, Ala. 116 13.7 259 30.2 Boston, Mass. 659 11.6 2,268 40.2 Buffalo, N.Y. 69 5.8 198 16.5 Charleston, S.C. 70 13.4 259 47.9 Charlotte, N.C. 118 9.9 245 20.1 Chicago, Ill. 1,614 21.5 2,619 34.5 Cincinnati, Ohio 112 7.3 230 14.7 Cleveland, Ohio 199 9.0 458 20.6 Columbus, Ohio 158 11.5 336 24.1 Dallas, Tex. 759 27.7 1,805 64.4 Dayton, Ohio 67 7.0 132 13.7 Denver, Colo. 335 20.1 1,010 58.9 Detroit, Mich. 606 14.1 1,233 28.7 El Paso, Tex. 46 7.5 116 18.3 Fort Lauderdale, Fla. 848 65.9 1,165 88.4 Fort Worth, Tex. 160 11.5 404 28.2 Fresno, Calif. 99 12.7 173 21.5 Gary, Ind. 47 7.7 78 12.6 Grand Rapids, Mich. 37 3.9 126 13.0 Greensboro, N.C. 128 12.0 151 14.0 Greenville, S.C. 62 7.4 255 29.8 Harrisburg, Pa. 46 7.7 78 12.9 Hartford, Conn. 167 14.8 565 50.2 Honolulu, Hawaii 124 14.6 256 29.6 Houston, Tex. 1,023 29.8 2,587 72.8 Indianapolis, Ind. 170 12.1 397 27.7 Jacksonville, Fla. 327 35.0 910 94.7 Jersey City, N.J. 313 56.6 619 111.8 Kansas City, Mo. 314 19.6 736 45.4 Knoxville, Tenn. 35 5.8 78 12.7 Las Vegas, Nev. 180 19.5 468 46.9 Little Rock, Ark. 82 15.8 171 32.6 Los Angeles, Calif. 3,327 37.1 5,557 61.1 Louisville, Ky. 90 9.4 166 17.2 Memphis, Tenn. 174 17.1 414 40.1 Miami, Fla. 1,324 67.0 2,423 120.1 Middlesex, N.J. 217 21.1 354 34.2 Milwaukee, Wis. 127 8.8 361 24.8 Minneapolis-Saint Paul, Min. 204 7.9 550 20.9 Monmouth-Ocean City, N.J. 111 11.1 366 36.4 Nashville, Tenn. 125 12.5 269 26.3 Nassau-Suffolk, N.Y. 370 14.1 1,010 38.4 New Haven, Conn. 318 19.5 987 60.4 New Orleans, La. 476 36.8 612 46.9 New York, N.Y. 7,163 83.8 13,288 155.3 Newark, N.J. 838 43.8 1,540 80.6 Norfolk, Va. 105 7.2 325 21.9 Oakland, Calif. 563 26.7 1,225 57.2 Oklahoma City, Okla. 113 11.6 310 31.5 Omaha, Neb. 49 7.5 136 20.6 Orange County, Calif. 553 22.6 717 29.0 Orlando, Fla. 331 26.1 870 66.3 Philadelphia, Pa. 1,005 20.3 2,110 42.5 Phoenix, Ariz. 292 12.8 863 36.9 Pittsburgh, Pa. 148 6.2 214 8.9 Portland, Oreg. 249 15.9 655 40.3 Providence, R.I. 96 10.5 285 31.1 Raleigh-Durham, N.C. 128 14.5 189 20.8 Richmond, Va. 140 15.9 385 42.9 Riverside-San Bernardino, Calif. 435 16.0 1,045 36.6 Rochester, N.Y. 76 7.1 243 22.4 Sacramento, Calif. 287 20.7 453 31.5 Saint Louis, Mo. 290 11.6 841 33.3 Salt Lake City, Utah 129 11.7 241 21.3 San Antonio, Tex. 217 16.1 426 31.1 San Diego, Calif. 631 24.8 1,474 56.7 San Francisco, Calif. 1,896 116.9 4,592 279.8 San Jose, Calif. 183 12.2 502 33.2 San Juan, P.R. 1,075 57.9 1,638 87.3 Sarasota, Fla. 90 18.0 148 28.9 Scranton, Pa. 26 4.1 54 8.4 Seattle, Wash. 424 20.4 1,043 49.1 Springfield, Mass. 92 15.3 210 35.0 Stockton, Calif. 34 6.9 109 21.6 Syracuse, N.Y. 71 9.5 168 22.2 Tacoma, Wash. 38 6.3 137 21.9 Tampa-Saint Petersburg, Fla. 535 25.5 1,421 66.6 Toledo, Ohio 33 5.4 90 14.6 Tucson, Ariz. 93 13.7 258 37.6 Tulsa, Okla. 70 9.7 236 32.1 Ventura, Calif. 73 10.8 130 19.0 Washington, D.C. 1,345 31.3 2,560 58.7 West Palm Beach, Fla. 529 59.7 787 86.5 Wichita, Kansas 62 12.6 96 19.2 Wilmington, Del. 93 17.8 261 49.1 Youngstown, Ohio 23 3.8 29 4.8 Metropolitan areas with 500,000 or more population 39,112 24.8 81,352 50.9 Metropolitan areas with 50,000 to 500,000 population 4,821 10.5 10,306 22.0 Non-metropolitan areas 2,587 4.9 5,288 10.0 Total (3) 46,716 18.2 97,368 37.5 Cumulative totals Adults/ Children Area of residence(2) adolescents < 13 years old Total Akron, Ohio 214 - 214 Albany-Schenectady, N.Y. 672 14 686 Albuquerque, N.M. 490 1 491 Allentown, Pa. 314 4 318 Ann Arbor, Mich. 194 4 198 Atlanta, Ga. 6,836 43 6,879 Austin, Tex. 1,705 14 1,719 Bakersfield, Calif. 357 3 360 Baltimore, Md. 4,548 113 4,661 Baton Rouge, La. 469 7 476 Bergen-Passaic, N.J. 2,425 51 2,476 Birmingham, Ala. 716 11 727 Boston, Mass. 6,510 117 6,627 Buffalo, N.Y. 653 8 661 Charleston, S.C. 611 5 616 Charlotte, N.C. 747 10 757 Chicago, Ill. 9,251 125 9,376 Cincinnati, Ohio 768 11 779 Cleveland, Ohio 1,414 27 1,441 Columbus, Ohio 1,085 6 1,091 Dallas, Tex. 5,867 24 5,891 Dayton, Ohio 481 8 489 Denver, Colo. 2,918 13 2,931 Detroit, Mich. 3,484 45 3,529 El Paso, Tex. 303 1 304 Fort Lauderdale, Fla. 5,114 109 5,223 Fort Worth, Tex. 1,350 15 1,365 Fresno, Calif. 519 4 523 Gary, Ind. 240 2 242 Grand Rapids, Mich. 326 3 329 Greensboro, N.C. 631 11 642 Greenville, S.C. 521 2 523 Harrisburg, Pa. 313 6 319 Hartford, Conn. 1,397 17 1,414 Honolulu, Hawaii 946 6 952 Houston, Tex. 9,225 87 9,312 Indianapolis, Ind. 1,178 5 1,183 Jacksonville, Fla. 2,140 49 2,189 Jersey City, N.J. 2,933 68 3,001 Kansas City, Mo. 2,197 9 2,206 Knoxville, Tenn. 238 2 240 Las Vegas, Nev. 1,260 14 1,274 Little Rock, Ark. 485 9 494 Los Angeles, Calif. 21,704 146 21,850 Louisville, Ky. 509 8 517 Memphis, Tenn. 1,007 9 1,016 Miami, Fla. 9,303 260 9,563 Middlesex, N.J. 1,515 33 1,548 Milwaukee, Wis. 914 12 926 Minneapolis-Saint Paul, Minn. 1,619 10 1,629 Monmouth-Ocean City, N.J. 1,253 35 1,288 Nashville, Tenn. 844 10 854 Nassau-Suffolk, N.Y. 3,200 66 3,266 New Haven, Conn. 2,654 77 2,731 New Orleans, La. 2,868 37 2,905 New York, N.Y. 54,716 1,183 55,899 Newark, N.J. 7,229 184 7,413 Norfolk, Va. 1,006 22 1,028 Oakland, Calif. 4,138 26 4,164 Oklahoma City, Okla. 825 1 826 Omaha, Neb. 343 1 344 Orange County, Calif. 2,811 21 2,832 Orlando, Fla. 2,249 42 2,291 Philadelphia, Pa. 7,082 87 7,169 Phoenix, Ariz. 2,236 9 2,245 Pittsburgh, Pa. 1,026 6 1,032 Portland, Oreg. 943 6 1,949 Providence, R.I. 791 8 799 Raleigh-Durham, N.C. 787 18 805 Richmond, Va. 1,006 13 1,019 Riverside-San Bernardino, Calif. 2,727 27 2,754 Rochester, N.Y. 742 8 750 Sacramento, Calif. 1,490 14 1,504 Saint Louis, Mo. 2,224 21 2,245 Salt Lake City, Utah 726 14 740 San Antonio, Tex. 1,591 14 1,605 San Diego, Calif. 4,877 32 4,909 San Francisco, Calif. 17,397 27 17,424 San Jose, Calif. 1,514 11 1,525 San Juan, P.R. 6,577 168 6,745 Sarasota, Fla. 570 12 582 Scranton, Pa. 188 3 191 Seattle, Wash. 3,536 10 3,546 Springfield, Mass. 574 15 589 Stockton, Calif. 307 8 315 Syracuse, N.Y. 497 6 503 Tacoma, Wash. 360 7 367 Tampa-Saint Petersburg, Fla. 3,781 53 3,834 Toledo, Ohio 271 4 275 Tucson, Ariz. 619 5 624 Tulsa, Okla. 549 5 554 Ventura, Calif. 378 1 379 Washington, D.C. 9,366 138 9,504 West Palm Beach, Fla. 2,916 107 3,023 Wichita, Kansas 276 2 278 Wilmington, Del. 617 6 623 Youngstown, Ohio 148 - 148 Metropolitan areas with 500,000 or more population 284,441 4,131 288,572 Metropolitan areas with 50,000 500,000 population 31,977 485 32,462 Non-metropolitan areas 16,621 268 16,889 Total (3) 334,344 4,906 339,250 1 Includes 9 months of data collected under the 1993 AIDS surveillance case definition for adults and adolescents. 2 Based on Metropolitan Statistical Areas (MSA) revised June 1993. 3 Totals include 1,327 persons whose area of residence is unknown. Table 3. AIDS cases by age group, exposure category, and sex, reported October 1991 through September 1992, October 1992 through September 1993;(1) and cumulative totals, by age group and exposure category, through September 1993, United States Males Oct. 1991- Oct. 1992- Sept. 1992 Sept. 1993 Adult/adolescent exposure category No. (%) No. (%) Men who have sex with men 24,334 (61) 46,025 (56) Injecting drug use 8,621 (22) 19,142 (23) Men who have sex with men and inject drugs 2,638 ( 7) 5,353 ( 7) Hemophilia/coagulation disorder 317 ( 1) 990 ( 1) Heterosexual contact: 1,613 ( 4) 3,328 ( 4) Sex with injecting drug user 703 1,102 Sex with bisexual male - - Sex with person with hemophilia 3 10 Born in Pattern-II(3) country 271 607 Sex with person born in Pattern-II country 14 43 Sex with transfusion recipient with HIV infection 18 59 Sex with HIV-infected person, risk not specified 604 1,507 Receipt of blood transfusion, blood components, or tissue(4) 385 ( 1) 695 ( 1) Other/risk not identified(5) 1,925 ( 5) 6,174 ( 8) Adult/adolescent subtotal 39,833 (100) 81,707 (100) Pediatric (< 13 years old) exposure category Hemophilia/coagulation disorder 23 ( 6) 18 ( 4) Mother with/at risk for HIV infection: 329 (89) 397 (91) Injecting drug use 114 126 Sex with injecting drug user 54 68 Sex with bisexual male 7 5 Sex with person with hemophilia 5 1 Born in Pattern-II country 19 22 Sex with person born in Pattern-II country 3 3 Sex with transfusion recipient with HIV infection 1 1 Sex with HIV-infected person, risk not specified 31 45 Receipt of blood transfusion, blood components, or tissue 12 16 Has HIV infection, risk not specified 83 110 Receipt of blood transfusion, blood components, or tissue 12 ( 3) 15 ( 3) Risk not identified 5 ( 1) 7 ( 2) Pediatric subtotal 369 (100) 437 (100) Total 40,202 82,144 Females Oct. 1991- Oct. 1992- Sept. 1992 Sept. 1993 Adult/adolescent exposure category No. (%) No. (%) Men who have sex with men - - Injecting drug use 2,815 (46) 6,891 (47) Men who have sex with men and inject drugs - - Hemophilia/coagulation disorder 6 ( 0) 27 ( 0) Heterosexual contact: 2,588 (42) 5,545 (37) Sex with injecting drug user 1,474 2,474 Sex with bisexual male 177 423 Sex with person with hemophilia 20 61 Born in Pattern-II(3) country 165 324 Sex with person born in Pattern-II country 15 31 Sex with transfusion recipient with HIV infection 49 101 Sex with HIV-infected person, risk not specified 688 2,131 Receipt of blood transfusion, blood components, or tissue(4) 278 ( 5) 496 ( 3) Other/risk not identified(5) 466 ( 8) 1,833 (12) Adult/adolescent subtotal 6,153 (100) 14,792 (100) Pediatric (< 13 years old) exposure category Hemophilia/coagulation disorder - - Mother with/at risk for HIV infection: 347 (96) 417 (97) Injecting drug use 144 138 Sex with injecting drug user 62 65 Sex with bisexual male 8 4 Sex with person with hemophilia 2 2 Born in Pattern-II country 12 15 Sex with person born in Pattern-II country 2 2 Sex with transfusion recipient with HIV infection 3 2 Sex with HIV-infected person, risk not specified 21 51 Receipt of blood transfusion, blood components, or tissue 10 7 Has HIV infection, risk not specified 83 131 Receipt of blood transfusion, blood components, or tissue 6 ( 2) 9 (2) Risk not identified 8 ( 2) 6 (1) Pediatric subtotal 361 (100) 432 (100) Total 6,514 15,224 Totals Oct. 1991- Oct. 1992- Cumulative Sept. 1992 Sept. 1993 total2 Adult/adolescent exposure category No. (%) No. (%) No. (%) Men who have sex with men 24,334 (53) 46,025 (48) 183,344 (55) Injecting drug use 11,436 (25) 26,033 (27) 80,713 (24) Men who have sex with men and inject drugs 2,638 ( 6) 5,353 ( 6) 21,142 (6) Hemophilia/coagulation disor 323 ( 1) 1,017 ( 1) 2,963 (1) Heterosexual contact: 4,201 ( 9) 8,873 ( 9) 24,358 (7) Sex with injecting drug user 2,177 3,576 11,750 Sex with bisexual male 177 423 1,250 Sex with person with hemophilia 23 71 193 Born in Pattern-II(3) country 436 931 3,758 Sex with person born in Pattern-II country 29 74 279 Sex with transfusion recipient with HIV infection 67 160 456 Sex with HIV-infected person, risk not specified 1,292 3,638 6,672 Receipt of blood transfusion, blood components, or tissue(4) 663 ( 1) 1,191 ( 1) 5,984 (2) Other/risk not identified(5) 2,391 ( 5) 8,007 ( 8) 15,840 (5) Adult/adolescent subtotal 45,986 (100) 96,499 (100) 334,344 (100) Pediatric (< 13 years old) exposure category Hemophilia/coagulation disorder 23 ( 3) 18 ( 2) 202 (4) Mother with/at risk for HIV infection: 676 (93) 814 (94) 4,328 (88) Injecting drug use 258 264 1,920 Sex with injecting drug user 116 133 846 Sex with bisexual male 15 9 88 Sex with person with hemophilia 7 3 21 Born in Pattern-II country 31 37 305 Sex with person born in Pattern-II country 5 5 23 Sex with transfusion recipient with HIV infection 4 3 19 Sex with HIV-infected person, risk not specified 52 96 275 Receipt of blood transfusion, blood components, or tissue 22 23 98 Has HIV infection, risk not specified 166 241 733 Receipt of blood transfusion, blood components, or tissue 18 ( 2) 24 ( 3) 327 (7) Risk not identified 13 ( 2) 13 ( 1) 49 (1) Pediatric subtotal 730 (100) 869 (100) 4,906 (100) Total 46,716 97,368 339,250 1 Includes 9 months of data collected under the 1993 AIDS surveillance case definition for adults and adolescents. 2 Includes 7 persons known to be infected with human immunodeficiency virus type 2 (HIV-2). See JAMA 1992;267:2775-9. 3 See technical notes. 4 Twenty-seven adults/adolescents and 2 children developed AIDS after receiving blood screened negative for HIV antibody. Six additional adults developed AIDS after receiving tissue or organs from HIV-infected donors. Three of the 6 received tissues or organs from a donor who was negative for HIV antibody at the time of donation. See N Engl J Med 1992;326:726-32. 5 "Other" refers to 11 health-care workers who developed AIDS after occupational exposure to HIV-infected blood, as documented by evidence of seroconversion; to 4 patients who developed AIDS after exposure to HIV within the health-care setting, as documented by laboratory studies; to 1 person who acquired HIV infection perinatally and was diagnosed with AIDS after age 13; and to 1 person with intentional self-inoculation of blood from an HIV-infected person. "Risk not identified" refers to persons whose mode of exposure to HIV is unknown. This includes persons under investigation; persons who died, were lost to follow-up, or declined interview; and persons whose mode of exposure to HIV remains unidentified after investigation. Table 4. Male adult/adolescent AIDS cases by exposure category and race/ethnicity, reported October 1992 through September 1993,(1) and cumulative totals, through September 1993, United States White, not Hispanic Oct. 1992- Cumulative Sept. 1993 total Exposure category No. (%) No. (%) Men who have sex with men 30,094 (73) 125,392 (78) Injecting drug use 4,285 (10) 12,670 ( 8) Men who have sex with men and inject drugs 3,001 ( 7) 11,959 ( 7) Hemophilia/coagulation disorder 794 ( 2) 2,349 ( 1) Heterosexual contact: 607 ( 1) 1,654 ( 1) Sex with injecting drug user 227 804 Sex with person with hemophilia 6 13 Born in Pattern-II(2) country 1 8 Sex with person born in Pattern-II country 10 52 Sex with transfusion recipient with HIV infection 25 72 Sex with HIV-infected person, risk not specified 338 705 Receipt of blood transfusion, blood components, or tissue 431 ( 1) 2,519 ( 2) Risk not identified(3) 2,032 ( 5) 4,380 ( 3) Total 41,244 (100) 160,923 (100) Black, not Hispanic Oct. 1992- Cumulative Sept. 1993 total Exposure category No. (%) No. (%) Men who have sex with men 9,614 (37) 34,166 (42) Injecting drug use 9,667 (37) 29,762 (36) Men who have sex with men and inject drugs 1,568 ( 6) 5,974 ( 7) Hemophilia/coagulation disorder 110 ( 0) 260 ( 0) Heterosexual contact: 2,125 ( 8) 6,279 ( 8) Sex with injecting drug user 682 2,118 Sex with person with hemophilia 1 4 Born in Pattern-II(2) country 605 2,571 Sex with person born in Pattern-II country 31 86 Sex with transfusion recipient with HIV infection 26 51 Sex with HIV-infected person, risk not specified 780 1,449 Receipt of blood transfusion, blood components, or tissue 157 ( 1) 606 ( 1) Risk not identified(3) 2,807 (11) 5,127 ( 6) Total 26,048 (100) 82,174 (100) Hispanic Oct. 1992- Cumulative Sept. 1993 total Exposure category No. (%) No. (%) Men who have sex with men 5,638 (42) 21,475 (45) Injecting drug use 5,094 (38) 18,143 (38) Men who have sex with men and inject drugs 712 ( 5) 3,021 ( 6) Hemophilia/coagulation disorder 68 ( 1) 224 ( 0) Heterosexual contact: 570 ( 4) 1,375 ( 3) Sex with injecting drug user 185 599 Sex with person with hemophilia 2 4 Born in Pattern-II(2) country - 10 Sex with person born in Pattern-II country 2 11 Sex with transfusion recipient with HIV infection 6 28 Sex with HIV-infected person, risk not specified 375 723 Receipt of blood transfusion, blood components, or tissue 91 ( 1) 385 ( 1) Risk not identified(3) 1,234 ( 9) 2,728 ( 6) Total 13,407 (100) 47,351 (100) Asian/Pacific Islander Oct. 1992- Cumulative Sept. 1993 total Exposure category No. (%) No. (%) Men who have sex with men 445 (74) 1,583 (79) Injecting drug use 28 ( 5) 79 ( 4) Men who have sex with men and inject drugs 22 ( 4) 57 ( 3) Hemophilia/coagulation disorder 12 ( 2) 35 ( 2) Heterosexual contact: 15 ( 2) 29 ( 1) Sex with injecting drug user 6 12 Sex with person with hemophilia - - Born in Pattern-II country - 3 Sex with person born in Pattern-II country - 1 Sex with transfusion recipient with HIV infection 2 2 Sex with HIV-infected person, risk not specified 7 11 Receipt of blood transfusion, blood components, or tissue 12 ( 2) 72 ( 4) Risk not identified 69 (11) 152 ( 8) Total 603 (100) 2,007 (100) American Indian/ Alaska Native Oct. 1992- Cumulative Sept. 1993 total Exposure category No. (%) No. (%) Men who have sex with men 158 (63) 388 (63) Injecting drug use 23 ( 9) 62 (10) Men who have sex with men and inject drugs 42 (17) 107 (17) Hemophilia/coagulation disorder 6 ( 2) 16 ( 3) Heterosexual contact: 4 ( 2) 10 ( 2) Sex with injecting drug user 1 5 Sex with person with hemophilia - - Born in Pattern-II country - - Sex with person born in Pattern-II country - - Sex with transfusion recipient with HIV infection - - Sex with HIV-infected person, risk not specified 3 5 Receipt of blood transfusion, blood components, or tissue 1 ( 0) 5 ( 1) Risk not identified 15 ( 6) 26 ( 4) Total 249 (100) 614 (100) Cumulative totals(4) Oct. 1992- Cumulative Sept. 1993 total Exposure category No. (%) No. (%) Men who have sex with men 46,025 (56) 183,344 (62) Injecting drug use 19,142 (23) 60,835 (21) Men who have sex with men and inject drugs 5,353 ( 7) 21,142 ( 7) Hemophilia/coagulation disorder 990 ( 1) 2,890 ( 1) Heterosexual contact: 3,328 ( 4) 9,361 ( 3) Sex with injecting drug user 1,102 3,539 Sex with person with hemophilia 10 22 Born in Pattern-II country 607 2,597 Sex with person born in Pattern-II country 43 150 Sex with transfusion recipient with HIV infection 59 154 Sex with HIV-infected person, risk not specified 1,507 2,899 Receipt of blood transfusion, blood components, or tissue 695 ( 1) 3,596 ( 1) Risk not identified 6,174 ( 8) 12,474 ( 4) Total 81,707 (100) 293,642 (100) 1 Includes 9 months of data collected under the 1993 AIDS surveillance case definition for adults and adolescents. 2 See technical notes. 3 "Risk not identified" refers to persons whose mode of exposure to HIV is unknown. This includes persons under investigation; persons who died, were lost to follow-up, or declined interview; and persons whose mode of exposure to HIV remains unidentified after investigation. 4 Includes 573 men whose race/ethnicity is unknown. Table 5. Female adult/adolescent AIDS cases by exposure category and race/ethnicity, reported October 1992 through September 1993,(1) and cumulative totals, through September 1993, United States White, not Hispanic Oct. 1992- Cumulative Sept. 1993 total Exposure category No. (%) No. (%) Injecting drug use 1,718 (46) 4,459 (43) Hemophilia/coagulation disorder 14 ( 0) 48 ( 0) Heterosexual contact: 1,387 (37) 3,595 (35) Sex with injecting drug user 586 1,703 Sex with bisexual male 199 627 Sex with person with hemophilia 50 140 Born in Pattern-II(2) country 3 5 Sex with person born in Pattern-II country 4 15 Sex with transfusion recipient with HIV infection 49 176 Sex with HIV-infected person, risk not specified 496 929 Receipt of blood transfusion, blood components, or tissue 223 ( 6) 1,398 (14) Risk not identified(3) 398 (11) 793 ( 8) Total 3,740 (100) 10,293 (100) Black, not Hispanic Oct. 1992- Cumulative Sept. 1993 total Exposure category No. (%) No. (%) Injecting drug use 3,861 (48) 11,386 (52) Hemophilia/coagulation disorder 7 ( 0) 15 ( 0) Heterosexual contact: 2,884 (36) 7,864 (36) Sex with injecting drug user 1,191 4,101 Sex with bisexual male 150 428 Sex with person with hemophilia 9 21 Born in Pattern-II(2) country 316 1,143 Sex with person born in Pattern-II country 26 110 Sex with transfusion recipient with HIV infection 27 63 Sex with HIV-infected person, risk not specified 1,165 1,998 Receipt of blood transfusion, blood components, or tissue 167 ( 2) 571 ( 3) Risk not identified(3) 1,089 (14) 1,892 ( 9) Total 8,008 (100) 21,728 (100) Hispanic Oct. 1992- Cumulative Sept. 1993 total Exposure category No. (%) No. (%) Injecting drug use 1,265 (44) 3,907 (47) Hemophilia/coagulation disorder 5 ( 0) 9 ( 0) Heterosexual contact: 1,192 (41) 3,377 (41) Sex with injecting drug user 667 2,337 Sex with bisexual male 60 162 Sex with person with hemophilia 1 7 Born in Pattern-II(2) country 4 11 Sex with person born in Pattern-II country 1 4 Sex with transfusion recipient with HIV infection 17 51 Sex with HIV-infected person, risk not specified 442 805 Receipt of blood transfusion, blood components, or tissue 88 ( 3) 349 ( 4) Risk not identified(3) 327 (11) 631 ( 8) Total 2,877 (100) 8,273 (100) Asian/Pacific Islander Oct. 1992- Cumulative Sept. 1993 total Exposure category No. (%) No. (%) Injecting drug use 15 (15) 34 (15) Hemophilia/coagulation disorder 1 ( 1) 1 ( 0) Heterosexual contact: 57 (58) 104 (45) Sex with injecting drug user 15 31 Sex with bisexual male 13 28 Sex with person with hemophilia - 2 Born in Pattern-II country 1 1 Sex with person born in Pattern-II country - - Sex with transfusion recipient with HIV infection 8 11 Sex with HIV-infected person, risk not specified 20 31 Receipt of blood transfusion, blood components, or tissue 16 (16) 59 (26) Risk not identified 10 (10) 32 (14) Total 99 (100) 230 (100) American Indian/ Alaska Native Oct. 1992- Cumulative Sept. 1993 total Exposure category No. (%) No. (%) Injecting drug use 17 (37) 52 (50) Hemophilia/coagulation disorder - - Heterosexual contact: 20 (43) 32 (31) Sex with injecting drug user 12 21 Sex with bisexual male 1 3 Sex with person with hemophilia 1 1 Born in Pattern-II country - - Sex with person born in Pattern-II country - - Sex with transfusion recipient with HIV infection - - Sex with HIV-infected person, risk not specified 6 7 Receipt of blood transfusion, blood components, or tissue 2 ( 4) 8 ( 8) Risk not identified 7 (15) 11 (11) Total 46 (100) 103 (100) Cumulative totals(4) Oct. 1992- Cumulative Sept. 1993 total Exposure category No. (%) No. (%) Injecting drug use 6,891 (47) 19,878 (49) Hemophilia/coagulation disorder 27 ( 0) 73 ( 0) Heterosexual contact: 5,545 (37) 14,997 (37) Sex with injecting drug user 2,474 8,211 Sex with bisexual male 423 1,250 Sex with person with hemophilia 61 171 Born in Pattern-II country 324 1,161 Sex with person born in Pattern-II country 31 129 Sex with transfusion recipient with HIV infection 101 302 Sex with HIV-infected person, risk not specified 2,131 3,773 Receipt of blood transfusion, blood components, or tissue 496 ( 3) 2,388 ( 6) Risk not identified 1,833 (12) 3,366 ( 8) Total 14,792 (100) 40,702 (100) 1 Includes 9 months of data collected under the 1993 AIDS surveillance case definition for adults and adolescents. 2 See technical notes. 3 "Risk not identified" refers to persons whose mode of exposure to HIV is unknown. This includes persons under investigation; persons who died, were lost to follow-up, or declined interview; and persons whose mode of exposure to HIV remains unidentified after investigation. 4 Includes 75 women whose race/ethnicity is unknown. Table 6. Pediatric AIDS cases by exposure category and race/ethnicity, reported October 1992 through September 1993, and cumulative totals, through September 1993, United States White, not Hispanic Oct. 1992- Cumulative Sept. 1993 total Exposure category No. (%) No. (%) Hemophilia/coagulation disorder 13 ( 9) 141 (14) Mother with/at risk for HIV infection: 118 (84) 663 (68) Injecting drug use 38 290 Sex with injecting drug user 22 132 Sex with bisexual male 4 39 Sex with person with hemophilia 2 13 Born in Pattern-II1 country - 3 Sex with person born in Pattern-II country - - Sex with transfusion recipient with HIV infection 1 6 Sex with HIV-infected person, risk not specified 10 45 Receipt of blood transfusion, blood components, or tissue 6 29 Has HIV infection, risk not specified 35 106 Receipt of blood transfusion, blood components, or tissue 9 ( 6) 167 (17) Risk not identified(2) 1 ( 1) 9 ( 1) Total 141 (100) 980 (100) Black, not Hispanic Oct. 1992- Cumulative Sept. 1993 total Exposure category No. (%) No. (%) Hemophilia/coagulation disorder 1 ( 0) 24 (1) Mother with/at risk for HIV infection: 489 (97) 2,556 (95) Injecting drug use 153 1,133 Sex with injecting drug user 70 390 Sex with bisexual male 2 28 Sex with person with hemophilia - 5 Born in Pattern-II1 country 37 300 Sex with person born in Pattern-II country 5 22 Sex with transfusion recipient with HIV infection 1 5 Sex with HIV-infected person, risk not specified 57 148 Receipt of blood transfusion, blood components, or tissue 12 43 Has HIV infection, risk not specified 152 482 Receipt of blood transfusion, blood components, or tissue 6 ( 1) 74 (3) Risk not identified(2) 8 ( 2) 29 (1) Total 504 (100) 2,683(100) Hispanic Oct. 1992- Cumulative Sept. 1993 total Exposure category No. (%) No. (%) Hemophilia/coagulation disorder 4 ( 2) 33 ( 3) Mother with/at risk for HIV infection: 197 (93) 1,074 (90) Injecting drug use 69 483 Sex with injecting drug user 40 318 Sex with bisexual male 3 20 Sex with person with hemophilia 1 3 Born in Pattern-II(1) country - 2 Sex with person born in Pattern-II country - 1 Sex with transfusion recipient with HIV infection 1 8 Sex with HIV-infected person, risk not specified 27 77 Receipt of blood transfusion, blood components, or tissue 5 25 Has HIV infection, risk not specified 51 137 Receipt of blood transfusion, blood components, or tissue 7 ( 3) 76 ( 6) Risk not identified(2) 4 ( 2) 11 ( 1) Total 212 (100) 1,194 (100) Asian/Pacific Islander Oct. 1992- Cumulative Sept. 1993 total Exposure category No. (%) No. (%) Hemophilia/coagulation disorder - 3 (14) Mother with/at risk for HIV infection: 2 (50) 10 (45) Injecting drug use 1 3 Sex with injecting drug user - 2 Sex with bisexual male - 1 Sex with person with hemophilia - - Born in Pattern-II country - - Sex with person born in Pattern-II country - - Sex with transfusion recipient with HIV infection - - Sex with HIV-infected person, risk not specified 1 1 Receipt of blood transfusion, blood components, or tissue - 1 Has HIV infection, risk not specified - 2 Receipt of blood transfusion, blood components, or tissue 2 (50) 9 (41) Risk not identified - - Total 4 (100) 22 (100) American Indian/ Alaska Native Oct. 1992- Cumulative Sept. 1993 total Exposure category No. (%) No. (%) Hemophilia/coagulation disorder - 1 ( 7) Mother with/at risk for HIV infection: 2 (100) 13 (93) Injecting drug use 1 6 Sex with injecting drug user 1 2 Sex with bisexual male - - Sex with person with hemophilia - - Born in Pattern-II country - - Sex with person born in Pattern-II country - - Sex with transfusion recipient with HIV infection - - Sex with HIV-infected person, risk not specified - 2 Receipt of blood transfusion, blood components, or tissue - - Has HIV infection, risk not specified - 3 Receipt of blood transfusion, blood components, or tissue - - Risk not identified - - Total 2 (100) 14 (100) Cumulative totals(3) Oct. 1992- Cumulative Sept. 1993 total Exposure category No. (%) No. (%) Hemophilia/coagulation disorder 18 ( 2) 202 ( 4) Mother with/at risk for HIV infection: 814 (94) 4,328 (88) Injecting drug use 264 1,920 Sex with injecting drug user 133 846 Sex with bisexual male 9 88 Sex with person with hemophilia 3 21 Born in Pattern-II country 37 305 Sex with person born in Pattern-II country 5 23 Sex with transfusion recipient with HIV infection 3 19 Sex with HIV-infected person, risk not specified 96 275 Receipt of blood transfusion, blood components, or tissue 23 98 Has HIV infection, risk not specified 241 733 Receipt of blood transfusion, blood components, or tissue 24 ( 3) 327 ( 7) Risk not identified 13 ( 1) 49 ( 1) Total 869 (100) 4,906 (100) 1 See technical notes. 2 "Risk not identified" refers to persons whose mode of exposure to HIV is unknown. This includes persons under investigation; persons who died, were lost to follow-up, or declined interview; and persons whose mode of exposure to HIV remains unidentified after investigation. 3 Includes 13 children whose race/ethnicity is unknown. Table 7. AIDS cases in adolescents and adults under age 25, by sex and exposure category, reported October 1991 through September 1992, October 1992 through September 1993,(1) and cumulative totals through September 1993, United States 13-19 years old Oct. 1991- Oct. 1992- Cumulative Sept. 1992 Sept. 1993 total Male exposure category No. (%) No. (%) No. (%) Men who have sex with men 36 (35) 91 (28) 319 (33) Injecting drug use 4 ( 4) 14 ( 4) 62 ( 6) Men who have sex with men and inject drugs 5 ( 5) 8 ( 2) 45 ( 5) Hemophilia/coagulation disorder 47 (46) 172 (52) 440 (45) Heterosexual contact: 3 ( 3) 13 ( 4) 29 ( 3) Sex with injecting drug user 1 6 11 Sex with person with hemophilia - 1 1 Born in Pattern-II(2) country - 1 8 Sex with person born in Pattern-II country - - 1 Sex with transfusion recipient with HIV infection - - - Sex with HIV-infected person, risk not specified 2 5 8 Receipt of blood transfusion, blood components, or tissue 5 ( 5) 12 ( 4) 42 ( 4) Risk not identified(3) 2 ( 2) 19 ( 6) 40 ( 4) Male subtotal 102 (100) 329 (100) 977 (100) Female exposure category Injecting drug use 12 (20) 14 ( 8) 86 (20) Hemophilia/coagulation disorder 1 ( 2) 1 ( 1) 5 ( 1) Heterosexual contact: 34 (58) 105 (62) 236 (54) Sex with injecting drug user 20 37 127 Sex with bisexual male 1 7 11 Sex with person with hemophilia 2 1 6 Born in Pattern-II country 1 4 11 Sex with person born in Pattern-II country - 1 2 Sex with transfusion recipient with HIV infection - 2 3 Sex with HIV-infected person, risk not specified 10 53 76 Receipt of blood transfusion, blood components, or tissue 1 ( 2) 14 ( 8) 41( 9) Risk not identified 11 (19) 36 (21) 67(15) Female subtotal 59 (100) 170 (100) 435 (100) Total 161 499 1,412 20-24 years old Oct. 1991- Oct. 1992- Cumulative Sept. 1992 Sept. 1993 total Male exposure category No. (%) No. (%) No. (%) Men who have sex with men 694 (63) 1,489 (60) 6,485 (64) Injecting drug use 146 (13) 282 (11) 1,245 (12) Men who have sex with men and inject drugs 110 (10) 204 ( 8) 1,063 (11) Hemophilia/coagulation disorder 42 ( 4) 154 ( 6) 385 ( 4) Heterosexual contact: 55 ( 5) 118 ( 5) 363 ( 4) Sex with injecting drug user 24 40 135 Sex with person with hemophilia - - 1 Born in Pattern-II(2) country 8 17 98 Sex with person born in Pattern-II country - 2 2 Sex with transfusion recipient with HIV infection 1 4 9 Sex with HIV-infected person, risk not specified 22 55 118 Receipt of blood transfusion, blood components, or tissue 6 ( 1) 22 ( 1) 85 ( 1) Risk not identified(3) 53 ( 5) 220 ( 9) 445 ( 4) Male subtotal 1,106 (100) 2,489 (100) 10,071 (100) Female exposure category Injecting drug use 123 (32) 283 (30) 931 (35) Hemophilia/coagulation disorder 1 ( 0) 4 ( 0) 9 ( 0) Heterosexual contact: 206 (54) 483 (51) 1,329 (50) Sex with injecting drug user 118 233 754 Sex with bisexual male 14 32 108 Sex with person with hemophilia 2 7 27 Born in Pattern-II country 5 11 64 Sex with person born in Pattern-II country - 1 12 Sex with transfusion recipient with HIV infection - 2 7 Sex with HIV-infected person, risk not specified 67 197 357 Receipt of blood transfusion, blood components, or tissue,12 ( 3) 19 ( 2) 81 (3) Risk not identified 40 (10) 167 (17) 291 (11) Female subtotal 382 (100) 956 (100) 2,641 (100) Total 1,488 3,445 12,712 1 Includes 9 months of data collected under the 1993 AIDS surveillance case definition for adults and adolescents. 2 See technical notes. 3 "Risk not identified" refers to persons whose mode of exposure to HIV is unknown. This includes persons under investigation; persons who died, were lost to follow-up, or declined interview; and persons whose mode of exposure to HIV remains unidentified after investigation. Table 8. AIDS cases by sex, age at diagnosis, and race/ethnicity, reported through September 1993,(1) United States White, not Black, not Hispanic Hispanic Hispanic Male Age at diagnosis (years) No. (%) No. (%) No. (%) Under 5 329 ( 0) 1,167 ( 1) 478 ( 1) 5-12 248 ( 0) 183 ( 0) 155 ( 0) 13-19 473 ( 0) 299 ( 0) 186 ( 0) 20-24 4,735 ( 3) 3,282 ( 4) 1,938 ( 4) 25-29 23,298 (14) 12,067 (14) 7,742 (16) 30-34 37,653 (23) 19,017 (23) 11,723 (24) 35-39 35,879 (22) 19,483 (23) 10,671 (22) 40-44 25,717 (16) 13,213 (16) 7,088 (15) 45-49 15,223 ( 9) 6,869 ( 8) 3,793 ( 8) 50-54 8,173 ( 5) 3,800 ( 5) 2,012 ( 4) 55-59 4,671 ( 3) 2,121 ( 3) 1,174 ( 2) 60-64 2,775 ( 2) 1,155 ( 1) 587 ( 1) 65 or older 2,328 ( 1) 869 ( 1) 437 ( 1) Male subtotal 161,502 (100) 83,525 (100) 47,984 (100) Female Age at diagnosis (years) Under 5 320 ( 3) 1,143 ( 5) 455 ( 5) 5-12 81 ( 1) 189 ( 1) 106 ( 1) 13-19 102 ( 1) 262 ( 1) 68 ( 1) 20-24 672 ( 6) 1,347 ( 6) 594 ( 7) 25-29 1,875 (18) 3,801 (16) 1,699 (19) 30-34 2,455 (23) 5,618 (24) 2,126 (24) 35-39 1,918 (18) 5,094 (22) 1,707 (19) 40-44 1,093 (10) 2,826 (12) 988 (11) 45-49 594 ( 6) 1,187 ( 5) 472 ( 5) 50-54 359 ( 3) 706 ( 3) 273 ( 3) 55-59 344 ( 3) 381 ( 2) 168 ( 2) 60-64 249 ( 2) 248 ( 1) 87 ( 1) 65 or older 632 ( 6) 258 ( 1) 91 ( 1) Female subtotal 10,694 (100) 23,060 (100) 8,834 (100) Total (2) 172,196 106,585 56,818 Asian/Pacific American Indian/ Islander Alaska Native Total(2) Male Age at diagnosis (years) No. (%) No. (%) No. (%) Under5 8 ( 0) 8 ( 1) 1,992 (1) 5-12 7 ( 0) 1 ( 0) 594 (0) 13-19 11 ( 1) 11 ( 2) 980 (0) 20-24 75 ( 4) 23 ( 4) 10,071 (3) 25-29 267 (13) 123 (20) 43,576 (15) 30-34 420 (21) 173 (28) 69,100 (23) 35-39 443 (22) 126 (20) 66,742 (23) 40-44 346 (17) 85 (14) 46,548 (16) 45-49 218 (11) 34 ( 5) 26,191 ( 9) 50-54 108 ( 5) 17 ( 3) 14,140 ( 5) 55-59 62 ( 3) 9 ( 1) 8,066 ( 3) 60-64 20 ( 1) 10 ( 2) 4,551 ( 2) 65 or older 37 ( 2) 3 ( 0) 3,680 ( 1) Male subtotal 2,022 (100) 623 (100) 296,231(100) Female Age at diagnosis (years) Under 5 1 ( 0) 5 ( 5) 1,933 (4) 5-12 6 ( 3) - 384 (1) 13-19 1 ( 0) 1 ( 1) 435 (1) 20-24 12 ( 5) 10 ( 9) 2,641 (6) 25-29 23 (10) 23 (21) 7,430 (17) 30-34 48 (20) 34 (31) 10,300 (24) 35-39 38 (16) 14 (13) 8,792 (20) 40-44 37 (16) 9 ( 8) 4,961 (12) 45-49 21 ( 9) 5 ( 5) 2,286 (5) 50-54 14 ( 6) 2 ( 2) 1,356 (3) 55-59 8 ( 3) 1 ( 1) 903 ( 2) 60-64 12 ( 5) 3 ( 3) 599 ( 1) 65 or older 16 ( 7) 1 ( 1) 999 ( 2) Female subtotal 237 (100) 108 (100) 43,019(100) Total (2) 2,259 731 339,250 1 Includes 9 months of data collected under the 1993 AIDS surveillance case definition for adults and adolescents. 2 Includes 575 males and 86 females whose race/ethnicity is unknown. Table 9. AIDS cases, case-fatality rates,(1) and deaths, by half-year and age group, through September 1993,(2) United States Adults/adolescents Cases diagnosed Case-fatality Deaths occurring Half-year during interval rate during interval Before 1981 92 81.5 30 1981 Jan. - June 98 89.8 37 July - Dec. 208 91.3 87 1982 Jan. - June 407 92.6 155 July - Dec. 707 91.1 290 1983 Jan. - June 1,312 93.2 526 July - Dec. 1,654 93.2 939 1984 Jan. - June 2,581 92.8 1,406 July - Dec. 3,408 92.8 1,981 1985 Jan. - June 4,970 92.0 2,825 July - Dec. 6,379 91.6 3,904 1986 Jan. - June 8,413 90.4 5,109 July - Dec. 10,026 88.3 6,568 1987 Jan. - June 13,115 88.6 7,613 July - Dec. 14,574 85.7 8,013 1988 Jan. - June 16,836 83.4 9,397 July - Dec. 17,425 83.1 10,764 1989 Jan. - June 20,096 78.7 12,379 July - Dec. 20,434 76.5 14,231 1990 Jan. - June 22,629 70.8 14,404 July - Dec. 22,128 66.3 15,265 1991 Jan. - June 25,769 58.7 15,902 July - Dec. 27,410 49.4 17,497 1992 Jan. - June 30,925 36.1 17,431 July - Dec. 31,177 23.4 17,555 1993 Jan. - June 27,847 11.4 14,787 July - Sept. 3,724 5.5 2,410 Total (3) 334,344 60.3 201,775 Children < 13 years old Cases diagnosed Case-fatality Deaths occurring Half-year during interval rate during interval Before 1981 6 66.7 1 1981 Jan. - June 11 81.8 2 July - Dec. 5 100.0 6 1982 Jan. - June 13 84.6 9 July - Dec. 16 81.3 5 1983 Jan. - June 32 100.0 13 July - Dec. 42 90.5 16 1984 Jan. - June 51 84.3 26 July - Dec. 62 87.1 22 1985 Jan. - June 99 76.8 45 July - Dec. 128 82.8 69 1986 Jan. - June 138 81.9 65 July - Dec. 189 70.9 91 1987 Jan. - June 218 72.0 117 July - Dec. 257 67.7 168 1988 Jan. - June 258 64.7 134 July - Dec. 338 61.2 174 1989 Jan. - June 352 60.2 171 July - Dec. 333 57.4 184 1990 Jan. - June 357 52.9 191 July - Dec. 377 43.0 190 1991 Jan. - June 357 42.3 163 July - Dec. 325 35.7 199 1992 Jan. - June 384 32.3 168 July - Dec. 318 27.0 197 1993 Jan. - June 213 18.3 161 July - Sep. 27 7.4 26 Total (3) 4,906 53.3 2,615 1 Case-fatality rates are calculated for each half-year by date of diagnosis. Each 6-month case-fatality rate is the number of deaths ever reported among cases diagnosed in that period (regardless of the year of death), divided by the number of total cases diagnosed in that period, multiplied by 100. For example, during the interval January through June 1982, AIDS was diagnosed in 407 adults/adolescents. Through September 1993, 377 of these 407 were reported as dead. Therefore, the case fatality rate is 92.6 (377 divided by 407, multiplied by 100). The case-fatality rates shown here may be underestimates because of incomplete reporting of deaths. Reported deaths are not necessarily caused by HIV-related disease. 2 Includes 9 months of data collected under the 1993 AIDS surveillance case defintions for adults and adolescents. 3 Death totals include 270 adults/adolescents and 2 children known to have died, but whose dates of death are unknown. Table 10. AIDS cases by year of diagnosis and definition category, diagnosed through September 1993,(1) United States Period of diagnosis Before Oct. 1989- Oct. 1990- Sept. 1989 Sept. 1990 Sept. 1991 Definition category No. (%) No. (%) No. (%) Pre-1987 definition 106,479 (79) 28,634 (64) 29,523 (58) 1987 definition 26,788 (20) 13,559 (30) 16,078 (31) 1993 definition(2) 1,610 ( 1) 2,402 ( 5) 5,467 (11) Severe HIV-related immunosuppression(3) 1,181 2,021 4,669 Pulmonary tuberculosis 362 333 706 Recurrent pneumonia 55 44 85 Invasive cervical cancer 16 8 13 Total 134,877 (100) 44,595 (100) 51,068 (100) Period of diagnosis Oct. 1991- Oct. 1992- Cumulative Sept. 1992 Sept. 1993 total Definition category No. (%) No. (%) No. (%) Pre-1987 definition 28,340 (47) 13,876 (29) 206,852 (61) 1987 definition 17,521 (29) 9,537 (20) 83,483 (25) 1993 definition(2) 15,032 (25) 24,404 (51) 48,915 (14) Severe HIV-related immunosuppression(3) 13,587 22,718 44,176 Pulmonary tuberculosis 1,195 1,115 3,711 Recurrent pneumonia 223 541 948 Invasive cervical cancer 38 48 123 Total 60,893 (100) 47,817 (100) 339,250 (100) 1 Includes 9 months of data collected under the 1993 AIDS surveillance case definition for adults and adolescents. 2 Persons who meet only the 1993 AIDS case definition and whose date of diagnosis is before January 1993 were diagnosed retrospectively. The sum of diagnoses listed for the four conditions under the 1993 definition do not equal the 1993 definition total because some persons have more than one diagnosis from the added conditions of pulmonary tuberculosis, recurrent pneumonia, and invasive cervical cancer. 3 Defined as CD4+ T-lymphocyte count of less than 200 cells/uL or a CD4+ percentage less than 14 in persons with laboratory confirmation of HIV infection. Table 11. Health-care workers with documented and possible occupationally acquired AIDS/HIV infection, by occupation, reported through September 1993, United States(1) Documented Possible occupational occupational transmission(2) transmission(3) occupation No. No. Dental worker, including dentist - 6 Embalmer/morgue technician - 3 Emergency medical technician /paramedic - 8 Health aide/attendant 1 9 Housekeeper/maintenace worker 1 6 Laboratory technician, clinical 15 14 Laboratory technician,nonclinical 1 1 Nurse 13 15 Physician, nonsurgical 5 8 Physician, surgical - 2 Respiratory therapist 1 2 Technician, dialysis 1 1 Technician, surgical 1 1 Technician/therapist, other than those listed above - 3 Other health-care occupations - 2 Total 39 81 1 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. See MMWR 1992;41:823-5. 2 Health-care workers who had documented HIV seroconversion after occupational exposure: 34 had percutaneous exposure, 4 had mucocutaneous exposure, 1 had both percutaneous and mucocutaneous exposures. Thirty-six exposures were to blood from an HIV-infected person, 1 to visibly bloody fluid, 1 to an unspecified fluid, and 1 to a concentrated virus in a laboratory. Eleven of these health-care workers have developed AIDS. 3 These health-care workers have been investigated and are without identifiable behavioral or transfusion risks; each reported percutaneous or mucocutaneous occupational exposures to blood or body fluids, or lab oratory solutions containing HIV, but HIV seroconversion specifically resulting from an occupational exposure was not documented. Table 12. Adult/adolescent AIDS cases by single and multiple exposure categories, reported through September 1993, United States AIDS cases Exposure category No. (%) Single mode of exposure Men who have sex with men 176,793 (53) Injecting drug use 68,029 (20) Hemophilia/coagulation disorder 2,212 ( 1) Heterosexual contact 23,536 ( 7) Receipt of transfusion(1) 5,978 ( 2) Receipt of transplant of tissues/organs(2) 6 ( 0) Other(3) 16 ( 0) Single mode of exposure subtotal 276,567 (83) Multiple modes of exposure Men who have sex with men;injecting drug use 18,885 ( 6) Men who have sex with men; hemophilia/coagulation disorder 82 ( 0) Men who have sex with men;heterosexual contact 3,718 ( 1) Men who have sex with men;receipt of transfusion/transplant 2,554 ( 1) Injecting drug use;hemophilia/ coagulation disorder 88 ( 0) Injecting drug use;heterosexual contact 11,003 ( 3) Injecting drug use;receipt of transfusion/transplant 1,114 ( 0) Hemophilia/coagulation disorder; heterosexual contact 29 ( 0) Hemophilia/coagulation disorder; receipt of transfusion/transplant 704 ( 0) Heterosexual contact;receipt of transfusion/transplant 822 ( 0) Men who have sex with men; injecting drug use;hemophilia/ coagulation disorder 20 ( 0) Men who have sex with men;injecting drug use; heterosexual contact 1,764 ( 1) Men who have sex with men;injecting drug use; receipt of transfusion/transplant 392 ( 0) Men who have sex with men;hemophilia/coagulation disorder;heterosexual contact 4 ( 0) Men who have sex with men;hemophilia/coagulation disorder;receipt of transfusion/transplant 27 ( 0) Men who have sex with men;heterosexual contact; receipt of transfusion/transplant 163 ( 0) Injecting drug use;hemophilia/coagulation disorder;heterosexual contact 20 ( 0) Injecting drug use;hemophilia/coagulation disorder;receipt of transfusion/transplant 28 ( 0) Injecting drug use;heterosexual contact; receipt of transfusion/transplant 421 ( 0) Hemophilia/coagulation disorder;heterosexual contact;receipt of transfusion/transplant 18 ( 0) Men who have sex with men;injecting drug use; hemophilia/coagulation disorder;heterosexual contact 4 ( 0) Men who have sex with men;injecting drug use; hemophilia/coagulation disorder; receipt of transfusion/transplant 5 ( 0) Men who have sex with men; injecting drug use;heterosexual contact; receipt of transfusion/transplant 71 ( 0) Men who have sex with men; hemophilia/coagulation disorder;heterosexual contact; receipt of transfusion/transplant 3 ( 0) Injecting drug use;hemophilia/ coagulation disorder;heterosexual contact; receipt of transfusion/transplant 10 ( 0) Men who have sex with men;injecting drug use; hemophilia/coagulation disorder;heterosexual contact; receipt of transfusion/transplant 1 ( 0) Multiple modes of exposure subtotal 41,950 (13) Risk not identified(4) 15,823 ( 5) Total 334,344 (100) 1 Includes 27 adult/adolescents and 2 children who developed AIDS after receiving blood screened negative for HIV antibody. 2 Six adults developed AIDS after receiving tissue from HIV-infected donors. Three of the 6 received tissue or organs from a donor who was negative for HIV antibody at the time of donation. See N Engl J Med 1992;326:726-32. 3 "Other" refers to 11 health-care workers who developed AIDS after occupational exposure to HIV-infected blood as documented by evidence of seroconversion; to 4 patients who developed AIDS after exposure to HIV within the health-care setting, as documented by laboratory studies; to 1 person who acquired HIV infection perinatally and was diagnosed with AIDS after age 13; and to 1 person with intentional self-inoculation of blood from an HIV-infected person. 4 "Risk not identified" refers to persons whose mode of exposure to HIV is unknown. This includes persons under investigation; persons who died, were lost to follow-up, or declined interview; and persons whose mode of exposure to HIV remains unidentified 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.