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Междисциплинарный центр по исследованиям и обучению в области СПИДа
Fostering an AIDS Research and Training Center Infrastructure in Russia
Recent Entries 
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When inaugurated as the new US President on Jan 20, Barack Obama faces calls that the USA is failing in leadership, accountability, and transparency on HIV/AIDS. But the USA is one of many countries failing to report essential data on the epidemic according to a new scorecard developed by AIDS Accountability International (AAI).
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Sally Hargreaves
Debate around migration and communicable diseases in Europe opened the second European Scientific Conference on Applied Infectious Disease Epidemiology ( ESCAIDE )—supported by the European Centre for Disease Prevention and Control ( ECDC )—that took place in Berlin, Germany, on Nov 19—21, 2008. “There has been a dramatic rise in migration to Europe; when people migrate they often bring their disease prevalence rates with them”, Francoise Hamers (Haute Autorité de Santé, Paris, France)
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Иллюстрация с сайта scientistlive.com
Французские и швейцарские ученые провели эксперимент, результаты которого могут объяснить причины провала клинических испытаний считавшейся наиболее перспективной вакцины для профилактики ВИЧ-инфекции. По мнению ученых, им удалось воспроизвести условия, при которых экспериментальный препарат не только не снижал, но и, напротив, мог увеличивать риск заражения вирусом иммунодефицита.


Клинические испытания созданной компанией Merck & Co вакцины против ВИЧ-инфекции под названием STEP были досрочно остановлены в сентябре прошлого года. Анализ предварительных данных исследования свидетельствовал о существенном увеличении риска заражения ВИЧ среди привитых участников, имевших антитела к аденовирусу 5 типа.
Ослабленная версия этого вируса использовалась в вакцине в качестве вектора – средства доставки отдельных генов ВИЧ в клетки пациента.
Группа ученых из Университета Лозанны и Университета Монпелье попыталась воспроизвести возможные последствия введения вакцины Merck на культурах клеток иммунной системы человека. Как выяснилось, культуры клеток, в которых имелись антитела к аденовирусу, реагировали на введение вакцины быстрым размножением лимфоцитов CD8. Поскольку эти клетки являются мишенью вируса иммунодефицита, рост их числа теоретически должен был повышать риск заражения при контакте с ВИЧ.
Дополнительные эксперименты подтвердили это предположение: скорость распространения ВИЧ в культурах клеток с антителами к аденовирусу 5 увеличивалась втрое по сравнению с культурами, в которых такие антитела отсутствовали.
По мнению авторов исследования, отчет о котором опубликован в The Journal of Experimental Medicine, полученные ими данные свидетельствуют о том, что экспериментальная вакцина, вопреки ожиданиям разработчиков, действительно могла повысить вероятность заражения ВИЧ для людей, которые ранее контактировали с использовавшимся в препарате аденовирусом.
Впрочем, ряд опрошенных Nature экспертов выразили сомнения в том, что опыты на культурах клеток адекватно отразили процессы, происходившие в организме пациентов. В связи с этим по-прежнему нельзя исключить, что повышенное число новых случаев ВИЧ-инфекции выявленное в группе привитых участников испытаний STEP, было обусловлено иными причинами, либо статистической погрешностью.
Ссылки по теме:
HIVvaccine failure explained? - Nature, 06.11.2008

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United Kingdom Development Minister Gareth Thomas on Tuesday announced a new fund worth 220 million British pounds, or about $350 million, for research into technologies aimed at curbing the spread of HIV worldwide.

The fund likely will be aimed at researchers who are developing new HIV/AIDS technologies, such as microbicides, vaccines or new treatments.

"Only through research will we find ways to halt this epidemic," Thomas said when announcing the fund at a meeting of researchers and other experts convened by the government in London.

He added, "I hope this funding will help discover new lifesaving technology."

According to Thomas, the HIV/AIDS pandemic will worsen unless increased funding and effort are dedicated to curbing its spread.

He added that although more HIV-positive people worldwide are gaining access to antiretroviral drugs and some statistics indicate a decline in global HIV/AIDS cases, such progress will be fruitless unless effective prevention methods are available.

"The reality is that the spread of HIV is set to spiral out of control unless we act now," he said, adding, "Five people are infected with HIV every minute. We must increase our efforts, and increase them now".

Source: Medical News Today, 6 November 2008

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The purpose of this conference is to increase, update, and improve the dissemination of knowledge on HIV/AIDS and infectious diseases for the target populations of professionals, professors, researchers, and students, focused on HIV/AIDS & Infectious Diseases: microbiologists/virologists, specialists & fellows/MSc./Ph.D. on immunology, physiology, pharmacology, clinical & epidemiological research, internal medicine, pediatrics, infectious diseases, human rehabilitation, psychiatry & behavioral medicine, sport medicine for health, nutrition, nursing, psychology, social work, public health & applied epidemiology, other sciences for health (biomedical & social).

read more details

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This report provides updated, integrated recommendations for services provided to partners of persons with human immunodeficiency virus (HIV) infection and three other sexually transmitted diseases (STDs) (i.e., syphilis, gonorrhea, and chlamydial infection) and replaces the CDC 2001 Program Operations Guidelines for STD Prevention---Partner Services and the 1998 HIV Partner Counseling and Referral Services Guidance (1,2). These recommendations are intended for health department program managers responsible for overseeing partner services programs for HIV infection and the three other STDs at the state and local levels. The recommendations also might be beneficial for HIV prevention community planning groups, STD program advisory bodies, technical assistance providers, community-based organizations, and clinical care providers.

The value of partner services in the control of syphilis and gonorrhea is widely accepted. However, such services are underused among partners of persons with HIV infection. On the basis of evidence of effectiveness and cost-effectiveness of these services, CDC strongly recommends that all persons with newly diagnosed or reported HIV infection or early syphilis receive partner services with active health department involvement. Persons with a diagnosis of, or who are reported with, gonorrhea or chlamydial infection also are suitable candidates for partner services; however, resource limitations and the numerous cases of these infections might preclude direct health department involvement in certain instances. Health departments might need to limit direct involvement in partner services for gonorrhea and chlamydial infection to selected high-priority cases and use other strategies for the remainder (e.g., expedited partner therapy).

These recommendations highlight the importance of program collaboration and service integration in the provision of partner services. Because coinfection with HIV and one or more other STDs is common, all persons with a diagnosis of HIV should be tested for other types of STDs, and vice versa; rates of coinfection with HIV and syphilis have been particularly high in recent years. Many persons at risk for these infections also are at risk for other infectious diseases, such as tuberculosis and viral hepatitis, as well as various other health conditions. STD and HIV partner services offer STD, HIV, and other public health programs an opportunity for collaboration to deliver comprehensive services to clients, improve program efficiency, and maximize the positive effects on public health.

Read this report
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В течение первых семи месяцев текущего года в России в России наблюдалось снижение заболеваемости населения по всем инфекционным болезням, за исключением социально-значимых заболеваний: ВИЧ-инфекции, туберкулеза и сифилиса. Об этом говорится в отчете Федеральной службы государственной статистики (Росстат), опубликованном на сайте ведомства.

Согласно сообщению, в январе-июле 2008 года, число выявленных случаев бессимптомного носительства ВИЧ возросло на 42,9 процента, по сравнению с аналогичным периодом прошлого года. Число диагностированных заболеваний, связанных с ВИЧ-инфекцией, увеличилось на 43,1 процента. Заболеваемость туберкулезом возросла на 4,8 процента, сифилисом – на 5,3 процента.

По данным Росстата, в течение первых семи месяцев текущего года в РФ было выявлено 18 908 человек с бессимптомным инфекционным статусом, вызванным ВИЧ-инфекцией, и 7008 человек с заболеваниями, вызванными вирусом иммунодефицита.  При этом 62,8 процентов больных было зарегистрировано в 10 субъектах РФ: Санкт-Перербурге (18,1 процент), Челябинской области (8,3 процента), Ульяновской области (5,9 процента), Нижегородской области (5,4 процента), Пермском крае (5 процентов), Иркутской области (4,5 процента), Москве (4,5 процента), Приморском крае (4,4 процента), Ростовской области (3,5 процента) и Самарской области (3,2 процента).  

Среди субъектов РФ с наиболее высоким уровнем заболеваемости сифилисом в докладе Росстата отмечены Республика Тыва (уровень заболеваемости в 9,8 раз выше среднероссийского), республики Хакассия и Алтай (3,4 – 3.1 раза), Читинская область, Еврейская АО, Иркутская и Амурская области, Республика Бурятия, Кемеровская область, Хабаровский край, Республика Марий Эл, Удмуртская республика (2,9 – 1,7 раза).

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1st-Nov-2008 10:50 am - классный вывод
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The salience of socioeconomic status and English-language ability in explaining health differentials across immigrant groups reinforces the importance of further research on the role of these factors in contributing to the health of immigrants above and beyond the need for additional attention to the health selection process.
1st-Nov-2008 10:42 am - Immigrant Health and Access to Care
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American Journal of Public Health November Issue Focuses on Immigrant Health, Access to Care
[Oct 27, 2008]

The November issue of the American Journal of Public Health includes several studies related to immigrant health and access to health care, including immigrant children's use of public health insurance programs, tobacco use-related health disparities, the well-being of indigenous farm workers, and language and cultural competency barriers in access to health care (American Journal of Public Health, November 2008).

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Health Services for Undocumented Immigrants Vary by State in Absence of 'Federal Guidance,' Los Angeles Times Reports

With "limited federal guidance" on what health care services undocumented immigrants are eligible to receive, many states are "grappling" with what services to provide, the Los Angeles Times reports. Federal law prohibits the use of federal funds to pay for nonemergency care to undocumented immigrants, but it is not clear what counts as an emergency, the Times reports. The federal government defines an emergency as "an acute condition that, without immediate care, would seriously jeopardize a patient's health or impair bodily functions, parts or organs," according to the Times. The federal government shares the cost of emergency care for undocumented immigrants with states through Medicaid. Congressional and legal efforts to further define services undocumented immigrants can receive have not been successful or clarified the issue, the Times reports.

Health and other benefits for undocumented immigrants vary state by state, the Times reports. Some states "tip toward the need to care for the sick," while others "see free health care as a de facto endorsement of [undocumented immigrants'] presence," according to the Times. In particular, there are discrepancies over whether services such as chemotherapy, life-support and dialysis are considered emergency care.

Some states -- including Colorado, New Mexico and Texas -- do not consider kidney failure an emergency condition because patients can survive for weeks without dialysis before the disease becomes fatal. Other states -- such as California, New York and North Carolina -- provide routine dialysis for undocumented immigrants. Georgia recently stopped paying for dialysis for undocumented immigrants after lawmakers said it was a financial burden on the state.

In early 2007, Mary Kahn, a spokesperson for the federal Medicaid program, said, "We do not pay for chronic care for illegal immigrants." However, she recently said that the federal government and California have been sharing the cost of providing dialysis for undocumented immigrants and that it has been up to states to decide whether to pay for various health services themselves.

The cost of one dialysis treatment is about $250, according to the Times. Undocumented immigrants who do not receive routine dialysis often end up in emergency departments when they are sometimes near death, and where care often costs much more, according to the Times. When patients are near death, federal law says they must receive dialysis until their condition stabilizes. Without routine care, however, their condition often deteriorates and they have to return to the ED weeks later. States that do pay for dialysis say that not covering routine dialysis is far more costly than the alternative.

In California, undocumented immigrants account for 1,350 of 61,000 people receiving state-funded dialysis, and the group's portion cost the state $51 million last year. Opponents of the policies are against using taxpayer funds to pay for services to undocumented immigrants, and some states are concerned that covering the life saving procedures would draw more undocumented immigrants to their jurisdictions (Zarembo/Gorman, Los Angeles Times, 10/29).

29th-Oct-2008 05:03 pm - раньше сядешь ...
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Американские исследователи пришли к выводу, что лечение ВИЧ-инфицированных надо начинать раньше, чем предлагают существующие рекомендации. Анализ статистических данных показал, что раннее начало терапии значительно повышает выживаемость пациентов.

Объективным показателем течения ВИЧ-инфекции считается концентрация в крови Т-лимфоцитов-хелперов (клеток CD4+), которые поражает вирус. У здоровых людей в кубическом миллиметре крови содержится более 800 этих клеток. В соответствии с существующими рекомендациями ВИЧ-инфицированные должны начинать антиретровирусную терапию лишь тогда, когда количество Т-хелперов снижается ниже 350 в кубическом миллиметре крови. Такая отсрочка терапии обосновывалась тем, что она позволяет значительно снизить частоту и тяжесть побочных эффектов препаратов, которые включают нарушения обмена холестерина и сердечно-сосудистые заболевания, а также расстройства желудочно-кишечного тракта и другие.

Чтобы проверить справедливость этих рекомендаций, ученые из Университета Вашингтона в Сиэтле проанализировали данные 8 374 ВИЧ-инфицированных из США и Канады с уровнем Т-хелперов от 351 до 500 в мм3 крови за период с 1996 по 2006 годы. Около 30% исследуемых начали принимать антиретровирусные препараты сразу после постановки диагноза, остальные в соответствии с рекомендациями отсрочили прием до снижения уровня клеток CD4+ ниже 350. Показатели выживаемости больных, начавших лечение сразу, оказались выше примерно на 70%.

Другие недавние исследования показали, что у людей, начавших лечение при уровне Т-хелперов выше 350 в мм3 крови значительно больше шансов поднять этот показатель до нормального уровня, а также что «лекарственные каникулы» (небольшие перерывы в лечении для снижения побочных реакций) приводят к снижению эффективности препаратов и ухудшают прогноз.

Совокупность полученных данных позволила пересмотреть рекомендации по началу антиретровирусной терапии и внести соответствующие поправки в руководства по лечению ВИЧ-инфекции и в инструкции по применению препаратов. Основной проблемой остается то, что около трети инфицированных узнают о своем заболевании, когда количество их Т-хелперов в кубическом миллиметре крови уже стало ниже 350.

29th-Oct-2008 04:58 pm - женщина виновата
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всегда

Шведский правительственный институт отказался предоставить полиции информацию о ВИЧ-инфицированном, который подозревается в заражении женщины.

В соответствии со шведским законодательством, ВИЧ-инфицированному, который осознанно вступает в незащищенный половой контакт со здоровым человеком, грозит от одного до десяти лет тюрьмы.

Тем не менее, Шведский институт по контролю за инфекционными заболеваниями отказался предоставить полицейским информацию о ВИЧ-инфицированном, который подозревается в заражении женщины. Ведущий медицинский специалист и региональный менеджер института Ян Альберт (Jan Albert) пояснил, что отныне их организация считает, что заражение ВИЧ нельзя расценивать как преступление, и что каждый человек обязан осознавать риск, связанный с незащищенным сексом.

Директор института Рагнар Норрби (Ragnar Norrby) добавил, что криминализация ВИЧ-инфекции затрудняет профилактическую работу, и что предусмотренное наказание за заражение слишком сурово. Кроме того, разработка антиретровирусных препаратов не позволяет более расценивать ВИЧ-инфекцию как приговор.

источник

29th-Oct-2008 04:54 pm - пользе скрытности
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Ученикам нескольких классов школы американского города Сент-Льюис (штат Миссури) пришлось пройти обследования на ВИЧ-инфекцию, сообщает AP. Экстренные меры были приняты после того, как инфицированный пациент, имя которого не называется, сообщил о том, что мог заразить неизлечимым заболеванием около 50 школьников.

Первые сообщения о возможном распространении ВИЧ-инфекции в Средней школе округа Нормандия появились в начале октября. В начале текущей недели школьникам предложили анонимные добровольные обследования на ВИЧ-инфекцию, для чего на территории учебного заведения были открыты шесть пунктов сдачи анализов. Кроме того, ученикам 4-12 классов были прочитаны образовательные лекции о ВИЧ/СПИДе.

Происходящее вызвало волну слухов в Сент-Льюисе. Ситуация усугубляется тем, что местный департамент здравоохранения отказывается предоставить какую-либо информацию о поле, возрасте и сфере занятий выявленного носителя инфекции, который, возможно, является учеником или сотрудником школы.

Неизвестными остаются и пути распространения инфекции. Представитель департамента Крэйг ЛеФевр сообщил журналистам лишь, что заражение вирусом иммунодефицита происходит при инъекционном употреблении наркотиков, незащищенном сексе и обмене иглами для пирсинга и нанесения татуировок.

источник

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Agence France Presse (10.27.08)

In the latest edition of its Global Burden of Disease report, released today in Geneva, the World Health organization lowered the number of global deaths it expects from HIV/AIDS. WHO's earlier estimate, which assumed antiretrovirals would reach 80 percent of those needing them by 2012, predicted that AIDS deaths would rise from 2.8 million in 2008 to 6.5 million in 2030. The new forecasts anticipates AIDS deaths will rise from 2.2 million in 2008, peak at 2.4 million in 2012, and fall to 1.2 million in 2030. "Deaths [from HIV/AIDS] will continue to increase somewhat for a few years. by 2030 they would have declined from current levels today," said Colin Mathers, WHO's coordinator for epidemiology and the burden of disease. WHO's latest forecast is in line with that of the UN, which last year also cut its estimate of the number of people with HIV/AIDS.

CDC HIV/Hepatitis/STD/TB Prevention News Update Monday, October 27, 2008

visit http://www.cdcnpin.org to view prior issues of the Prevention News Update or search for archived article abstracts
24th-Oct-2008 10:09 am - ЮНЭЙДС после Пиота
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наиболее вероятные кандидаты:
  • Tim Barnett: Barnett has been a Labour Party member of Parliament in New Zealand since 1996. He currently is a senior government whip but in the past has worked for nongovernmental organizations in the U.K. and elsewhere. The Lancet adds that his "particular strengths lie in participative democracy, citizens' access, partnerships with NGOs and innovative law reform."
     
  • Stefano Bertozzi: Bertozzi is an HIV/AIDS researcher and founding director of the Division of Health Economics and Policy at Mexico's National Institute of Public Health. He also is a member of the Technical Evaluation Reference Group at the Global Fund To Fight AIDS, Tuberculosis and Malaria.
     
  • Michel Sidibe: Sidibe, who currently is the deputy executive director for UNAIDS, has worked for the United Nations for 20 years. According to the Lancet, his "record in working with international and local organizations at all levels is impressive, as is his commitment to human rights, especially for women and children, and to ... greater involvement of people living with or affected by HIV/AIDS."
     
  • Debrework Zewdie: Zewdie is the director of the Global HIV/AIDS Program at the World Bank. She helped form the Multi-Country HIV/AIDS Program, which has funded more than 40 projects with a total budget of $1.5 billion. In addition, with a background in immunology, Zewdie has a "strong history, particularly in Africa, of research, management and advocacy, especially in women's health," according to the Lancet.
гоню про дробности
20th-Oct-2008 05:04 pm - обновление на сайте
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несколько реструктурирована библиотека, ссылка с гл. страницы, но

что-то не заладилось, не все ссылки работают

просьба проверить и подтвердить (не)рабочее сосояние -- есть подзрение на кривой кеш

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Accurate and timely data on the number of persons in the United States living with human immunodeficiency virus (HIV) infection (HIV prevalence) are needed to guide planning for disease prevention, program evaluation, and resource allocation. However, overall HIV prevalence cannot be measured directly because a proportion of persons infected with HIV have neither been diagnosed nor reported to local surveillance programs. In addition, national HIV prevalence data are incomplete because local reporting systems for confidential, name-based HIV reporting have been fully implemented only since April 2008. With the advent of highly active antiretroviral therapies that delay the progression of HIV to acquired immunodeficiency syndrome (AIDS), and of AIDS to death (1), and changes in the AIDS case definition to include an immunologic diagnosis (2), earlier back-calculation methods from the 1990s for estimating HIV prevalence based on the number of reported AIDS cases are no longer reliable. With 80% of states reporting name-based HIV diagnoses as of January 2006, an extended back-calculation method now can be used to estimate HIV prevalence more accurately. Based on this method, CDC now estimates that 1.1 million adults and adolescents (prevalence rate: 447.8 per 100,000 population) were living with diagnosed or undiagnosed HIV infection in the United States at the end of 2006. The majority of those living with HIV were nonwhite (65.4%), and nearly half (48.1%) were men who have sex with men (MSM). The HIV prevalence rates for blacks (1,715.1 per 100,000) and Hispanics (585.3 per 100,000) were, respectively, 7.6 and 2.6 times the rate for whites (224.3 per 100,000).

An extended back-calculation method has been described in detail and was used recently to calculate the incidence of HIV infection in the United States (3). The method was used in this analysis to estimate HIV prevalence based on the number of HIV diagnoses by calendar year and disease severity (i.e., whether the person received an AIDS diagnosis in the same calendar year as the HIV diagnosis). HIV prevalence at the end of 2006 for the 50 states and District of Columbia was estimated using information from the national HIV/AIDS Reporting System for persons aged >13 years who were diagnosed with HIV during 2006 and reported to CDC by the end of June 2007. Forty states provided data on both HIV and AIDS diagnoses, whereas 10 states (California, Delaware, Hawaii, Illinois, Maryland, Massachusetts, Montana, Oregon, Rhode Island, and Vermont) and the District of Columbia provided data only for AIDS diagnoses. For the areas without name-based HIV data, statistical procedures and AIDS data were used to estimate HIV cases, based on the ratio of HIV to AIDS in states with integrated surveillance systems (4). The number of undiagnosed HIV infections was calculated by subtracting diagnosed AIDS prevalence and diagnosed HIV prevalence from the estimated overall HIV prevalence. Using an established method, data also were adjusted for reporting delays and redistribution of risk factors among persons initially reported without sufficient information to be classified into an HIV transmission category (5). HIV prevalence rates per 100,000 population were calculated for various demographic characteristics; population denominators for rate calculations were based on official postcensus estimates for 2006 (6).

Among the estimated number of persons living with HIV at the end of 2006, 46.1% (1,715.1 per 100,000 population) were black, 34.6% (224.3 per 100,000) were white, 17.5% (585.3 per 100,000) were Hispanic, 1.4% (129.6 per 100,000) were Asian/Pacific Islander, and 0.4% (231.4 per 100,000) were American Indian/Alaska Native (Table). Males accounted for 74.8% of prevalent HIV cases (685.7 per 100,000). The greatest percentage of cases was attributed to male-to-male sexual contact, accounting for 48.1% overall (and 64.3% among men). High-risk heterosexual contact, defined as heterosexual contact with a person known to have, or to be at high risk for, HIV infection (e.g., an injection drug user) accounted for 27.6% of prevalent cases overall (12.6% of cases among men and 72.4% of cases among women). Injection drug use (IDU) accounted for 18.5% of total cases (15.9% of cases among men and 26.3% of cases among women). The remainder of cases were attributed to men who reported both male-to-male sexual contact and IDU (5.0%) or whose transmission category was classified as other (0.8%; including hemophilia, blood transfusion, perinatal exposure, and risk factors not reported or not identified). Overall, an estimated 232,700 (21.0%) persons living with HIV infection had not been diagnosed as of the end of 2006.

The HIV prevalence rate for black men (2,388.2 per 100,000 population; 95% confidence interval [CI] = 2,197.9 -- 2,578.4) was six times the rate for white men (394.6 per 100,000; CI = 363.3 -- 425.9) (Figure), and the rate for Hispanic men (883.4 per 100,000; CI = 784.9 -- 982.4) was more than twice the rate for white men. The HIV prevalence rate for black women (1,122.4 per 100,000; CI = 1,002.2 -- 1,242.5) was nearly 18 times the rate for white women (62.7 per 100,000; CI = 54.7 -- 70.7), and the rate for Hispanic women (263.0 per 100,000; CI = 231.6 -- 294.4) was more than four times the rate for white women. The HIV prevalence rate for black women was greater than the rate for all other groups, except for black men.

Reported by: ML Campsmith, DDS, P Rhodes, PhD, HI Hall, PhD, T Green, PhD, Div of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC.

Editorial Note:

Reduced mortality resulting from the use of highly active antiretroviral therapies is a major factor contributing to the number of persons in the United States living with HIV disease (1). Additionally, more than 56,000 new HIV infections are estimated to occur annually (3).

The estimate of HIV prevalence in this report is similar to an estimate for 2003 (1,039,000 -- 1,185,000) that used the same extended back-calculation method (4). However, because of improvements in national HIV surveillance data since 2003, the two estimates cannot be compared directly. The 2006 estimate is based on a data set that 1) includes HIV diagnoses from 10 states that were not reporting in 2003 and 2) has been refined by an improved ability to identify and remove duplicate HIV case data that reflect reports by more than one state. Using the refined data set, CDC now estimates the HIV prevalence for 2003 to have been 994,000, suggesting that HIV prevalence in the United States increased by approximately 112,000 (11.3%) from 2003 to 2006. Analysis of the refined data also indicated that the percentage of HIV-positive persons who were undiagnosed decreased from approximately 25% in 2003 to 21% in 2006; an estimated 30% of this change resulted from a decrease in the number of undiagnosed persons, and 70% resulted from an increase in the total number of persons living with HIV (CDC, unpublished data, 2008).

The burden of HIV infection was disproportionate among populations. Blacks made up 12% of the adult and adolescent population in the United States in 2006 (6), but accounted for 46.1% of persons estimated to be living with HIV. Similarly, nearly half (48.1%) of the persons living with HIV were MSM, and although not precisely known, the percentage of MSM in the general population is estimated to be much lower. Data from CDC's National Survey of Family Growth indicate that, among males aged 15 -- 44 years, 3.7% ever have had anal sex with another male, and the proportion of men who had a male sexual partner in the past 12 months was 2.9% (7).

The findings in this report are subject to at least three limitations. First, reported HIV data used in the extended back-calculation method represent only a portion of persons in the United States who were diagnosed with HIV infection; several high-morbidity areas, including California, Illinois, Maryland, and the District of Columbia, did not contribute HIV data. Availability of reported HIV data from these areas will increase accuracy of future prevalence estimates. Second, not all persons who are infected with HIV have been diagnosed and reported to the public health surveillance system, and data must be estimated for undiagnosed persons. Finally, the data have been adjusted statistically to account for delays in reporting new cases and deaths, and cases reported without risk factor information have been redistributed among other transmission categories (5). These adjustments were based on risk redistribution assumptions from the mid-1990s that might no longer be valid, which could result in over- or under-adjustment of the data.

Previous studies have indicated that persons generally reduce their sexual risk behaviors (e.g., decrease the number of sex partners and reduce unprotected intercourse through increased condom use) after being diagnosed with HIV (8). Thus, increasing the percentage of HIV-infected persons who are diagnosed and linked with effective care and prevention services has the potential to reduce new HIV infections over time. To help achieve that, CDC has focused resources on increasing testing for HIV, particularly among populations that are disproportionately affected by HIV infection. Recent CDC activities have included publication of revised recommendations for HIV testing in health-care settings (9) and creation of a new program, the Heightened National Response to the HIV/AIDS Crisis in the African American Community (10). In 2007, as part of the President's Domestic HIV Initiative, CDC allocated funds to expand routine HIV testing, primarily among blacks. In addition to testing, expanding the number and reach of effective HIV prevention services for at-risk populations, including blacks, Hispanics, and MSM of all races, can contribute to reducing the disproportionate numbers of infections in these groups. Culturally appropriate opportunities for HIV testing, diagnosis, and access to early treatment and prevention services to reduce further HIV transmission are key to reducing new infections and ultimately decreasing HIV prevalence in the United States.

References

  1. Bhaskaran K, Hamouda O, Sannes M, et al. Changes in the risk of death after HIV seroconversion compared with mortality in the general population. JAMA 2008;300:51 -- 9.
  2. CDC. 1993 revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults. MMWR 1992;41(No. RR-17).
  3. Hall HI, Song R, Rhodes P, et al. Estimation of HIV incidence in the United States. JAMA 2008;300:520 -- 9.
  4. Glynn M, Rhodes P. What is really happening with HIV trends in the United States? Modeling the national epidemic [Session T1-B11-13]. Presented at the National HIV Prevention Conference, Atlanta, GA, June 12 -- 15, 2005.
  5. Green TA. Using surveillance data to monitor trends in the AIDS epidemic. Stat Med 1998;17:143 -- 54.
  6. National Center for Health Statistics. Bridged-race vintage postcensal population estimates for July 1, 2000 -- July 1, 2006, by year, county, single-year of age, bridged-race, Hispanic origin, and sex. Available at http://www.cdc.gov/nchs/about/major/dvs/popbridge/datadoc.htm#vintage2006.
  7. Mosher WD, Chandra A, Jones J. Sexual behavior and selected health measures: men and women 15 -- 44 years of age, United States, 2002. Adv Data 2005;362:1 -- 55.
  8. Weinhardt LS, Carey MP, Johnson BT, Bickham NL. Effects of HIV counseling and testing on sexual risk behavior: a meta-analytic review of published research, 1985 -- 1997. Am J Public Health 1999;89:1397 -- 405.
  9. CDC. Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings. MMWR 2006;55(No. RR-14).
  10. CDC. A heightened national response to the HIV/AIDS crisis among African Americans. Available at http://www.cdc.gov/hiv/topics/aa/resources/reports/heightendresponse.htm.

Table

TABLE. Estimated number,* percentage, and rate† of persons aged >13 years living with human immunodeficiency virus (HIV) infection, by selected characteristics — United States, 2006CharacteristicHIV prevalence(95% CI§)%Rate(95% CI)SexMale828,000(786,000–870,000)74.8685.7(650.9–720.5)Female278,400(253,400–303,400)25.2220.4(200.6–240.2)Age group (yrs)13–2456,500(45,000–68,000)5.1111.0(88.4–133.6)25–49770,000(730,000–810,000)69.6720.4(683.0–757.9)>50280,000(255,000–305,000)25.3313.5(285.5–341.4)Race/EthnicityWhite382,600(354,600–410,600)34.6224.3(207.9-240.7)Black510,100(478,100–542,100)46.11,715.1(1,607.5–1,822.7)Hispanic¶194,000(175,000–213,000)17.5585.3(528.0–642.6)Asian/Pacific Islander15,100(12,600–17,600)1.4129.6(108.2–151.1)American Indian/Alaska Native4,600(3,100–6,100)0.4231.4(156.0–306.9)HIV transmission categoryMale-to-male sexual contact532,000(492,000–572,000)48.1Injection drug use (male)131,500(114,500–148,500)11.9Injection drug use (female)73,100(62,100–84,100)6.6Male-to-male sexual contact and injection drug use54,900(44,900–64,900)5.0High-risk heterosexual contact (male)**104,000(89,000–119,000)9.4High-risk heterosexual contact (female)**201,700(179,700–223,700)18.2Other††9,100(7,600–10,600)0.8Total§§1,106,400(1,056,400–1,156,400)100447.8(427.5–468.0)* Estimated numbers, from national HIV/AIDS Reporting System data, are adjusted for reporting delays and reclassification of cases reported without information regarding an HIV transmission category, but are not adjusted for underreporting. Estimates are rounded to the nearest 100.† Per 100,000 population at the end of 2006. Rates for transmission category subgroups were not calculated because population denominators were unavailable. Rates for racial/ethnic populations do not include an adjustment for redistribution of persons of unknown race/ethnicity.§ Confidence interval.¶ Might be of any race.** Heterosexual contact with a person known to have, or to be at high risk for, HIV infection.†† Includes hemophilia, blood transfusion, perinatal exposure, and risk factors not reported or not identified.§§ Because column totals were calculated independently of the values of the subpopulations and all values were rounded, the values might not sum to the respective column total.
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Figure

FIGURE. Estimated human immunodeficiency virus (HIV) prevalencerate* among persons aged ≥13 years, by race/ethnicity and sex — United States, 2006†
MMWR October 3, 2008 / 57(39);1073-1076
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Самый опасный вид вируса СПИДа начал свое распространение среди людей около 1900 года в Африке к югу от Сахары, утверждается в новом исследовании.

Исследование, опубликованное в последнем номере Nature, выявило, что ВИЧ начал распространяться между 1884 и 1924 годами, когда на западе Центральной Африки стали возникать города. Таким образом, СПИД появился на несколько десятилетий раньше предыдущей предполагаемой даты его возникновения, 1930 года.

В ходе исследования ученые провели анализ образцов ткани и обнаружили второй по возрасту генетический вид ВИЧ-1 группы M. Они использовали этот и другой генетический вид вируса ВИЧ-1, чтобы создать генеалогическое древо вирусного штамма и определить время происхождения вируса ВИЧ-1 группы М.

Исследователи работали с образцами фрагментов тканей 1960 года, полученных в результате биопсии у зараженной СПИДом женщины из Киншасы в Демократической Республике Конго. Этот вирус является вторым по возрасту из всех известных вирусов ВИЧ-1 группы М. Самый старый образец был получен у мужчины из Киншасы в 1959 году.

"Предыдущая работа по прослеживанию происхождения проводилась на замороженных образцах, и было доступно лишь небольшое их количество", – сообщил в пресс-релизе университета руководитель исследования Майкл Воробеи, доцент по экологии и эволюционной биологии Университета Аризоны в Таксоне.

"До сих пор самые старые доступные образцы датировались концом 1970-х и 1980-ми, эпохой, когда мы знали о СПИДе. Теперь у нас впервые появилась возможность сравнить два относительно старых образца вируса ВИЧ. Это помогло нам установить, как быстро эволюционировал вирус, и сделать уверенные выводы о том, когда он перешел к людям, как быстро росла эпидемия, и с какого времени и какие факторы позволили вирусу стать микроорганизмом, опасным для человека", – отметил Воробеи.

Предыдущие исследования показали, что ВИЧ перешел от шимпанзе к людям на юго-востоке Камеруна.

Воробеи заявил, что эпидемия СПИДа, начавшаяся с распространения вируса на рубеже веков, совпадает с урбанизацией колониальной Африки, в частности, современного города Киншаса в Демократической Республике Конго.

Рисковое поведение, сопровождавшее рост городов, могло стать основной причиной быстрого распространения вируса.

Воробеи относится с оптимизмом к возможности исчезновения вируса СПИДа.

"Я думаю, что сложившаяся картина, в соответствии с которой изменения, выпавшие на долю человечества, могли создать возможности для распространения ВИЧ, ясно свидетельствует о том, что мы теперь можем провести изменения, направленные на то, чтобы повернуть эпидемию вспять. Слабое место СПИДа в том, что его вирус сравнительно нелегко передается. Есть ряд способов снижения темпов распространения вируса и его дальнейшего уничтожения, начиная с повышения качества анализа и превентивных мер и заканчивая широким применением антиретровирусной медикаментозной терапии", – отметил он.

Источник: Вашингтон Пост
 

2nd-Oct-2008 08:56 am - 23% от 140 млн = 32.3 млн
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Почти четверть россиян проверялись на ВИЧ

Почти четверть россиян (23%) проходили в этом году обследование на ВИЧ. Об этом они заявили в ходе опроса Всероссийского центра изучения общественного мнения (ВЦИОМ), посвященного отношению людей к этой проблеме.

Также в ходе исследования выяснилось, что отношение граждан к ВИЧ-инфицированным зависит от степени близости отношений между ними. Так, если бы инфицированным оказался близкий друг или член семьи, то 35% опрошенных не изменили бы к нему отношение, однако если бы это произошло с коллегой или соседом по дому, то лишь 23-24% респондентов относились бы к нему по-прежнему.

Посильную помощь и поддержку родственнику готовы оказать 28% опрошенных, коллеге - 16%, соседу - 14%. При общении с ВИЧ-инфицированным родственником сделают вид, что ничего не случилось, хотя 19% признались, что внутренне изменят отношение к худшему.

Свести общение с родственником к минимуму готовы 4% респондентов, с коллегой - 14%, а с соседом - 23%.
Как указано в сообщении ВЦИОМ, наибольшие трудности в определении отношения к ВИЧ-инфицированным наблюдаются у пожилых людей. Треть россиян старше 60 лет (33%) не смогли определиться с ответом, тогда как среди молодежи таких только 12%.

По данным ВЦИОМ, телевидение является основным источником информации россиян о ВИЧ. В этом качестве респонденты чаще всего называют социальную рекламу и телепередачи медицинской тематики (по 48%), 21% опрошенных отметили специальные телепередачи о ВИЧ и СПИД. Из радиопередач медицинской тематики и информационных материалов в госполиклиниках получают знания о ВИЧ по 19% респондентов. Каждый десятый (11%) получает информацию от друзей и знакомых, 6% - из информационных плакатов в коммерческих медучреждениях. Лишь 1% россиян указывает как источник информации телефон доверия по СПИД/ВИЧ.

Как следует из опроса ВЦИОМ, каждый третий россиянин (33%) в случае заражения ВИЧ-инфекцией обратился бы в местную поликлинику, 23% - на горячую линию по СПИД-ВИЧ, 18% - в региональный СПИД-центр, 14% - в частную поликлинику, 15%- к родственникам, друзьям и знакомым. По 8% опрошенных заявили, что искали бы информацию в Интернете или вообще не стали бы никуда обращаться.

Инициативные всероссийские опросы ВЦИОМ проведены в апреле-мае 2008г. Опрашивались каждый раз по 1 тыс. 600 человек в 140 населенных пунктах в 42 областях, краях и республиках России. Статистическая погрешность не превышает 3,4%.

[Остаётся предположить, что погрешность к оценке, вынесенный в заголовок отношения не имеет, или много выше. По-любому, количество анализов известно и является отчётной позиицией ФНМЦ СПИД -- около 20 млн. Мождет ли быть ещё 10 млн ананимных тестов? имхо: вряд ли]

01 октября 2008г. РБК
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В 2008 году на наличие ВИЧ-инфекции было осмотрено 8 тысяч мигрантов, приехавших в Вологодскую область

Одиннадцать ВИЧ-инфицированных мигрантов, прибывших в Вологодскую область на заработки, были выявлены с начала года. Как сообщили корреспонденту ИА REGNUM в пресс-службе департамента здравоохранения Вологодчины, по действующему законодательству ВИЧ-инфицированные иностранные граждане были депортированы.

С начала года специалисты по профилактике и борьбе со СПИДом осмотрели около 8 тысяч иностранцев, приехавших в Вологодскую область в поисках работы. Нередко мигранты пытаются подделать медицинские документы. Так, в 2008 году было выявлено три подобных случая, по которым в дальнейшем были заведены уголовные дела.

Добавим, что большинство приезжающих на заработки малообразованны и плохо говорят по-русски. Многие даже не слышали об опасных заболеваниях. Поэтому специалисты областного центра по профилактике и борьбе со СПИДом выпустили специальные информационные брошюры о ВИЧ-инфекции на турецком, узбекском и таджикском языках.

…и ещё 3357 новостей в сюжете «ВИЧ-инфекция и СПИД»



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After more than two decades and a truly epic struggle, the HIV/Aids epidemic appears to be levelling off. The numbers of new infections are dropping. By now we have medicine we can give those infected to stop them dying and we know how to prevent people becoming HIV positive. And yet every day, destitute women with children to feed sell their bodies for unsafe sex, babies are born with the virus and men die for lack of drugs. So much has been achieved in the fight against Aids, and so much remains to do.

The UNAIDS report in July - its two-yearly official verdict on the state of the epidemic - showed a drop in new infections from 3 million in 2004 to 2.7 million last year. Thanks to the roll-out of antiretroviral drugs, which keep the virus at low levels in the blood, deaths have dropped from 2.2 million to 2 million a year. There are encouraging signs that some of the messages about unsafe sexual behaviour are getting through: condom use is increasing among young people with multiple partners in some places, and in seven African countries - Burkina Faso, Cameroon, Ethiopia, Ghana, Malawi, Uganda and Zambia - the age at which young people first have sex appears to be going up.

The apparent end of the first, most acute stage of the Aids epidemic is causing a re-think on the part of some in the UN and donors such as the Department for International Development (Dfid). Thanks to civil society campaigning and public outrage, unprecedented amounts of money and commitment have been ploughed into the fight against HIV/Aids in the developing world. Some argue that was at the expense of very weak health systems in Africa and Asia whose few doctors, nurses and other health workers have been diverted from dealing with other diseases. Dfid's latest AIDS strategy, Achieving Universal Access, came with £6bn for "health systems and services" up to 2015, with the aim of making progress on tuberculosis (TB), malaria and maternal and child health at the same time.

It's the hot topic of the moment among AIDS experts. Many agree in principle, but are wary. Paul de Lay, director of evidence, monitoring and policy at UNAIDS, argues that two-thirds of AIDS funding already goes on health sector strengthening. He cites labs that can test for hepatitis as well as HIV, clinics built that deal with other health problems too, commodity and procurement systems for drugs and devices, and better salaries and incentives for health workers. There should indeed be coordination in the efforts to improve care for TB, malaria and other diseases alongside HIV, but vertical programmes have been shown to be effective. "Verticality gives you a priority and something to measure against," he says.

Few doubt that relaxing the pressure on the epidemic would be a disaster. There are 7,500 new infections every day. The relative success of the drug roll-out (3 million in poor countries are now on treatment) means that more people with potentially infectious HIV are alive - 33 million now. "We're at a chronic stage," says John Howson, associate director of the International HIV/Aids Alliance. "But there is fatigue. We have been fighting this epidemic for an awful long time."

Those on antiretroviral drugs will have to take them for life, and more expensive drugs will be needed as resistance inevitably sets in. Ending the supply of drugs is unthinkable, but donations to the Global Fund to fight Aids, TB and malaria, which finances treatment programmes, including £1bn committed last September by Dfid, will be stretched to meet the need.

Scientific setbacks

Efforts to prevent the spread of HIV have taken a higher priority, but there has been disappointment on the scientific front. Two major vaccine trials have been halted in the last year and there is no other contender at the moment. Virus-killing microbicides for women have not yet been shown to work and the take-up of circumcision is proving slow because of doubts and cultural issues.

Many think the best hope now is education. At the International Aids conference in Mexico in August, experts on the Global HIV Prevention Working Group urged countries to expand their behaviour change programmes "aggressively". Aimed at the right people, campaigns against unsafe sex and the needle-sharing that spreads HIV among drug users can be 50-90% effective, they claimed. "Behavioural HIV prevention works. Some have been pessimistic that it's possible to reduce HIV risk behaviours on a large scale, but this concern is misplaced," says Helene Gayle, president of Care USA.

Yet there are huge cultural barriers to cross. Women, who make up 60% of those infected in sub-Saharan Africa, have low status, often no job or money and no power to refuse sex. They may be refused permission by their husband to give birth at a hospital where they can be given drugs to prevent the baby becoming infected. Not just healthcare but social change is needed if the epidemic is genuinely to go into reverse.

Source: the Guardian (UK), 24 September 2008
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всё чаще -- хороший термин :)
Мэтт Макграт
Би-би-си

Специалисты предупреждают, что число носителей ВИЧ среди наркоманов продолжает расти.

Согласно докладу, опубликованному в британском медицинском журнале Lancet, во всем мире около 3 миллионов человек, вводящих себе наркотики внутривенно, возможно, уже являются носителями ВИЧ.

В девяти странах более 40% наркоманов инфицированы.

Авторы доклада обеспокоены нехваткой данных из стран Африки и утверждают, что и на этом континенте наркоманы также подвергаются повышенному риску заражения.

 

 
% НАРКОМАНОВ С ВИЧ
Эстония 72,1%
Аргентина 49,7%
Бразилия 48%
Кения 42,9%
Бирма 42,6%
Индонезия 42,5%
Таиланд 42,5%
Украина 41,8%
Непал 41,4%
Исследование подготовили специалисты из Университета Нового Южного Уэльса в Австралии.

Они выяснили, что в мире растет как число людей, вводящих наркотики внутривенно, так и процент ВИЧ-инфицированных среди них.

Вирус передается в основном через уже использованные шприцы.

В некоторых странах Юго-Восточной Азии, Латинской Америки и Восточной Европы доля ВИЧ-инфицированных наркоманов превышает 40%. В Эстонии она превышает 72%. В России этот показатель составляет около 37%.

Общая игла

Между тем, в Великобритании лишь 2,3% наркоманов являются носителями ВИЧ. В Австралии и Новой Зеландии этот показатель еще ниже - 1,5%.

Исследователи говорят, что этим странам удалось добиться таких показателей благодаря введенной в 1980-х годах схеме, позволяющей наркоманам получать новые одноразовые иглы в обмен на использованные.

В докладе говорится, что необходимость развивать подобные проекты стала очевидной.

"Широкое распространение ВИЧ среди людей, вводящих наркотики внутривенно, является серьезной медицинской проблемой в глобальных масштабах", - заявляют авторы доклада.

 

Адрес статьи на bbcrussian.com
http://news.bbc.co.uk/go/pr/fr/-/hi/russian/sci/tech/newsid_7633000/7633005.stm

Дата и время публикации: 2008/09/24 08:17:21 GMT
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Subpopulation Estimates from the HIV Incidence Surveillance System --- United States, 2006

CDC has created an HIV incidence surveillance system in selected areas of the United States as a component of its national human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) reporting system (1). The purpose of the new system is to estimate the number of new HIV infections occurring each year in the United States. Initial results published recently for 2006 (2) showed that 73% of new infections were in males, 45% were in blacks, and 53% were in men who have sex with men (MSM). To provide additional subpopulation estimates by age group, race/ethnicity, and HIV transmission category, CDC conducted a more detailed analysis of data from the new surveillance system. The results indicated that, in 2006, of new HIV infections among males, 72% were in MSM. Among MSM with new infections, 46% were white, 35% were black, and 19% were Hispanic. Among MSM aged 13--29 years, the number of new HIV infections in blacks (5,220) was 1.6 times the number in whites (3,330) and 2.3 times the number in Hispanics (2,300). Among females, the predominant HIV transmission category was high-risk heterosexual contact, which accounted for 80% of new infections. The HIV incidence rate for black females was 14.7 times the rate for white females, and the rate for Hispanic females was 3.8 times the rate for white females. MSM (of all races), blacks, and Hispanics were represented disproportionately in 2006 among those with new HIV infections. The new incidence data will help guide local, state, and national intervention measures tailored to those populations at greatest risk for HIV infection.

The ability to distinguish recent from long-standing HIV infection using a serologic testing algorithm for recent HIV seroconversion (STARHS) (3,4) enabled development of the new national HIV incidence surveillance system and integration with the established national HIV/AIDS reporting system (1). HIV surveillance data, testing and treatment history, and STARHS results are now used to estimate HIV incidence using a stratified extrapolation approach. Detailed descriptions of this method have been published previously (2,5). For this report, the extrapolations were based on a total of 33,802 HIV diagnoses (with or without AIDS, adjusted to 39,400 for reporting delays) in 2006 among adults and adolescents aged >13 years, reported to CDC from 22 states* through June 2007. Based on risk factors, cases were classified in the following hierarchy of transmission categories: 1) male-to-male sexual contact, 2) injection-drug use, 3) both male-to-male sexual contact and injection-drug use, 4) high-risk heterosexual contact (i.e., with a person of the opposite sex known to have HIV or an HIV risk factor [e.g., male-to-male sexual contact or injection-drug use]), and 5) all other risk factors combined. Data for the fifth category are not reported because the number of cases was too small to permit analysis by race/ethnicity.

Incidence was calculated for the 22 states included in the analysis and extrapolated to the 50 states and the District of Columbia by applying the ratio of HIV incidence to AIDS in the 22 states to those states without incidence data. Percentages and rates were based on extrapolated data. Rates were calculated based on official postcensal estimates for 2006 (6). Data were adjusted for reporting delays and redistribution of risk factors among persons initially reported without sufficient information to classify them into a transmission category (7). Persons diagnosed with AIDS within 6 months of HIV diagnosis were classified as having long-term infections. Missing testing and treatment history and STARHS results were imputed using a 20-fold multiple imputation procedure (5,8). Stratified data were analyzed for three racial/ethnic populations: white (i.e., non-Hispanic white), black (non-Hispanic black), and Hispanic. An estimated 2.6% of new infections in 2006 occurred among American Indian/Alaska Natives and Asian/Pacific Islanders; however, these populations were not included in the analyses because the small numbers precluded further stratification. The 22 states accounted for approximately 73% of AIDS cases in the United States (excluding territories) diagnosed in 2006.

Of the estimated 54,230 new infections among whites, blacks, and Hispanics in 2006, 46% of the infections occurred among blacks, 36% occurred among whites, and 18% occurred among Hispanics. Among males, 40% of new infections occurred in blacks, 41% occurred in whites, and 19% occurred in Hispanics. Among females, 61% of infections were in blacks, 23% were in whites, and 16% were in Hispanics. Among both males and females, the highest rates of new infections occurred among blacks (115.7 and 55.7 per 100,000 population, respectively) (Table). Among black males, the incidence rate was 5.9 times the rate among white males; the rate among black males aged 13--29 years was 7.1 times the rate among white males in the same age group. Among black females, the incidence rate was 14.7 times the rate among white females. Among Hispanic males and females, incidence rates were 2.2 and 3.8 times the rates among white males and females, respectively. High-risk heterosexual contact was the predominant transmission category (80%) among females but accounted for 13% of new infections among males (20% among blacks, 13% among Hispanics, and 6% among whites).

The male-to-male sexual contact transmission category represented 72% of new infections among males, including 81% of new infections among whites, 63% among blacks, and 72% among Hispanics. Among MSM, whites had 46% of new infections, and blacks and Hispanics had 35% and 19%, respectively. Among MSM aged 13--29 years, blacks had an estimated 5,220 (48%) infections, compared with 3,300 (31%) for whites and 2,300 (21%) for Hispanics. MSM aged 13--29 years had 38% of new infections among all MSM and 25% of new infections among white MSM, 52% among black MSM, and 43% among Hispanic MSM. Among white MSM, by age group, the largest number of new infections (5,600 [34%]) was among those aged 30--39 years (Figure).

Reported by: J Prejean, PhD, R Song, PhD, Q An, MS, HI Hall, PhD, Div of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC.
Editorial Note:

The new CDC HIV incidence surveillance system provides the first U.S. estimates of HIV incidence based on a biologic marker of recent infection. Recently published estimates of HIV incidence provided overall incidence estimates for the nation (2), but stratification was limited. The additional analyses presented in this report show the distribution of new HIV infections among certain racial/ethnic populations, transmission categories, and age groups.

The distribution of new HIV infections in 2006 demonstrates that, more than 25 years after the first report of AIDS, the disease continues to affect the MSM population more than any other in the United States. Although MSM represented the most new infections in the white, black, and Hispanic populations, the age distribution of persons with new infections suggests important differences by race and ethnicity. Among black and Hispanic MSM, most new infections were in persons aged 13--29, whereas, among white MSM, most new infections were in persons aged 30--39 years.

The recently published incidence estimates confirmed that new infections of HIV occurred disproportionately among blacks and Hispanics (2). The results in this report indicate further that the disparity between racial/ethnic minorities and whites is greatest among females. Data on new HIV diagnoses, especially among females and young MSM, also have suggested these racial/ethnic differences (9,10); however, using new diagnoses as a proxy for incidence is complicated by numerous factors, including 1) difficulty in ascertaining the relationship between testing rates and HIV diagnoses and 2) diagnoses that occur years after the initial infection.

The findings in this report are subject to at least three limitations. First, although the 22 states account for 73% of all AIDS diagnoses in the United States (excluding territories), they might not be nationally representative. Data from some areas with high AIDS morbidity but without confidential, name-based HIV reporting in 2006 were not included (e.g., California and the District of Columbia). Second, classification of cases with no risk factor data was based on historical patterns of reassignment to transmission category groups; these cases were assumed to constitute a representative sample of all cases initially reported without a risk factor. Finally, the stratified extrapolation approach is based on a number of assumptions that require more discussion than could be included in this report; however, these assumptions have been discussed fully in previous reports (2,5).

In areas not covered by the new CDC HIV incidence surveillance system and in areas without enough HIV incidence surveillance data to accommodate subpopulation analyses, data on HIV diagnoses continue to provide the best data regarding the distribution of HIV infection despite the potential limitations of using HIV diagnosis data as a proxy measurement for HIV incidence. However, comprehensive surveillance systems are essential for HIV incidence estimation. All states are now implementing confidential, name-based HIV surveillance, and national data on HIV diagnoses and incidence likely will continue to improve. CDC will use the HIV incidence data in conjunction with data from the national HIV/AIDS reporting system and other recently implemented surveillance systems (e.g., the Variant, Atypical and Resistant HIV Surveillance System and the National HIV Behavioral Surveillance System) to provide greater understanding of the scope of HIV infection and to refine and evaluate national prevention programs. CDC supports state and local health departments and community-based organizations to promote effective HIV prevention interventions that target those persons at greatest risk for HIV infection.

Acknowledgments

This report is based, in part, on contributions by N Benbow, MAS, Chicago Dept of Public Health, M Merritt, Illinois Dept of Public Health; Y Bennani, MPH, New York City Dept of Health and Mental Hygiene, L Smith, MD, New York State Dept of Health; KA Brady, MD, Philadelphia County Dept of Public Health, G Obiri, DrPH, Pennsylvania Dept of Health; S Chan, MPH, Houston Dept of Health and Human Svcs, Texas; D Crippen, Georgia Div of Public Health; N Diallo, MPH, Virginia Dept of Health; JA Donnelly, Colorado Dept of Public Health and Environment; A Exarchos, MPH, Washington State Dept of Health; DK Fields, Indiana State Dept of Health; T Harris, MPH, Oklahoma State Dept of Health; CL Jablonski, MA, Texas Dept of State Health Svcs; K McCormick, MHA, South Carolina Dept of Health and Environmental Control; H Mergenthaler, MPH, Arizona Dept of Health Svcs; A Merriweather, MSPH, Alabama Dept of Public Health; H Noga, MPH, Connecticut Dept of Public Health; M O'Connor, MPH, Michigan Dept of Community Health; PJ Padgett, PhD, North Carolina Dept of Health and Human Svcs; S Ramirez, MPH, Louisiana Dept of Health and Hospitals; C Sadashige, MSS, New Jersey Dept of Health and Senior Svcs; TJ Shavor, MBA, Tennessee Dept of Health; S Singh, MPH, Mississippi State Dept of Health; M Van Dyne, Missouri Dept of Health and Senior Svcs; and S White, MPH, Florida Dept of Health.
References

1. Lee LM, McKenna MT. Monitoring the incidence of HIV infection in the United States. Public Health Rep 2007;122(Suppl 1):72--9.
2. Hall HI, Song R, Rhodes P, et al; HIV Incidence Surveillance Group. Estimation of HIV incidence in the United States. JAMA 2008;300:520--9.
3. Janssen RS, Satten GA, Stramer SL, et al. New testing strategy to detect early HIV-1 infection for use in incidence estimates and for clinical and prevention purposes. JAMA 1998;280:42--8.
4. Parekh BS, Kennedy MS, Dobbs T, et al. Quantitative detection of increasing HIV type I antibodies after seroconversion: a simple assay for detecting recent HIV infection and estimating incidence. AIDS Res Hum Retroviruses 2002;18:295--307.
5. Karon JM, Song R, Kaplan E, Brookmeyer R, Kaplan EH, Hall HI. Estimating HIV incidence in the United States from HIV/AIDS surveillance data and biomarker HIV test results. Stat Med 2008;27:4617--33.
6. National Center for Health Statistics. Bridged-race vintage 2006 postcensal population estimates for July 1, 2000--July 1, 2006, by year, county, single-year of age, bridged-race, Hispanic origin, and sex. Hyattsville, MD: US Department of Health and Human Services, CDC. Available at http://www.cdc.gov/nchs/about/major/dvs/popbridge/datadoc.htm#vintage2006.
7. Green TA. Using surveillance data to monitor trends in the AIDS epidemic. Stat Med 1998;17:143--54.
8. Rubin DB. Multiple imputation for nonresponse in surveys. New York, NY: John Wiley and Sons, Inc.; 1987.
9. CDC. Racial/ethnic disparities in diagnoses of HIV/AIDS---33 states, 2001--2005. MMWR 2007;56:189--93.
10. CDC. Trends in HIV/AIDS diagnoses among men who have sex with men---33 states, 2001--2006. MMWR 2008;57:681--6.

* The 22 states were those with confidential, name-based HIV surveillance and HIV incidence surveillance with adequate data to calculate incidence estimates: Alabama, Arizona, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Louisiana, Michigan, Mississippi, Missouri, New Jersey, New York, North Carolina, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Washington.

Table


Figure

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В Калининграде к 4 годам лишения свободы приговорена 29-летняя ВИЧ-инфицированная девушка, которая, находясь на лечении в Калининградской областной инфекционной больнице, сбывала героин прямо в помещении медучреждения. Как сообщил сегодня, 9 сентября, корреспонденту ИА REGNUM представитель суда Ленинградского района Калининграда, пациентка, несмотря на тяжелые заболевания гепатитом С и ВИЧ-инфекцией, дважды продала наркотик в здании инфекционной больницы Калининграда - 0,059 грамма героина за 1200 рублей и 0,088 грамма героина за 600 рублей. Впоследствии оказалось, что это была проверочная закупка, проведенная сотрудниками регионального управления Госнаркоконтроля.

По данным собеседника ИА REGNUM, девушка родилась в калининградском поселке Дорожном, в народе именуемом Табор из-за круглосуточного сбыта наркотиков [в настоящее время решением региональных властей Дорожный стерт с лица земли. - ИА REGNUM], имеет образование 5 классов, родила двух детей и уже дважды была судима за сбыт наркотиков.

В качестве смягчающих обстоятельств суд учел признание вины подсудимой, наличие на иждивении детей 11 и 7 лет, тяжелые заболевания гепатитом С и ВИЧ-инфекцией. Отбывать наказание подсудимая станет в исправительной колонии общего режима.

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