National Experts Retreat from Estimate of 40,000 New US HIV Infections Annually

WASHINGTON--(BUSINESS WIRE)--In a community forum and conference call hosted today by the Federal AIDS Policy Partnership (FAPP) to discuss HIV incidence versus actual reported cases of HIV in the US and the long-awaited release of new, more closely-studied HIV data from 2005, HIV/AIDS experts participating in the call appeared to retreat from a longstanding, but increasingly controversial CDC estimate of approximately 40,000 new HIV cases in the US annually—a CDC estimate that advocates from AIDS Healthcare Foundation (AHF) and other AIDS organizations believe is far too low, and likely has been for a number of years.

During the question and answer session of the FAPP Forum on the CDC HIV/AIDS 2006 Surveillance Report, an audience member asked the panelists, “Why do you keep using the 40,000 number if it’s not accurate?” to which an official on the panel replied, “I don’t think we’re using it anymore.” AIDS and policy experts across the country agree that it is crucial that the CDC get this number right: the number is often a critical component in determining funding, policy, and planning for HIV/AIDS services, and the advocates note that underreporting results in under-funding and an ineffective overall response to the US epidemic that has no doubt led to more infections.

The annual estimate of new infections put forth by the CDC since as far back as 1998 has come under intense scrutiny recently after the CDC released its 2006 HIV Surveillance Report in late March. That report showed a new number 48% higher than the total number of HIV cases reported into the surveillance system the year before—between the years 2005 and 2006. The number of HIV case reports jumped to 52,878 new reported cases in 2006, up from 35,537 reported in 2005. At the time of the report’s release, CDC officials attributed this jump to its own better data collection from a differing number of states and dependent areas surveyed in each year—33 states and 5 dependent areas in 2005; then up to 45 states and 5 dependent areas in 2006.

However, advocates from AHF believe that regardless of the number of states and areas included, the startling difference in these CDC numbers of actual reported HIV cases over the two years (2005 & 2006) shows an alarming trend of either significant underreporting by the CDC over the past decade—by perhaps as many as 200,000 cumulative cases of HIV during the past ten years—or, the numbers could indicate a dramatic increase in the number of new HIV infections. Either option is cause for alarm, and AHF will call on White House officials later this week to press the Centers for Disease Control (CDC) to publicly release this data.

“The CDC claims that this year-over-year spike in cases does not represent an increase in HIV prevalence, but that the difference in their numbers is simply due to better reporting and that the US epidemic is stable,” said Michael Weinstein, President of AIDS Healthcare Foundation. “The CDC’s actions here would be like the Department of Labor announcing a bad news/good news situation: the bad news—the unemployment rate is 50% higher than we thought; but the good news is that it is stable and not growing. Either way it’s alarming, and the public should be informed about this urgent matter. We’d called on the CDC as far back as November to release its 2005 numbers so that Congress could consider the ramifications of having more estimated persons becoming HIV positive than we may have thought. The implication of revising the long-standing HIV estimate and the CDC’s laissez faire attitude do not bode well for the nation’s ability to address our own growing epidemic. We call on the White House to step in and demand the public release of this CDC data.”

Also during the meeting and conference call, panelist Walt Senterfitt, Ph.D, representing the Community HIV/AIDS Mobilization Project (CHAMP) and who also works as an epidemiologist with the Los Angeles County Department of Public Health, concluded his presentation, “Why We Need New Incidence Estimates and What Do We Do While Waiting for Them,” noting:

• We don’t yet have a good new estimate of the annual incidence of HIV in the U.S.
• Preliminary evidence points to that number being significantly higher than the old 40,000 estimate, but not necessarily rising
• Whatever it is, it is too high and there is no evidence that it is declining!
• We are as a nation still not doing nearly enough effective prevention to end this epidemic.

“Practically speaking, all US AIDS funding and policy depends on this number. The CDC appears to have known this 40,000 number has been too low for years, yet has done almost nothing to correct this commonly held—but inaccurate—understanding,” said Tom Myers, General Counsel and Chief of Public Affairs for AIDS Healthcare Foundation. “In effect, the CDC has sat back and allowed fundamentally flawed AIDS funding and policy decisions to be implemented, with disastrous consequences. As it was in the beginning of the epidemic, government indifference to the true scope of the AIDS epidemic is causing harm, something we believe is a complete dereliction of the CDC’s fundamental duty to protect the public health.”

AHF has long warned of this disconnect between the CDC’s annual estimates of HIV incidence versus its actual case reports, and has long called for the release of this data. AHF will now renew this call and increase the pressure on government officials to release the data. AHF welcomes other concerned AIDS advocates to come on board and band together to combat this seeming government indifference to the actual size of the AIDS problem facing the US—a factor that has led to serious under-funding of prevention and treatment services, as well as something that has pitted states against states, cities against rural areas, and north against south, for funding for crucial lifesaving HIV/AIDS services.

“Since the lifetime cost of caring for a person living with HIV is $600,000, the lack of reliable estimates handicap policy makers about the resources that will be necessary to cope with this epidemic. One way or another, case reports represent real people needing care,” said Whitney Engeran, III, Director of the Public Health Division for AIDS Healthcare Foundation. “Looking forward, those 53,000 individuals identified as HIV positive in 2006 represent a lifetime aggregate cost of care of nearly $32 billion regardless of when they were infected. Getting the most accurate estimates at the earliest possible time allow us all to better target prevention and services funds.”

About AHF

AIDS Healthcare Foundation (AHF) is the US’ largest HIV/AIDS organization. AHF currently provides treatment, care and support services to more than 65,000 individuals in 20 countries worldwide in the US, Africa, Latin America/Caribbean and Asia. Additional information is available at www.aidshealth.org