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As of Oct. 31, 1995, a total of 501,310 people with AIDS have been reported to state and territorial health departments in the United States, and of those, 311,380 (62%) have died of the disease, the Centers for Disease Control Prevention reports.1
The AIDS surveillance case definition was substantially expanded in late 1987 and again in 1993 to reflect increased knowledge of the natural history of HIV to remain consistent with the clinical management of HIV disease.
Of the half-million U.S. AIDS cases, 50,352 (10%) were reported during the period 1981-1987; 201,217 (41%) during 1988 to 1992; and 247,741 (49%) during 1993 through October 1995. The proportion of cases among people who reported injecting-drug use increased from 17% during 1981 to 1987, to 27% during 1993 to October 1995, and the proportion of cases attributed to heterosexual transmission increased from 3% to 10%. Cases among men who have sex with men decreased from 64% to 45%, reflecting that rate of disease has declined, but the group still represents the largest proportion of cases, the agency reported.
"The AIDS epidemic is increasing more rapidly among injecting-drug users and persons infected through heterosexual contact with a partner at risk for or known to have HIV infection or AIDS," the CDC reported. "The increase in AIDS cases resulting from heterosexual transmission also is reflected in the increase in cases reported among women."
Geographic patterns also have changed, as reflected by increases occurring among people in the South. Regardless of transmission mode or region, the epidemic continues to affect blacks and Hispanics disproportionately. The impact of the epidemic among racial/ethnic minorities is reflected by rates of reported AIDS cases that are six and three times higher for blacks and Hispanics, respectively, than for whites.
The World Health Organization estimates that 18 million adults and 1.5 million children have been infected with HIV, resulting in approximately 4.5 million AIDS cases worldwide.
1. Centers for Disease Control and Prevention. First 500,000 AIDS cases, 1995. MMWR 1995; 44:849-853. *