摘要：Objectives. In the United States a growing proportion of cases of heterosexually acquired HIV infections occur in women and in persons of color. We analyzed the association between race/ethnicity, whether diagnoses of HIV infection and AIDS were made concurrently, and the survival after diagnosis of heterosexually acquired AIDS. Methods. We used data from 29 states that report confidential name-based HIV/AIDS cases to the Centers for Disease Control and Prevention to calculate estimated annual percentage change in the number of actual diagnoses and analyzed the association between race/ethnicity and concurrent diagnoses of HIV and AIDS. We adjusted for reporting delays and absence of information about HIV risk factors. Results. During 1999 to 2004, diagnoses of heterosexually acquired HIV were made for 52 569 persons in 29 states; 33 554 (64%) were women. Among men and women, 38 470 (73%) were non-Hispanic Black; 7761 (15%), non-Hispanic White; and 5383 (10%), Hispanic. The number of persons with heterosexually acquired HIV significantly increased: 6.1% among Hispanic men (95% confidence interval=2.7, 9.7) and 4.5% among Hispanic women (95% confidence interval=1.8, 7.3). The number significantly decreased (–2.9%) among non-Hispanic Black men. Concurrent HIV and AIDS diagnoses were slightly more common for non-Hispanic Whites (23%) and Hispanics (23%) than for non-Hispanic Blacks (20%). Conclusions. To decrease the incidence of heterosexually acquired HIV infections, prevention and education programs should target all persons at risk, especially women, non-Hispanic Blacks, and Hispanics. Worldwide, most HIV infections result from heterosexual transmission. 1 In the United States, a growing proportion of cases of AIDS has been attributed to heterosexual contact. By contrast, the proportion of AIDS cases transmitted by male-to-male sexual contact and by injection drug use has decreased since the start of the HIV epidemic. In 2004, heterosexually acquired HIV infections accounted for a large proportion (33%) of new diagnoses of HIV infection reported to the Centers for Disease Control and Prevention (CDC), second only to the proportion acquired by male-to-male sexual contact (47%). 2 Most HIV infections in women in the United States are heterosexually acquired. 3 The proportion of heterosexually acquired cases of HIV infection is higher for younger women than for older women. 4 – 6 The HIV epidemic continues to disproportionately affect persons from certain racial and ethnic groups. Late diagnosis of HIV infection (near the time of AIDS diagnosis) has been shown to be more common for persons with heterosexually acquired HIV infections, non-Hispanic Blacks, and Hispanics than for persons in other transmission categories or belonging to other racial and ethnic groups. 7 This has been attributed to the fact that non-Hispanic Blacks and Hispanics historically have had less access to treatment and prevention services. 8 Important indicators of access to screening and testing services are the interval between HIV diagnosis and AIDS diagnosis and survival after an AIDS diagnosis. Few studies have reported on these indicators among persons with heterosexually acquired HIV. In addition, few studies have reported on survival rates for persons with heterosexually acquired AIDS. 9 , 10 To clarify the characteristics of persons with heterosexually acquired HIV infection in the United States, we analyzed the association between race/ethnicity, whether diagnoses of HIV infection and AIDS were made concurrently, and survival after diagnosis of heterosexually acquired AIDS.
