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U.S. Agency To Raise HIV Estimates

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By DAVID BROWN, The Washington Post

Published: December 1, 2007

WASHINGTON - New government estimates of the number of Americans who become infected with the AIDS virus each year are 50 percent higher than previously thought, sources said Friday.

For more than a decade, epidemiologists at the Centers for Disease Control and Prevention have pegged the number of new HIV infections each year at 40,000. They now think it is between 55,000 and 60,000.

The higher estimate is the product of a new method of testing blood samples that can identify those who were infected within the previous five months. With a way to distinguish recent infections from long-standing ones, epidemiologists then can estimate how many new infections are appearing nationwide each month or year.

The higher estimate is based on data from 19 states, including Florida, and large cities that have been extrapolated to the nation as a whole.

The CDC has not announced the new estimate, but two people in direct contact with the scientists preparing it confirmed it Friday.

What is uncertain is whether the American HIV epidemic is growing or is simply larger than anyone thought. It will take two more years of using the more accurate method of estimation to spot a trend.

"The likelihood is that this bigger number represents a clearer picture of what has been there for the past few years. But we won't know for sure for a while," said Walt Senterfitt, an epidemiologist who is the chairman of the Community HIV/AIDS Mobilization Project, a New York-based activist organization.

There is evidence, however, that at least some of the higher number may reflect an uptick in infections in recent years. Information from 33 states with the most precise form of reporting showed a 13 percent increase in HIV infections in gay men from 2001 to 2005.

The news comes less than two weeks after UNAIDS, the United Nations agency responsible for charting the course of the global epidemic, drastically reduced its estimate of the number of people living with the disease worldwide. The reason was the same - crude methods of counting were replaced by better ones.

A paper describing the new U.S. estimate is under review at a scientific journal, Thomas Skinner, a CDC spokesman, said Friday night.

"We have to wait until this paper comes out, until it has gone through peer review, before we know what the new estimates look like," he said.

Rumors have circulated for weeks that CDC was preparing a dramatic upward revision of HIV incidence. The Washington Blade, a gay-oriented newspaper, reported rumors of the new estimates two weeks ago.

The CDC has reported the figure of 40,000 new infections each year for more than a decade, citing it as evidence that the epidemic in this country is stable. While widely cited, that number never has been adequately explained or justified in the eyes of many epidemiologists.

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