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AIDS In America: We Are Not Out Of The Woods Yet

Yesterday I introduced my friend Charles Roth. Charles was diagnosed with HIV/AIDS in 2003 and was already in bad shape. He had been tested as healthy the previous year, but the disease struck quickly, hospitalizing him for a week and keeping him out of work for a month and a half. He returned to work but repeated illnesses due to AIDS meant that by 2006, he was unable to work full-time. A bank executive, Charles still tries to find occasional contract work or odd jobs like résumé writing and tax preparation, but with the recession, these jobs are low-paying and hard to come by. For the most part he makes do with a tiny state disability check and food stamps.

So how typical is Charles’s case? We’ve all heard of success stories like Magic Johnson, who was diagnosed with HIV in 1991 and still has not developed AIDS. But clearly neither case tells the whole story.

Here’s a website showing how the disease usually progresses. Charles’s case is clearly not typical: Generally it takes between 8 and 10 years after an HIV infection for clinical AIDS to be observed. However, as many as ten percent of people with HIV develop AIDS within 2-3 years. But despite the early progression to AIDS, Charles has done better than expected. He had a viral load of 1.5 million HIV molecules per ml of blood when diagnosed; the median survival time for people with such a high load is less than 3.5 years.

So what is the expected survival rate for Americans with an AIDS diagnosis? The CDC has a thorough web site with a vast array of data. This chart gives you a good sense of the odds:

The vertical axis gives the proportion of AIDS patients surviving (it uses decimal proportions; multiply by 100 for percentages), and the horizontal axis shows the length of time following diagnosis. 108 months is 9 years, so you can see that roughly 65 percent of those diagnosed with AIDS in 1998 survived 9 years. Year after year, the prospects have improved, little by little. But the prospects aren’t the same for everyone. Take a look at this chart from the same site:

This combines results from many diagnosis years and just considers the survival rates for each race. As you can see, Blacks and American Indians do the worst, while Asians/Pacific Islanders do significantly better than Whites. Why? That’s a question for a separate post, but the graph shows that being white places Charles around the middle of the pack in terms of expected survival rates.

Does Charles’s race and gender make him more or less likely to be HIV positive? Take a look at this chart:

This graph (taken from this PDF) gives the portion of the population with HIV, by race and gender. As a white male, Charles is more than five times as likely to have HIV as white females, but less than half as likely as black females. Black males are over five times as likely to have HIV as white males. You might also notice that infection rates roughly parallel survival rates for those already infected. I’ll have more on that later as well.

But what about the fact that Charles wasn’t diagnosed with HIV/AIDS until 2003? How common is that? AIDS certainly isn’t in the news as much lately as it was, say, in the 1980s. Aren’t infection rates going down? This chart gives the answer:

The chart (from this page) gives the number of new HIV diagnoses by year from 1980 to 2006. As you can see, it peaked in the mid 1980s, but it’s been steady at around 50,000 new infections per year since around 1990. This problem isn’t going away.

*This blog post was originally published at The Daily Monthly*

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