CDC report on new HIV infections in U.S. did not include data from Puerto Rico; omission has widespread consequences, advocates say

Sep 2 2008

A CDC report released last month about new annual HIV infections in the U.S. did not include data from Puerto Rico, an omission that Hispanic HIV/AIDS advocates say could have widespread consequences nationwide, the Orlando Sentinel reports.

According to the advocates, CDC ignored the seriousness of HIV/AIDS in Puerto Rico, which has the fifth-largest concentration of HIV cases nationwide, by not including data in the report. In addition, the omission significantly lowers estimates on the number of Hispanics nationwide affected by HIV/AIDS. According to Guillermo Chacon, vice president of the Latino Commission on AIDS, the share of new HIV infections represented by Hispanics increases from the 17.3% reflected in the CDC report to 22% when data on Puerto Rico are included.

Accurate new infection estimates also help gauge how quickly HIV is spreading, which groups are at high risk and which areas have higher rates of HIV, all of which are necessary to develop effective prevention and treatment strategies, according to advocates. Chacon said that the report is "not acceptable," adding that the "number the CDC came up with doesn't fully reflect the severity of this epidemic among Latinos." Chacon added that "[n]ew policies" that address HIV/AIDS "are being formulated based, precisely, on the numbers" in the CDC report.

National HIV/AIDS estimates that do not accurately reflect HIV incidence among Hispanics could result in fewer resources allocated for prevention and treatment targeting Hispanics. "Excluding Puerto Rico, which has such a high incidence [of HIV], implies a reduction of funds for everybody," Rosaura Lopez, director of an HIV clinic in the San Juan suburb of Rio Piedras, said.

CDC said it did not include data on Puerto Rico in the report because it uses census population data for the report, and population is estimated differently in Puerto Rico than in the rest of the country. Kevin Fenton -- director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention -- said the agency is working with health officials in Puerto Rico to estimate HIV incidence. According to the Sentinel, CDC "further complicated" the issue last month when officials announced that eight states and Puerto Rico would not receive federal funding for an advanced HIV monitoring system (Rivera-Lyles, Orlando Sentinel, 8/30).

Related Editorial

CDC's new estimate of HIV incidence "has critical implications for the nation," David Holtgrave -- chair of the Department of Health, Behavior and Society at Johns Hopkins Bloomberg School of Public Health -- and Julie Scofield, executive director of the National Alliance of State and Territorial AIDS Directors, write in a Baltimore Sun opinion piece, adding that the U.S. "has much work to do."

Holtgrave and Scofield outline "seven things the U.S. can do now to get smarter and better at fighting the [HIV] epidemic," including increasing funding for HIV prevention services and funding a "new testing technology that enables better HIV incidence estimates" in additional states. In addition, CDC should aim to reduce new HIV cases by 50% in five years and increase efforts to fight HIV among minority communities and men who have sex with men, the authors write.

The authors add that the "next president must go further and once again make HIV in the U.S. a priority," concluding that the current "national path of apathy is not only ill-advised and expensive but also unethical and a public health error of the greatest magnitude" (Holtgrave/Scofield, Baltimore Sun, 8/31).