Choosing Unsafe Sex: AIDS-Risk Denial among Disadvantaged Women

By Elisa J. Sobo | Go to book overview

Chapter 2
Women and AIDS in the United States

As I write, the cumulative total number of reported AIDS cases in the United States hovers at about 400,000. By the end of 1993, about 61 percent of all individuals who had been diagnosed with AIDS since its biomedical identification were dead ( CDC 1994a). AIDS is the third leading cause of death among U.S. men and women aged twenty-five to forty- four; it is the ninth leading cause overall ( CDC 1993d).

Most of the people who are now suffering from AIDS were infected years ago with Human Immunodeficiency Virus (HIV), the virus associated with AIDS. Today, between 550,000 and 1,000,000 U.S. residents are HIV positive (infected). The higher estimate, itself a downward correction for a 1986 Public Health Service estimate that up to 1,500,000 individuals harbored the virus, was arrived at during a workshop in 1989 ( CDC 1990), and will remain the "official" Centers for Disease Control and Prevention (CDC) figure until the results of a 1994 workshop are announced. The lower estimate comes from an analysis of the first three years of data collected in a six-year national household survey carried out between 1988 and 1994 under the auspices of the National Center for Health Statistics (NCHS). The survey, called the National Health and Nutrition Examination Survey, collects data on numerous health topics using blood tests and other techniques ( McQuillan et al. 1994).

The NCHS finding, which is about half the official CDC estimate, suggested to many researchers that HIV infections -- and so AIDS cases -- are not increasing as quickly as experts originally thought they would. But others point out that the survey did not cover people who do not live in private households, so prisoners, the homeless, and people who were hospitalized at the time of the study -- people who are generally at an increased risk for HIV infection -- are not represented in the figure given. Geraldine McQuillan, who oversaw the HIV data collection and analyses, suggests that, had these people been included, the figure might have been 600,000 rather than 550,000 (personal communication). She also

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