As of June 1997 report of AIDS cases in the United States totaled 612,078 (CDC, 1997), including 604,176 adults/adolescents (511,934 males and 92,242 females) and 7,902 children (<13 years old). From 1981 through 1997, approximately 374,656 and 4,602 adults/adolescents and children (<13 years old) have died because of AIDS, respectively (CDC, 1997). Table I (CDC, 1997) shows a summary of exposure category in adults/adolescents and children in the general U.S. population. In Table I (see also Tables II-IV), other exposures include HIV-infected blood, body fluids, or concentrated virus in health care,
TABLE I. AIDS Cases by Exposure Category in Adults/Adolescents and Children in the U.S. Population through June 1997"
Exposure category Total %
Men who have sex with men 298,699 49
Injecting drug use 154,664 26
Heterosexual contacts 54,571 9
Men who have sex with men and injecting drug use 38,923 6
Hemophilia/coagulation disorder 4,567 1
Receipt of blood transfusions, blood components, or tissue 8,075 1
Other risks 44,677 7
Adult/adolescent subtotal 604,176
Children (<13 years old)
Mother with/at risk for HIV infection 7,157 91
Receipt of blood transfusions, blood components, or tissue 375 5
Hemophilia/coagulation disorder 232 2
Other risks 138 2
Children subtotal 7,902 Total 612,078
"CDC: HIV Surveillance Report (1997, Vol. 9, No. 1).
laboratory, or household settings as supported by seroconversion, epidemiologic, and/or laboratory evidence (CDC, 1997).
Although the percentage of AIDS cases (Table I) resulting from heterosexual contacts among adults and adolescents is still low (95%), relative to other major risk factors, the number of AIDS cases in this subgroup is increasing rapidly (Ward & Duchin, 1998). For example, from 1990 through 1995, the incidence of AIDS (i.e., new cases within a given period) increased 189% for individuals infected with HIV because of heterosexual contacts with persons infected with this virus or at risk for HIV, in comparison with 12% for bisexual and homosexual men (Ward & Duchin, 1998). In these findings, adults/adolescent women are being significantly affected, compared to the rate of HIV infection among men. For example, from 1990 through 1995 the rate of AIDS resulting from heterosexual contacts among men in the general population increased by 27%, whereas the rate for women was 103% (Ward & Duchin, 1998).
Similarly, from 1995 through 1997, a total of 6,606 new cases of AIDS among adults/adolescent men were reported to the CDC (1997), compared to 11,399 of cases among adults/adolescent women. These findings probably explain the fact that the main risk factor for HIV infection among children has involved mothers with HIV or at risk for HIV infection (i.e., 91% in Table I). These findings suggest the need for the development of mental health services tailored to persons with HIV/AIDS from the subgroup of heterosexuals, with particular emphasis on heterosexual women who appeared to be at a higher risk for HIV infection, relative to the rate of this disease among men.
It should be noted that among adults/adolescent AIDS cases reported to the CDC through 1997, only 5% represent persons 13-25 years of age. Persons within this age range, however, are at highest risk for HIV infection (Paniagua, O'Boyle, & Wagner, 1997; Ward & Duchin, 1998). Because symptoms suggesting AIDS are generally developed 10 to 15 years after the acquisition of the virus, most clients with AIDS cases seen by mental health professionals were probably infected with the HIV virus during their adolescence or young adult stage (i.e., 13-25 years).
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