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Undiagnosed HIV Prevalence Among Adults and Adolescents in the United States at the End of 2006

Campsmith, Michael L DDS, MPH; Rhodes, Philip H PhD; Hall, H Irene PhD; Green, Timothy A PhD

JAIDS Journal of Acquired Immune Deficiency Syndromes:
doi: 10.1097/QAI.0b013e3181bf1c45
Epidemiology and Social Science

Objectives: To describe adults/adolescents (age 13 years and older) living with undiagnosed HIV infection in the United States at the end of 2006.

Methods: HIV prevalence and percentage undiagnosed were estimated from cumulative HIV incidence using an extended back-calculation model (using both HIV and AIDS data, the time of first diagnosis with HIV, and disease severity at diagnosis) and estimated cumulative deaths.

Results: An estimated 1,106,400 adults/adolescents (95% confidence interval = 1,056,400-1,156,400) were living with HIV in the United States at the end of 2006; overall, 21.0% (232,700; 95% confidence interval = 221,200-244,200) were undiagnosed. Whites had the lowest percentage undiagnosed (18.8%) compared with Hispanics/Latinos (21.6%), blacks/African Americans (22.2%), American Indians/Alaska Natives (25.8%), and Asians/Pacific Islanders (29.5%; all P < 0.001). Persons with a behavioral risk of injection drug use (IDU) had the lowest percentage undiagnosed (female IDU: 13.7% and male IDU: 14.5%); men exposed through heterosexual contact had the highest (26.7%) followed by men who have sex with men (23.5%).

Conclusions: Differences in undiagnosed HIV were evident across demographic and behavior groups. Effective testing programs and early access to treatment and prevention services are necessary to reduce undiagnosed HIV infections and HIV prevalence.

Author Information

From the Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA.

Received for publication May 12, 2009; accepted August 31, 2009.

The previous work by the authors “Estimated prevalence of undiagnosed HIV infection in the United States at the end of 2006” was presented at 16th Conference on Retroviruses and Opportunistic Infections; February 8-11, 2009; Montreal, Canada. Abstract W-187.

The findings and conclusions in this article are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

Correspondence to: Michael L. Campsmith, DDS, MPH, MS E-47, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA 30333 (e-mail:

© 2010 Lippincott Williams & Wilkins, Inc.