Reports on HIV/AIDS: 1990

JULY, 1990, MMWR, Vol. 39, No. SS-3, pp. 23-30
In 1988, HIV infection accounted for 360 deaths among children in the United
States. Although HIV infection is not a major cause of infant mortality, it is now
among the 10 leading causes of death for children 1-4 years of age. In 1988, the death
rate for black children (2.1/100,000) was five times higher than the rate for white
children (0.4/100,000) (6).
HIV-Seroprevalence Data
Published data were available from a survey for maternal HIV antibody conducted
in New York State by using specimens submitted for metabolic screening of
newborns (8). Blood specimens were submitted for an estimated 99% of all infants
born in the state during the period November 30, 1987-November 30, 1988. Statewide
HIV-seroprevalence rates were 0.13% for whites, 1.82% for blacks, and 1.31% for
Hispanics; 1,816 births to HIV-seropositive mothers occurred during the 1-year study
period, including 982 (54%) among blacks and 539 (30%) among Hispanics.
From October 1985 through December 1989, a total of 358,584 civilian female
applicants for military service were tested for antibody to HIV as part of the entrance
medical examination; 225 (0.06%) were seropositive. Among the women tested,
seroprevalence rates were 0.02% for whites, 0.15% for blacks, and 0.08% for Hispanics
(U.S. Department of Defense, unpublished data). Fifty-four of the HIV-seropositive
applicants were from New York, where seroprevalence rates were 0.06% for whites,
0.54% for blacks, and 0.34% for Hispanics.
DISCUSSION
Current trends in the ongoing surveillance of HIV seroprevalence and AIDS
incidence document the special needs of black and Hispanic communities for
prevention of HIV infection and treatment of HIV disease among women of childbearing age and their children. Specific public health needs include education and
development of skills pertaining to the prevention of HIV, HIV-antibody testing and
counseling, information related to early interventions for HIV-seropositive individuals, access to these interventions, and provision of social services related to management and prevention of HIV infection.
Public health surveillance indicates that IV-drug use represents the primary route
of HIV transmission among black and Hispanic women and children. Programs for
preventing HIV infection among blacks and Hispanics should focus on drug-related
issues in addition to precautions regarding heterosexual and homosexual contact.
Drug-prevention and rehabilitation programs should include HIV-related services,
and drug-treatment services should be more available within black and Hispanic
communities.
State and local health agencies should provide prevention and care services
through multiple sources, recognizing the socioeconomic barriers and the diverse
patterns of culture and communication represented within these two racial/ethnic
minority groups.
References
1. Selik RM, Castro KG, Pappaioanou M. Racial/ethnic differences in the risk of AIDS in the
United States. Am J Public Health 1988;78:1539-45.
2. Selik RM, Castro KG, Pappaioanou M. Birthplace and the risk of AIDS among Hispanics in the
United States. Am J Public Health 1989;79:836-39.
3. Gwinn M, Selik R, Allen D, Petersen L, St. Louis M, Dondero T. Racial and ethnic differences
in HIV seroprevalence in selected United States populations. Abstract W.D.P.24. In: Abstracts,
V International Conference on AIDS. Montreal, June 4-9, 1989:746.

95