Reports on HIV/AIDS: 1990

NOVEMBER 30, 1990, MMWR, Vol. 39, RR-16 [inclusive page numbers]
Ascertainment estimates based on male U.S. residents who are 25-44 years of age
at the time of death can be applied to all persons with life-threatening symptomatic
HIV infection if ascertainment is similar for most other HIV-infected persons. For
example, ascertainment may be less complete for IVDUs in New York City (A 12) and
for children <13 years of age. Male U.S. residents 25-44 years of age at diagnosis
(representing approximately two-thirds of all AIDS cases diagnosed through 1986;
Table Al) are used as a reference group because nearly all male U.S. residents 25-44
years of age at death were already members of this age group at diagnosis (22,540
[98%] of 22,965, based on deaths reported through September 1990). Of the remaining cases, approximately two-thirds represent adult and adolescent male U.S.
residents of other ages; the proportion of IVDUs who are members of these latter age
groups is lower than that in the reference group. Most other AIDS cases are among
females and among male nonresidents (i.e., males living in U.S. territories); the
proportion of IVDUs who are members of these latter groups is higher than that for
the reference group (Table Al). Because resident males in groups other than the 25-44
age group may have more complete ascertainment than the reference group but
females, children, and nonresidents may have less complete ascertainment, average
ascertainment for HIV-infected persons (ascertainment without regard to age, gender,
or mode of transmission) may very well be similar to that for men 25-44 years of age
at diagnosis.
Table Al illustrates that ascertainment of life-threatening symptomatic HIV infection by the AIDS surveillance data among male U.S. residents 25-44 years of age at
death may be similar to that for all persons infected with HIV. Table Al shows the
distribution of reported AIDS cases diagnosed through 1986 among the three groups
TABLE Al. Hypothetical example of current ascertainment of life-threatening symptomatic human immunodeficiency virus (HIV) infection by reported acquired immunodeficiency syndrome (AIDS) in the United States
Percentage of Average
Percentage intravenous drug ascertainment
Category of all cases* users and children (%)t
Male U.S. residents 25-44
years of age at diagnosis 68 16 75
Other adult and adolescent
male U.S. residents 21 9 77
Adult and adolescent male
nonresidents, and females
and children' 11 60 62
All cases 100 - 741
*Based on cases diagnosed through 1986 and reported through September 1990.
tAssumes 50% ascertainment among intravenous drug users (IVDUs) and children, and 80% for
all others.
'Nonresidents are persons living in U.S. territories.
"The number of persons with life-threatening symptomatic HIV infection in each group is the
number of reported AIDS cases in that group divided by the ascertainment in that group.
Overall ascertainment is the number of reported cases divided by the total number with
life-threatening symptomatic HIV infection. Percent ascertainment is 100 divided by the sum of
the percentage of cases in each group divided by ascertainment in that group.

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