Reports on HIV/AIDS: 1990

JULY, 1990, MMWR, Vol. 39, No. SS-3, pp. 23-30
(e.g., Puerto Rico, Virgin Islands), because postcensus projections and population
data specific for age, sex, and racial/ethnic minority group were unavailable for U.S.
territories. To estimate the non-Hispanic white population, the authors assumed all
Hispanics to be white (5), and their number was subtracted from the white population
(Irwin R. Demo-Detail, unpublished postcensus estimates recorded on computer tape,
adjusted to agree with the Census Bureau's national estimates by age, sex, and race
in Current Population Reports, Series P-25, No. 1022). Asians and Pacific Islanders
were assumed to represent 79% of the population other than whites and blacks, and
American Indians and Alaskan Natives were assumed to represent 21% of this
"other" population (the same distribution estimated for 1980).
Mortality data are provisional, based on a 10% sample of death certificates for U.S.
deaths in 1988 (6). Deaths due to AIDS or other HIV disease were assumed to be
those in which the underlying cause of death was assigned code 042, 043, or 044,
according to the International Classification of Diseases, 9th Edition (7). Hispanics
were not separated from whites or other racial/ethnic groups in analysis of mortality
data.
The prevalence of HIV infection among childbearing women was determined by
anonymously testing blood for antibodies to HIV by the enzyme immunoassay (EIA)
and Western blot methods. Blood samples were routinely collected from newborn
infants for diagnosis of hereditary metabolic disorders. The prevalence of HIV
antibody in these samples measures the prevalence of HIV infection among childbearing women because maternal antibody is transferred to the infants before birth,
sample selection is relatively unbiased, and blood specimens are available for >90%
of births.
RESULTS
HIV/AIDS Morbidity and Mortality
Hispanic and black children and women of childbearing age have accounted for a
disproportionate share of AIDS cases compared with the proportion of the U.S.
population they represent (Figures 1, 2). The annual incidence of AIDS among
children and women of childbearing age in the United States has been increasing
every year for most racial/ethnic groups but has been persistently higher among
blacks and Hispanics than among other groups (Figures 3, 4).
Most AIDS cases among women of childbearing age have been related to
intravenous (IV)-drug use, either directly (by IV-drug users sharing needles or
syringes) or indirectly (by sexual contact with an IV-drug user) (Table 1). Among
blacks and Hispanics, most cases among children have been indirectly related to
IV-drug use (by perinatal transmission to an infant or fetus from a mother who used
IV drugs or whose sex partner used IV drugs) (Table 2). The proportion of pediatric
cases related to IV-drug use has been smaller among other racial/ethnic groups.
The mortality rate from HIV/AIDS per 1,000,000 population for black and white
women, respectively, was 1.8 and 0.4 among those 15-24 years of age, 15.1 and 1.5
among those 25-34 years of age, and 16.9 and 1.7 among those 35-44 years of age.
Among women 25-34 years of age, HIV-related deaths accounted for 11% and 3% of
all deaths among black and white women, respectively. Overall, 1,010 deaths
(6.4/100,000) occurred among black females and 880 deaths (0.8/100,000) among
white females for all ages combined (6).

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