In 1997, women accounted for 21% of AIDS cases in adults, and the proportion of all cases that are among females continues to grow. At least two-thirds of AIDS in women can be attributed to injection drug use either directly or through sex with drug users. Although a subset of women with HIV have injected drugs or have had sex with a known injection drug user, an increasing proportion of women have become infected through sexual activity with men whose risk behaviors were unknown to them. AIDS is more prevalent in African-American and Hispanic women, in women in the Northeast and the South, and in women in large cities. Approximately 6,000 to 7,000 HIV-infected women give birth every year. Trend data show a relatively steady national rate of HIV prevalence in childbearing women between 1989 and 1994, the last year for which data are available.
Perinatal transmission accounted for at least 432 AIDS cases in the United States in 1997. The number of perinatally acquired AIDS cases rose rapidly in the late 1980s and early 1990s, peaked around 1992, and subsequently declined by approximately 43% by 1996. Such data on perinatal AIDS cases reflect the number of children born with HIV infection in previous years, and more recent data are not available because of reporting delays. Changes in the number of perinatal AIDS cases, therefore, are not direct estimates of the impact of prevention activities on perinatal transmission of HIV.
Pediatrics AIDS cases are concentrated in eastern states, and especially in the New York metropolitan area. In 1996, three states alone—New York, New Jersey, and Florida—reported 330 cases. This represents 49% of the diagnosed cases, even though only 15% of children are born in those states (CDC, 1996b; Ventura et al., 1998). In contrast to the concentration of perinatal AIDS cases in the Northeast, they are far less common in most geographical areas. In 1997, 39 states had fewer than ten perinatally transmitted AIDS cases (CDC, 1997c).