The Changing Epidemic


The first cases of AIDS were reported in 1981 (CDC, 1981). Through 1999, a total of 733,374 AIDS cases and 430,411 AIDS-related deaths were reported. Approximately 99 percent (724,656) of AIDS cases were reported among adults and adolescents age 13 and older; 1 percent (8,718) were reported among children under the age of 13. In 1999, 46,400 new AIDS cases were reported (CDC, 2000b). Cases reported in the United States account for less than 1 percent of the estimated cases reported worldwide (Text Box A.1).

During the first decade of the epidemic, the number of new AIDS cases rose by between 65 percent and 90 percent annually (CDC, 1996).2 In 1996, AIDS incidence3 and AIDS deaths declined for the first time in the history of the epidemic (CDC, 1997) (Figure A.1). These declines can be attributed to advances in antiretroviral therapies that slow disease


This section relies heavily on information contained in “The States of the HIV/AIDS Epidemic” (Kaiser Family Foundation, 2000).


These numbers must be interpreted with caution, however, as the AIDS case definition changed in 1985, 1987, and 1993.


The expansion of the AIDS case definition in 1993 created a temporary distortion in AIDS trend incidence. By the end of 1996, the temporary distortion caused by reporting prevalent and incident cases that met criteria added in 1993 had almost entirely disappeared. Figure A.1 reflects this distortion in the AIDS incidence trend.

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