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Sunday, December 2nd 2007

The Estimates Are Above Reproach

The CDC is apparently about to make a massive “adjustment” in the incidence of HIV in the United States.

U.S. health officials are finalizing statistics that are expected to show the number of people infected with HIV in the U.S. every year has been up to 50% higher than previously estimated, according to researchers familiar with the discussions.

[I]t is widely believed that the U.S. Centers for Disease Control and Prevention plans to release data next year showing that in 2005 the number of new HIV infections was 20% to 50% higher than the older numbers, or as many as 60,000 new infections.

And of course this raises some questions (as well as eyebrows). Is the epidemic, at least internationally, being over or understated?

The expected upward U.S. revision, along with last week’s 16% reduction by the United Nations in the estimated global AIDS toll, raises fresh questions about how accurate a grasp public health officials have of the scope of the HIV/AIDS epidemic. For years, official statistics painted a picture of an epidemic that had stabilized in the U.S., but was hitting nearly 40 million people globally.


For years, epidemic trackers relied heavily on studies of HIV infection levels in prenatal clinics to estimate the global AIDS epidemic as affecting 39.5 million, with a range of uncertainty of between 34.7 million and 47.1 million. Now, new data based on house-to-house surveys from 30 countries helped UNAIDS and the World Health Organization lower that figure to about 33 million.

The news, although good, touched off a wave of outrage by critics who charged criticism that UNAIDS and WHO delayed correcting statistics to maximize the threat of AIDS and keep AIDS at the top of the agenda of world health priorities. “Every advocacy organization will always select the higher numbers if given the choice,” be it polio or AIDS, says former WHO scientist James Chin, now University of California at Berkeley Clinical Professor of Epidemiology. “These are myths they perpetuated to keep it on the front burner,” says Dr. Chin.