We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

The Expanding Regional Diversity of the Acquired Immunodeficiency Syndrome Epidemic in the United States

Dale J. Hu, MD, MPH; Patricia L. Fleming, PhD; Mitzi A. Mays; John W. Ward, MD
Arch Intern Med. 1994;154(6):654-659. doi:10.1001/archinte.1994.00420060084009.
Text Size: A A A
Published online


Background:  The geographic spread of the human immunodeficiency virus (HIV) epidemic reflects multiple subepidemics in different regions and population groups.

Methods:  To describe regional trends in the acquired immunodeficiency syndrome (AIDS) in the United States, we analyzed national surveillance data for persons with AIDS diagnosed from 1988 through 1991.

Results:  Highest annual AIDS incidence rates were in the US territories (52.7 per 100000) and the Northeast (27.7 per 100 000). The greatest percentage increases were in the US territories (68.8%), the South (60.1%), and the Midwest (52.4%). Men who have sex with men constituted the majority of AIDS cases nationally (54.6%), as well as in the Midwest (67.8%), the South (57.4%), and the West (75.3%). Among injecting drug users, the greatest rates of increase in AIDS cases were observed among blacks in the South. Although large increases in the number of persons with HIV transmitted through heterosexual contact were reported from almost all regions, the largest increase was in the South.

Conclusion:  High rates of increase in AIDS cases from the Midwest, South, and US territories probably reflect later entry of HIV into these regions compared with the earlier HIV epidemics in large metropolitan areas of the Northeast and West. In particular, because the South has the largest population of the regions, and sexually transmitted disease surveillance data suggest that substantial populations in the South are at risk, the marked increase in AIDS incidence in this region suggests that the major impact of the epidemic may yet be seen. The continuing spread of HIV and AIDS in different communities and regions demonstrates the need to expand preventive and therapeutic services.(Arch Intern Med. 1994;154:654-659)


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

19 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.