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2004 National Healthcare Quality Report

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Findings

HIV-Infection Deaths per 100,000 Population

Although a cure for HIV infection has not been identified, current drug therapies are sometimes able to reduce the amount of virus in an infected individual's body, resulting in better prognosis for an HIV patient today versus 10 years ago.

Figure 2.12. New AIDS cases and HIV infection deaths, per 100,000 population, 1996-2002

Figure 2.12. New AIDS cases and HIV infection deaths, per 100,000 population, 1996-2002

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Source: Centers for Disease Control and Prevention, National Center for HIV, STD and TB Prevention, HIV/AIDS Reporting System; Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System — Mortality.

  • Mortality rates due to AIDS have declined considerably since 1995. HIV deaths declined more than 57% from 1996 to 1998 (Figure 2.12).
  • Although there was a decline in the rate of new AIDS cases between 1998 and 2001, the rate of HIV mortality stayed virtually the same during that time.

New AIDS Cases per 100,000 Population Age 13 and Older

Changes in HIV infection rates are a reflection of behavioral changes in at-risk individuals that may only partly be influenced by the health care system. However, individual and community programs have shown progress in changing care-seeking behaviors, and, if patients get appropriate treatment for HIV infection, the incidence of new cases may be reduced.

Figure 2.13. New AIDS cases by age group, 1998-2002

Figure 2.13. New AIDS cases by age group, 1998-2002

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Source: Centers for Disease Control and Prevention, National Center for HIV, STD and TB Prevention, HIV/AIDS Reporting System.

  • After declining nearly 5.6% between 1998 and 2001, the rate of new AIDS cases has leveled.
  • New AIDS infection rates vary by age, with adults between 18 and 44 being infected at a rate that is 44% higher than the national rate of Americans age 13 and older (Figure 2.13).
  • Black, non-Hispanic adults contract AIDS at a rate that is over four times higher (75.4 cases per 100,000) than the national average of 17.2 cases per 100,000 (see Tables Appendix, Table 1.54).

Receipt of HAART, Prophylaxis for PCP, and Prophylaxis for MAC

Receipt of these three treatments by eligible AIDS patients represents widely accepted standards for appropriate HIV care. Current national data do not reflect the extent to which these standards are being met; data from the HIV Research Network are presented below. (The Network is sponsored by AHRQ, the Substance Abuse and Mental Health Services Administration, the Health Resources and Services Administration, the Office of AIDS Research at the National Institutes of Health, and the Office of the Assistant Secretary for Planning and Evaluation, HHS.)

Figure 2.14. Percentage of eligible AIDS patients receiving recommended treatments, 2001

Figure 2.14. Percentage of eligible AIDS patients receiving recommended treatments, 2001

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Source: HIV Research Network.

Note: Data from the HIV Research Network are not nationally representative of the level of care received by all Americans living with HIV. Participation in this network is voluntary, and network data only represent patients that are actually receiving care. Furthermore, data shown above are not representative of the HIV Research Network as a whole, because they represent only a subset of network sites that have the best quality data. (For more information on the HIV Research Network, see: http://www.ahrq.gov/data/hivnet.htm.)

  • In 2001, 91% of eligible patients (two or more CD4 test results below 350) received HAART (Figure 2.14).
  • Of those eligible (2,533 patients with at least two CD4 cell counts below 200), 88% received PCP prophylaxis.
  • Of those eligible (754 patients with at least two CD4 cell counts below 50), 88% received MAC prophylaxis.

 

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