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2004 National Healthcare Quality Report

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Effectiveness: HIV and AIDS

Importance and Measures

Human immunodeficiency virus (HIV) causes the progressive deterioration of the body's immune system, which, if untreated, eventually leads to a condition known as acquired immune deficiency syndrome (AIDS). Since 1996, new antiretroviral treatments using combinations of different antiretroviral drugs (known as highly active antiretroviral therapy, or HAART) have been used.

Prevalence and Incidence

  • 877,275 adult and adolescent Americans have been diagnosed with AIDS through 20021. Of these, 81.8% are male1.
  • 9,300 children under the age of 13 have been diagnosed with AIDS1.
  • The greatest numbers of AIDS cases have occurred in the age groups of 25-34 and 35-44 years, affecting 301,278 and 347,860 Americans, respectively1.

Morbidity and Mortality

  • After years on the increase, the rate of HIV mortality began a decline in the mid-1990s.
  • As of 2002, HIV was the seventh leading cause of death for Americans ages 15-24 and the fifth leading cause of death for Americans ages 25-442.


  • The total cost of treating HIV and AIDS patients in the United States is between $6.7 billion and $7.8 billion annually, or $20,000 to $24,700 per person with a diagnosed infection3, 4.
  • More than half of adult AIDS patients and more than 90% of children with AIDS rely on Medicaid for coverage5. Combined Federal and State Medicaid expenditures for AIDS patients totaled $8.5 billion in fiscal year 20036.


This report tracks two quality measures for HIV and AIDS:

  • HIV-infection deaths per 100,000 population
  • New AIDS cases per 100,000 population age 13 and over

The report also presents supplemental data on receipt of highly active antiretroviral therapy (HAART), prophylaxis for Pneumocystis pneumonia (PCP), and prophylaxis for Mycobacterium avium complex (MAC)i from the HIV Research Network. Providers in this network pool data and collaborate on research to provide policymakers and investigators with timely information about access to and cost, quality, and safety of HIV care as well as to share information and best practices.

i It is recommended that persons with HIV infection receive prophylaxis for PCP when CD4 cells fall below 200 per cubic milliliter, and they should receive prophylaxis for MAC when CD4 cells reach 50.


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