[[But keep in mind that the infections that caused many of these cases occured before the alarm had been sounded and the public had been informed that this killer was on the prowl.]]
But not so true anymore. Most people with HIV/AIDS nowadays were infected since most were aware of this virus, how it’s spread, and since testing was available. Not all, though. I know a few long-term survivors. I’m just saying that people are still being infected. Sexual behavior is complicated and hard to change though, even after watching friends and loved ones die from AIDS.
[[It is likely that the new HIV infection rate among Gays has actually decreased as awareness among the gay population has risen and more and more gays are practicing safe sex and monogamy.]]
True, but there is also evidence that there is an increase in unsafe sex among young gay males in some urban areas. We also see other diseases like gonorrhea making an upswing in the gay community. Who knows if it’s denial, fatalism, or what. In the Rocky mountain west, anyway, we don’t see any big decrease in cases in this population. Gay males continue to be the hardest hit - among newly diagnosed as well as those living with the disease (“Newly diagnosed” meaning newly tested, though they might have been infected some time ago in some cases). And we don’t see a big move toward heterosexual cases. But then we don’t have as big an epidemic in the injection drug using population, either.
[[On the other hand, the fact that AIDS cases in heterosexual women were up from 7% in 1983 to nearly 23% in 1998 would indicate that the HIV transmissions in this demographic were on the rise years before these AIDS cases were reported. This wouldn’t surprise me considering the false sense of security that was so pervasive among the heterosexual population at the outset of the epidemic.]]
In the US, at least, you find this move into the heterosexual population starting with an earlier move into the drug using population. It then spreads both ways. In the east and the south in particular it’s becoming more heterosexual - especially among non-white populations.
[[As for how many new HIV infections are occuring today and what demographics they affect, who knows for sure? Its easier to ascertain the number of new AIDS cases because they show up in the hospitals, but new HIV infections are much more difficult to count. Many people don’t get tested and can live for years oblivious of their HIV status. How are those people factored into the statistics?]]
HIV case reporting only reflects testing behavior, true. We are finding in my state that even after HIV became reportable we continue to get cases of end-stage AIDS cases reported. These are usually people who either avoided testing for HIV altogether (and so are being reported with HIV and AIDS at the same time) or tested a long time ago and delayed getting services until they were dying. It’s sad.
[[Is it an estimation game, or are they not factored in at all? To say the least, I’m very skeptical of the methodologies used in gathering data on this epidemic.]]
I would venture to say that the surveillance system for this disease is the best (and most secure) surveillance system for any disease or condition in the world. It is limited by the fact that some people who are infected avoid testing, but we also do seroprevalence testing (anonymous population-wide testing in sentinel sites), so we have a pretty good idea how much is out there. I doubt very much there would be a lot of surprises, anyway.
[[I do recall reading that U.S. heterosexual HIV transmissions had surpassed homosexual transmissions years ago. I would not be surprised at all if that were the case]]
In certain small, specific populations in the US that might be true. Worldwide half the cases are female, and it is definitely primarily a heterosexual disease. Central Africa is being devastated by it.