(October 2002) In 2001, an estimated 940,000 adults and children in the United States and Canada were living with HIV/AIDS; an estimated 45,000 became infected during 2001. Sex between men is the primary transmission route in the United States and Canada, but injecting drug use and heterosexual relations are also important. Although prevalence has increased among women, men account for the vast majority of North American adults living with HIV/AIDS and for an estimated 70 percent of new infections. Racial minorities and disadvantaged populations are disproportionately at risk of infection. African Americans accounted for 54 percent of new HIV infections in 2000, for example, although they made up just 13 percent of the U.S. population. About 80 percent of U.S. women infected with HIV are African American or Hispanic, according to the U.S. Centers for Disease Control and Prevention (CDC). These groups make up less than 30 percent of all U.S. women.

Researchers have reported high and increasing HIV prevalence among gay men in several areas in the United States and Canada. A recent CDC study conducted in six American cities found that about 30 percent of gay black men ages 23 to 29 had HIV/AIDS, as did 14 percent of Hispanic gay men and 7 percent of white gay men.30 After six years of steady decline, the rate of HIV infection among British Columbia’s gay male population increased by 9 percent between 2000 and 2001, according to statistics released by the British Columbia Centre for Disease Control and Prevention.31 The increased incidence of sexually transmitted infections among gay men in San Francisco, Los Angeles, and other large cities suggests that younger men are ignoring the safe sex rules that effectively stemmed the HIV/AIDS epidemic among North American gay men in the early 1990s. Without a reduction in high-risk behavior, HIV is likely to spread further. A similar increase in STIs has been detected in France, Australia, and other more developed countries.

Peter Lamptey is president of the Family Health International (FHI) Institute for HIV/AIDS. Merywen Wigley is an associate technical officer at the FHI Institute for HIV/AIDS. Dara Carr is a technical director for health communication at PRB. Yvette Collymore is senior editor at PRB. Excerpted from PRB’s Population Bulletin “Facing the HIV/AIDS Pandemic.”