HIV/AIDS Surveillance Report
Monday    November 1, 1993  

Suggested Citation: 
Centers for Disease Control and Prevention.  HIV/AIDS Surveillance
Report, November 1993 

Report Description
The U.S. AIDS case data presented below are extracted from the
"HIV/AIDS/ Survillance Report", published each quarter by the 
Division of HIV/AIDS, Center for Infectious Diseases, Centers for 
Disease Control and Prevention, Atlanta, GA  30333.  In addition to 
the data presented here, the printed report contains maps, figures, 
and technical notes.  Single copies of the printed report are 
available from: 

                        CDC National AIDS Clearinghouse 
                        P.O. Box 6003 
                        Rockville, MD  20849-6003 


Table 1. AIDS cases and annual rates per 100,000 population, by 
state, reported October 1991 through September 1992, October 1992 
through September 1993;(1) and cumulative totals, by state and age
group, through September 1993,(2) United States 
                                     Oct. 1991-         Oct. 1992-
                                     Sept. 1992         Sep. 1993 
State of residence                  No.    Rate        No.    Rate

Alabama                             465    11.4        705    17.0
Alaska                               18     3.2         60    10.2
Arizona                             408    10.9      1,202    31.3
Arkansas                            237    10.0        420    17.5
California                        8,641    28.4     17,474    56.4
Colorado                            415    12.3      1,193    34.5
Connecticut                         538    16.3      1,693    51.4
Delaware                            126    18.5        346    49.9
District of Columbia                724   121.0      1,370   232.3
Florida                           5,007    37.7      9,613    70.6
Georgia                           1,348    20.4      2,597    38.4
Hawaii                              175    15.4        324    27.9
Idaho                                36     3.5         71     6.6
Illinois                          1,842    16.0      3,005    25.8
Indiana                             370     6.6        831    14.6
Iowa                                 86     3.1        196     7.0
Kansas                              188     7.5        335    13.3
Kentucky                            207     5.6        316     8.4
Louisiana                           829    19.5      1,172    27.4
Maine                                50     4.0        126    10.2
Maryland                          1,096    22.6      2,353    47.6
Massachusetts                       767    12.8      2,532    42.4
Michigan                            784     8.4      1,752    18.6
Minnesota                           237     5.3        624    13.9
Mississippi                         231     8.9        468    17.9
Missouri                            650    12.6      1,679    32.3
Montana                              22     2.7         35     4.3
Nebraska                             68     4.3        179    11.1
Nevada                              235    18.3        601    44.0
New Hampshire                        48     4.3         99     9.0
New Jersey                        2,051    26.4      4,390    56.3
New Mexico                           90     5.8        307    19.4
New York                          8,232    45.6     16,031    88.4
North Carolina                      648     9.6      1,059    15.5
North Dakota                          4     0.6          4     0.6
Ohio                                696     6.4      1,490    13.5
Oklahoma                            228     7.2        716    22.3
Oregon                              283     9.7        732    24.4
Pennsylvania                      1,338    11.2      2,556    21.2
Rhode Island                        102    10.2        305    30.3
South Carolina                      347     9.7      1,395    38.4
South Dakota                          8     1.1         23     3.2
Tennessee                           442     8.9        967    19.2
Texas                             2,944    17.0      7,164    40.4
Utah                                145     8.2        270    14.9
Vermont                              26     4.6         60    10.5
Virginia                            606     9.6      1,590    24.9
Washington                          573    11.4      1,459    28.2
West Virginia                        61     3.4         78     4.3
Wisconsin                           224     4.5        700    13.9
Wyoming                               4     0.9         36     7.7

Subtotal                         44,900    17.8     94,703    37.0

Guam                                  1     0.7          2     1.5
Pacific Islands, U.S.                 -       -          -       -
Puerto Rico                       1,796    50.5      2,621    73.1
Virgin Islands, U.S.                 19    18.6         42    40.8

Total                            46,716    18.2     97,368    37.5


                                 Cumulative totals
                             Adults/         Children 
                           adolescents    < 13 years old     Total

Alabama                        2,275             43           2,318 
Alaska                           154              2             156 
Arizona                        3,059             14           3,073 
Arkansas                       1,239             21           1,260 
California                    62,201            356          62,557 
Colorado                       3,516             18           3,534 
Connecticu                     4,415             98           4,513 
Delaware                         830              7             837 
District of Columbia           5,231             78           5,309 
Florida                       32,008            751          32,759 
Georgia                        9,255             87           9,342 
Hawaii                         1,250             10           1,260 
Idaho                            203              2             205 
Illinois                      10,522            140          10,662 
Indiana                        2,443             17           2,460 
Iowa                             577              6             583 
Kansas                         1,031              5           1,036 
Kentucky                       1,148             13           1,161 
Louisiana                      4,811             67           4,878 
Maine                            427              4             431 
Maryland                       7,187            152           7,339 
Massachusetts                  7,238            132           7,370 
Michigan                       4,904             62           4,966 
Minnesota                      1,829             13           1,842 
Mississippi                    1,483             20           1,503 
Missouri                       4,626             33           4,659 
Montana                          134              2             136 
Nebraska                         469              4             473 
Nevada                         1,641             15           1,656 
New Hampshire                    368              6             374 
New Jersey                    18,106            423          18,529 
New Mexico                       831              2             833 
New York                      63,660          1,321          64,981 
North Carolina                 3,735             75           3,810 
North Dakota                      32              -              32 
Ohio                           4,944             68           5,012 
Oklahoma                       1,795             15           1,810 
Oregon                         2,233              9           2,242 
Pennsylvania                   9,086            120           9,206 
Rhode Island                     842              9             851 
South Carolina                 3,022             38           3,060 
South Dakota                      57              2              59 
Tennessee                      2,734             26           2,760 
Texas                         23,572            213          23,785 
Utah                             818             20             838 
Vermont                          176              2             178 
Virginia                       4,710             82           4,792 
Washington                     4,765             18           4,783 
West Virginia                    359              5             364 
Wisconsin                      1,705             19           1,724 
Wyoming                           91              -              91 

Subtotal                     323,747          4,645         328,392 

Guam                              12              -              12 
Pacific Islands, U.S               2              -              2
Puerto Rico                   10,436            256          10,692 
Virgin Islands, U.S.             147              5             152 

Total                        334,344          4,906         339,250 

(1)  Includes 9  months of data collected under the 1993 AIDS 
surveillance case definition for adults and adolescents.
(2)  During the third quarter of 1993, CDC received reports of
23,664 cases and  9,951 deaths among adults/adolescents and 196 
cases and 105 deaths among children.




Table 2. AIDS cases and annual rates per 100,000 population, by 
metropolitan area with 500,000 or more population, reported October 
1991 through September 1992, October 1992 through September 1993;1) 
and cumulative totals, by area and age group, through September 
1993, United States 
                                     Oct. 1991-        Oct. 1992- 
                                     Sept. 1992        Sept. 1993 
Metropolitan
area of residence(2)                 No.    Rate        No.    Rate 

Akron, Ohio                           36     5.4         46     6.9 
Albany-Schenectady, N.Y.             106    12.2        217    24.7 
Albuquerque, N.M.                     58     9.6        186    30.2 
Allentown, Pa.                        32     5.3        122    20.0 
Ann Arbor, Mich.                      29     5.8         63    12.4 
Atlanta, Ga.                         956    31.3      1,773    56.4 
Austin, Tex.                         241    27.6        586    65.0 
Bakersfield, Calif.                   50     8.8        161    27.3 
Baltimore, Md.                       669    27.7      1,628    66.6 
Baton Rouge, La.                      92    17.1        135    24.7 
Bergen-Passaic, N.J.                 267    20.9        677    52.8 
Birmingham, Ala.                     116    13.7        259    30.2 
Boston, Mass.                        659    11.6      2,268    40.2 
Buffalo, N.Y.                         69     5.8        198    16.5 
Charleston, S.C.                      70    13.4        259    47.9 
Charlotte, N.C.                      118     9.9        245    20.1 
Chicago, Ill.                      1,614    21.5      2,619    34.5 
Cincinnati, Ohio                     112     7.3        230    14.7 
Cleveland, Ohio                      199     9.0        458    20.6 
Columbus, Ohio                       158    11.5        336    24.1 
Dallas, Tex.                         759    27.7      1,805    64.4 
Dayton, Ohio                          67     7.0        132    13.7 
Denver, Colo.                        335    20.1      1,010    58.9 
Detroit, Mich.                       606    14.1      1,233    28.7 
El Paso, Tex.                         46     7.5        116    18.3 
Fort Lauderdale, Fla.                848    65.9      1,165    88.4 
Fort Worth, Tex.                     160    11.5        404    28.2 
Fresno, Calif.                        99    12.7        173    21.5 
Gary, Ind.                            47     7.7         78    12.6 
Grand Rapids, Mich.                   37     3.9        126    13.0 
Greensboro, N.C.                     128    12.0        151    14.0 
Greenville, S.C.                      62     7.4        255    29.8 
Harrisburg, Pa.                       46     7.7         78    12.9 
Hartford, Conn.                      167    14.8        565    50.2 
Honolulu, Hawaii                     124    14.6        256    29.6 
Houston, Tex.                      1,023    29.8      2,587    72.8 
Indianapolis, Ind.                   170    12.1        397    27.7 
Jacksonville, Fla.                   327    35.0        910    94.7 
Jersey City, N.J.                    313    56.6        619   111.8 
Kansas City, Mo.                     314    19.6        736    45.4 
Knoxville, Tenn.                      35     5.8         78    12.7 
Las Vegas, Nev.                      180    19.5        468    46.9 
Little Rock, Ark.                     82    15.8        171    32.6 
Los Angeles, Calif.                3,327    37.1      5,557    61.1 
Louisville, Ky.                       90     9.4        166    17.2 
Memphis, Tenn.                       174    17.1        414    40.1 
Miami, Fla.                        1,324    67.0      2,423   120.1 
Middlesex, N.J.                      217    21.1        354    34.2 
Milwaukee, Wis.                      127     8.8        361    24.8 
Minneapolis-Saint Paul, Min.         204     7.9        550    20.9 
Monmouth-Ocean City, N.J.            111    11.1        366    36.4 
Nashville, Tenn.                     125    12.5        269    26.3 
Nassau-Suffolk, N.Y.                 370    14.1      1,010    38.4 
New Haven, Conn.                     318    19.5        987    60.4 
New Orleans, La.                     476    36.8        612    46.9 
New York, N.Y.                     7,163    83.8     13,288   155.3 
Newark, N.J.                         838    43.8      1,540    80.6 
Norfolk, Va.                         105     7.2        325    21.9 
Oakland, Calif.                      563    26.7      1,225    57.2 
Oklahoma City, Okla.                 113    11.6        310    31.5 
Omaha, Neb.                           49     7.5        136    20.6 
Orange County, Calif.                553    22.6        717    29.0 
Orlando, Fla.                        331    26.1        870    66.3 
Philadelphia, Pa.                  1,005    20.3      2,110    42.5 
Phoenix, Ariz.                       292    12.8        863    36.9 
Pittsburgh, Pa.                      148     6.2        214     8.9 
Portland, Oreg.                      249    15.9        655    40.3 
Providence, R.I.                      96    10.5        285    31.1 
Raleigh-Durham, N.C.                 128    14.5        189    20.8 
Richmond, Va.                        140    15.9        385    42.9 
Riverside-San Bernardino, Calif.     435    16.0      1,045    36.6 
Rochester, N.Y.                       76     7.1        243    22.4 
Sacramento, Calif.                   287    20.7        453    31.5 
Saint Louis, Mo.                     290    11.6        841    33.3 
Salt Lake City, Utah                 129    11.7        241    21.3 
San Antonio, Tex.                    217    16.1        426    31.1 
San Diego, Calif.                    631    24.8      1,474    56.7 
San Francisco, Calif.              1,896   116.9      4,592   279.8 
San Jose, Calif.                     183    12.2        502    33.2 
San Juan, P.R.                     1,075    57.9      1,638    87.3 
Sarasota, Fla.                        90    18.0        148    28.9 
Scranton, Pa.                         26     4.1         54     8.4 
Seattle, Wash.                       424    20.4      1,043    49.1 
Springfield, Mass.                    92    15.3        210    35.0 
Stockton, Calif.                      34     6.9        109    21.6 
Syracuse, N.Y.                        71     9.5        168    22.2 
Tacoma, Wash.                         38     6.3        137    21.9 
Tampa-Saint Petersburg, Fla.         535    25.5      1,421    66.6 
Toledo, Ohio                          33     5.4         90    14.6 
Tucson, Ariz.                         93    13.7        258    37.6 
Tulsa, Okla.                          70     9.7        236    32.1 
Ventura, Calif.                       73    10.8        130    19.0 
Washington, D.C.                   1,345    31.3      2,560    58.7 
West Palm Beach, Fla.                529    59.7        787    86.5 
Wichita, Kansas                       62    12.6         96    19.2 
Wilmington, Del.                      93    17.8        261    49.1 
Youngstown, Ohio                      23     3.8         29     4.8 

Metropolitan areas with 
  500,000 or more population      39,112    24.8     81,352    50.9 

Metropolitan areas with 
  50,000 to 500,000 population     4,821    10.5     10,306    22.0 

Non-metropolitan areas             2,587     4.9      5,288    10.0 

Total (3)                         46,716    18.2     97,368    37.5 


                                   Cumulative totals
                         Adults/           Children 
Area of residence(2)  adolescents    < 13 years old      Total

Akron, Ohio                  214             -            214 
Albany-Schenectady, N.Y.     672             14           686 
Albuquerque, N.M.            490              1           491 
Allentown, Pa.               314              4           318 
Ann Arbor, Mich.             194              4           198 
Atlanta, Ga.               6,836             43         6,879 
Austin, Tex.               1,705             14         1,719 
Bakersfield, Calif.          357              3           360 
Baltimore, Md.             4,548            113         4,661 
Baton Rouge, La.             469              7           476 
Bergen-Passaic, N.J.       2,425             51         2,476 
Birmingham, Ala.             716             11           727 
Boston, Mass.              6,510            117         6,627 
Buffalo, N.Y.                653              8           661 
Charleston, S.C.             611              5           616 
Charlotte, N.C.              747             10           757 
Chicago, Ill.              9,251            125         9,376 
Cincinnati, Ohio             768             11           779 
Cleveland, Ohio            1,414             27         1,441 
Columbus, Ohio             1,085              6         1,091 
Dallas, Tex.               5,867             24         5,891 
Dayton, Ohio                 481              8           489 
Denver, Colo.              2,918             13         2,931 
Detroit, Mich.             3,484             45         3,529 
El Paso, Tex.                303              1           304 
Fort Lauderdale, Fla.      5,114            109         5,223 
Fort Worth, Tex.           1,350             15         1,365 
Fresno, Calif.               519              4           523 
Gary, Ind.                   240              2           242 
Grand Rapids, Mich.          326              3           329 
Greensboro, N.C.             631             11           642 
Greenville, S.C.             521              2           523 
Harrisburg, Pa.              313              6           319 
Hartford, Conn.            1,397             17         1,414 
Honolulu, Hawaii             946              6           952 
Houston, Tex.              9,225             87         9,312 
Indianapolis, Ind.         1,178              5         1,183 
Jacksonville, Fla.         2,140             49         2,189 
Jersey City, N.J.          2,933             68         3,001 
Kansas City, Mo.           2,197              9         2,206 
Knoxville, Tenn.             238              2           240 
Las Vegas, Nev.            1,260             14         1,274 
Little Rock, Ark.            485              9           494 
Los Angeles, Calif.       21,704            146        21,850 
Louisville, Ky.              509              8           517 
Memphis, Tenn.             1,007              9         1,016 
Miami, Fla.                9,303            260         9,563 
Middlesex, N.J.            1,515             33         1,548 
Milwaukee, Wis.              914             12           926 
Minneapolis-Saint Paul, 
                 Minn.     1,619             10         1,629 
Monmouth-Ocean City, N.J.  1,253             35         1,288 
Nashville, Tenn.             844             10           854 
Nassau-Suffolk, N.Y.       3,200             66         3,266 
New Haven, Conn.           2,654             77         2,731 
New Orleans, La.           2,868             37         2,905 
New York, N.Y.            54,716          1,183        55,899 
Newark, N.J.               7,229            184         7,413 
Norfolk, Va.               1,006             22         1,028 
Oakland, Calif.            4,138             26         4,164 
Oklahoma City, Okla.         825              1           826 
Omaha, Neb.                  343              1           344 
Orange County, Calif.      2,811             21         2,832 
Orlando, Fla.              2,249             42         2,291 
Philadelphia, Pa.          7,082             87         7,169 
Phoenix, Ariz.             2,236              9         2,245 
Pittsburgh, Pa.            1,026              6         1,032 
Portland, Oreg.              943              6         1,949 
Providence, R.I.             791              8           799 
 Raleigh-Durham, N.C.        787             18           805 
Richmond, Va.              1,006             13         1,019 
Riverside-San Bernardino, 
                  Calif.   2,727             27         2,754 
Rochester, N.Y.              742              8           750 
Sacramento, Calif.         1,490             14         1,504 
Saint Louis, Mo.           2,224             21         2,245 
Salt Lake City, Utah         726             14           740 
San Antonio, Tex.          1,591             14         1,605 
San Diego, Calif.          4,877             32         4,909 
San Francisco, Calif.     17,397             27        17,424 
San Jose, Calif.           1,514             11         1,525 
San Juan, P.R.             6,577            168         6,745 
Sarasota, Fla.               570             12           582 
Scranton, Pa.                188              3           191 
Seattle, Wash.             3,536             10         3,546 
Springfield, Mass.           574             15           589 
Stockton, Calif.             307              8           315 
Syracuse, N.Y.               497              6           503 
Tacoma, Wash.                360              7           367 
Tampa-Saint Petersburg, 
                  Fla.     3,781             53         3,834 
Toledo, Ohio                 271              4           275 
Tucson, Ariz.                619              5           624 
Tulsa, Okla.                 549              5           554 
Ventura, Calif.              378              1           379 
Washington, D.C.           9,366            138         9,504 
West Palm Beach, Fla.      2,916            107         3,023 
Wichita, Kansas              276              2           278 
Wilmington, Del.             617              6           623 
Youngstown, Ohio             148              -           148 

Metropolitan areas with 500,000 
   or more population    284,441          4,131       288,572 

Metropolitan areas with 50,000
   500,000 population     31,977            485        32,462 

Non-metropolitan areas    16,621            268        16,889 
 
Total (3)                334,344          4,906       339,250 


1 Includes 9 months of data collected under the 1993 AIDS
surveillance case definition for adults and adolescents.
2 Based on Metropolitan Statistical Areas (MSA) revised June 1993.
3 Totals include 1,327 persons whose area of residence is unknown.







Table 3. AIDS cases by age group, exposure category, and sex, 
reported October 1991 through September 1992, October 1992 through
September 1993;(1) and cumulative totals, by age group and exposure 
category, through September 1993, United States 

                                                           Males

                                          Oct. 1991-     Oct. 1992- 
                                          Sept. 1992    Sept. 1993
Adult/adolescent
exposure category                          No.  (%)      No. (%)
Men who have sex with men                 24,334 (61)   46,025 (56) 
Injecting drug use                         8,621 (22)   19,142 (23) 
Men who have sex with men and inject drugs 2,638 ( 7)    5,353 ( 7) 
Hemophilia/coagulation disorder              317 ( 1)      990 ( 1) 
Heterosexual contact:                      1,613 ( 4)    3,328 ( 4) 
  Sex with injecting drug user               703          1,102 
  Sex with bisexual male                       -              - 
  Sex with person with hemophilia              3             10 
  Born in Pattern-II(3) country              271            607 
  Sex with person born
    in Pattern-II country                     14             43 
  Sex with transfusion recipient
    with HIV infection                        18             59 
  Sex with HIV-infected person, 
    risk not specified                       604          1,507 
Receipt of blood transfusion, 
 blood components, or tissue(4)              385 ( 1)      695 ( 1) 
Other/risk not identified(5)               1,925 ( 5)    6,174 ( 8) 

Adult/adolescent subtotal                 39,833 (100) 81,707 (100) 


Pediatric (< 13 years old)
exposure category 

Hemophilia/coagulation disorder               23  ( 6)     18 ( 4)
Mother with/at risk for HIV 
   infection:                                329  (89)    397 (91)
    Injecting drug use                       114          126 
    Sex with injecting drug user              54           68 
    Sex with bisexual male                     7            5 
    Sex with person with hemophilia            5            1 
    Born in Pattern-II country                19           22 
    Sex with person born
      in Pattern-II country                    3            3 
    Sex with transfusion recipient
      with HIV infection                       1            1 
    Sex with HIV-infected person, 
      risk not specified                      31           45 
    Receipt of blood transfusion, 
      blood components, or tissue             12           16 
    Has HIV infection,
      risk not specified                      83          110 
Receipt of blood transfusion, 
  blood components, or tissue                 12  ( 3)     15 ( 3)
Risk not identified                            5  ( 1)      7 ( 2)

Pediatric subtotal                           369 (100)    437 (100) 

Total                                     40,202       82,144 


                                                  Females 

                                        Oct. 1991-     Oct. 1992- 
                                        Sept. 1992    Sept. 1993
Adult/adolescent
exposure category                         No.  (%)      No. (%) 

Men who have sex with men                    -           -
Injecting drug use                       2,815  (46)  6,891 (47)
Men who have sex with men and inject drugs   -           -

Hemophilia/coagulation disorder            6  ( 0)     27 ( 0)
Heterosexual contact:                  2,588  (42)  5,545 (37)
  Sex with injecting drug user         1,474        2,474 
  Sex with bisexual male                 177          423 
  Sex with person with hemophilia         20           61 
  Born in Pattern-II(3) country          165          324 
  Sex with person born
    in Pattern-II country                 15           31 
  Sex with transfusion recipient
    with HIV infection                    49          101 
  Sex with HIV-infected person, 
    risk not specified                   688        2,131 
Receipt of blood transfusion, 
 blood components, or tissue(4)          278  ( 5)    496 ( 3)
Other/risk not identified(5)             466  ( 8)  1,833 (12)

Adult/adolescent subtotal              6,153 (100) 14,792 (100) 


Pediatric (< 13 years old)
exposure category 
Hemophilia/coagulation disorder            -            - 
Mother with/at risk for HIV 
   infection:                            347  (96)    417 (97)
    Injecting drug use                   144          138 
    Sex with injecting drug user          62           65 
    Sex with bisexual male                 8            4 
    Sex with person with hemophilia        2            2 
    Born in Pattern-II country            12           15 
    Sex with person born
      in Pattern-II country                2            2 
    Sex with transfusion recipient
      with HIV infection                   3            2 
    Sex with HIV-infected person, 
      risk not specified                  21           51 
    Receipt of blood transfusion, 
      blood components, or tissue         10            7 
    Has HIV infection,
      risk not specified                  83          131 
Receipt of blood transfusion, 
  blood components, or tissue              6  ( 2)      9  (2)
Risk not identified                        8  ( 2)      6  (1)

Pediatric subtotal                       361 (100)    432 (100) 

Total                                  6,514       15,224 


                                           Totals 
                             Oct. 1991-   Oct. 1992-    Cumulative
                             Sept. 1992   Sept. 1993    total2
Adult/adolescent
exposure category                No.    (%)   No.    (%)    No. (%) 

Men who have sex with men   24,334  (53) 46,025  (48) 183,344  (55) 
Injecting drug use          11,436  (25) 26,033  (27)  80,713  (24) 
Men who have sex with men 
  and inject drugs           2,638  ( 6)  5,353  ( 6)  21,142  (6)
Hemophilia/coagulation disor   323  ( 1)  1,017  ( 1)   2,963  (1)
Heterosexual contact:        4,201  ( 9)  8,873  ( 9)  24,358  (7)
    Sex with injecting
               drug user     2,177        3,576        11,750 
    Sex with bisexual male     177          423         1,250 
    Sex with person 
            with hemophilia     23           71           193 
    Born in Pattern-II(3) 
                  country      436          931         3,758 
    Sex with person born
      in Pattern-II country     29           74           279 
    Sex with transfusion recipient
      with HIV infection        67          160           456 
    Sex with HIV-infected person, 
      risk not specified     1,292        3,638         6,672 
Receipt of blood transfusion, 
  blood components, 
              or tissue(4)     663  ( 1)  1,191  ( 1)   5,984  (2)
Other/risk not identified(5) 2,391  ( 5)  8,007  ( 8)  15,840  (5) 

Adult/adolescent subtotal   45,986 (100) 96,499 (100) 334,344 (100) 


Pediatric (< 13 years old)
exposure category 

Hemophilia/coagulation disorder  23  ( 3)     18  ( 2)     202  (4) 
Mother with/at risk for HIV 
      infection:                676  (93)    814  (94)   4,328 (88) 
   Injecting drug use           258          264         1,920
   Sex with injecting drug user 116          133           846
   Sex with bisexual male        15            9            88
   Sex with person with 
                hemophilia        7            3            21
   Born in Pattern-II country    31           37           305
   Sex with person born 
     in Pattern-II country        5            5            23
   Sex with transfusion recipient 
     with HIV infection           4            3            19
   Sex with HIV-infected person,
     risk not specified          52           96           275
   Receipt of blood transfusion,
     blood components, or tissue 22           23            98
   Has HIV infection, 
      risk not specified        166          241           733
Receipt of blood transfusion, 
  blood components, or tissue    18  ( 2)     24  ( 3)     327  (7) 
Risk not identified              13  ( 2)     13  ( 1)      49  (1) 

Pediatric subtotal              730 (100)    869 (100)   4,906
(100) 

Total                        46,716       97,368       339,250

1 Includes 9  months of data collected under the 1993 AIDS
surveillance case definition for adults and adolescents.
2 Includes 7 persons known to be infected with human
immunodeficiency virus type 2 (HIV-2). See JAMA 1992;267:2775-9.
3 See technical notes.
4 Twenty-seven adults/adolescents and 2 children developed AIDS 
after receiving blood screened negative for HIV antibody.  Six
additional adults developed AIDS after receiving tissue or organs 
from HIV-infected donors.  Three of the 6 received tissues or 
organs from a donor who was negative for HIV antibody at the time 
of donation.  See N Engl J Med 1992;326:726-32. 
5 "Other" refers to 11 health-care workers who developed AIDS after 
  occupational exposure to HIV-infected blood, as documented by 
evidence of seroconversion; to 4 patients who developed AIDS after
exposure to HIV within the health-care setting, as documented by
laboratory studies; to 1 person who acquired HIV infection
perinatally and was diagnosed with AIDS after age 13; and to 1
person with intentional self-inoculation of blood from an 
HIV-infected person.  "Risk not identified" refers to persons whose 
mode of exposure to HIV is unknown.  This includes persons under
investigation; persons who died, were lost to follow-up, or 
declined interview; and persons whose mode of exposure to HIV 
remains unidentified after investigation. 

Table 4. Male adult/adolescent AIDS cases by exposure category and
race/ethnicity, reported October 1992 through September 1993,(1)
and cumulative totals, through September 1993, United States

                                           White, not 
                                            Hispanic
                                    Oct. 1992-  Cumulative
                                    Sept. 1993    total 
Exposure category                    No.   (%)     No.   (%)

Men who have sex with men         30,094  (73) 125,392  (78)
Injecting drug use                 4,285  (10)  12,670  ( 8)
Men who have sex with men 
  and inject drugs                 3,001  ( 7)  11,959  ( 7)
Hemophilia/coagulation disorder      794  ( 2)   2,349  ( 1)
Heterosexual contact:                607  ( 1)   1,654  ( 1)
    Sex with injecting drug user       227           804
    Sex with person with hemophilia      6            13
    Born in Pattern-II(2) country        1             8
    Sex with person born
      in Pattern-II country             10            52
    Sex with transfusion recipient
      with HIV infection                25            72
    Sex with HIV-infected person, 
      risk not specified               338           705
Receipt of blood transfusion, 
  blood components, or tissue        431  ( 1)   2,519  ( 2)
Risk not identified(3)             2,032  ( 5)   4,380  ( 3)

Total                             41,244 (100) 160,923 (100)


                                           Black, not 
                                            Hispanic
                                    Oct. 1992-  Cumulative
                                    Sept. 1993    total 
Exposure category                    No.   (%)     No.   (%)

Men who have sex with men         9,614  (37)  34,166  (42) 
Injecting drug use                9,667  (37)  29,762  (36) 
Men who have sex with men 
  and inject drugs                1,568  ( 6)   5,974  ( 7) 
Hemophilia/coagulation disorder     110  ( 0)     260  ( 0) 
Heterosexual contact:             2,125  ( 8)   6,279  ( 8) 
    Sex with injecting drug user       682         2,118
    Sex with person with hemophilia      1             4
    Born in Pattern-II(2) country      605         2,571
    Sex with person born
      in Pattern-II country             31            86
    Sex with transfusion recipient
      with HIV infection                26            51
    Sex with HIV-infected person, 
      risk not specified               780         1,449
Receipt of blood transfusion, 
  blood components, or tissue        157  ( 1)     606  ( 1)
Risk not identified(3)             2,807  (11)   5,127  ( 6)

Total                             26,048 (100)  82,174 (100)


                                           Hispanic 
                                    Oct. 1992-  Cumulative
                                    Sept. 1993    total 
Exposure category                    No.   (%)     No.   (%)

Men who have sex with men           5,638  (42)  21,475  (45) 
Injecting drug use                  5,094  (38)  18,143  (38) 
Men who have sex with men 
  and inject drugs                    712  ( 5)   3,021  ( 6) 
Hemophilia/coagulation disorder        68  ( 1)     224  ( 0) 
Heterosexual contact:                 570  ( 4)   1,375  ( 3) 
    Sex with injecting drug user        185           599 
    Sex with person with hemophilia       2             4 
    Born in Pattern-II(2) country         -            10 
    Sex with person born
      in Pattern-II country               2            11 
    Sex with transfusion recipient
      with HIV infection                  6            28 
    Sex with HIV-infected person, 
      risk not specified                375           723 
Receipt of blood transfusion, 
  blood components, or tissue           91  ( 1)     385  ( 1)
Risk not identified(3)               1,234  ( 9)   2,728  ( 6)

Total                               13,407 (100)  47,351 (100)


                                          Asian/Pacific 
                                             Islander 
                                    Oct. 1992-  Cumulative
                                    Sept. 1993    total 
Exposure category                    No.   (%)     No.   (%)

Men who have sex with men            445  (74)   1,583  (79)
Injecting drug use                    28  ( 5)      79  ( 4)
Men who have sex with men 
  and inject drugs                    22  ( 4)      57  ( 3)
Hemophilia/coagulation disorder       12  ( 2)      35  ( 2)
Heterosexual contact:                 15  ( 2)      29  ( 1)
    Sex with injecting drug user         6            12
    Sex with person with hemophilia      -             -
    Born in Pattern-II country           -             3
    Sex with person born
      in Pattern-II country              -             1
    Sex with transfusion recipient
      with HIV infection                 2             2
    Sex with HIV-infected person, 
      risk not specified                 7            11
Receipt of blood transfusion, 
  blood components, or tissue         12  ( 2)      72  ( 4)
Risk not identified                   69  (11)     152  ( 8)

Total                                603 (100)   2,007 (100)


                                        American Indian/
                                          Alaska Native 
                                    Oct. 1992-  Cumulative
                                    Sept. 1993    total 
Exposure category                    No.   (%)     No.   (%)

Men who have sex with men            158  (63)     388  (63)
Injecting drug use                    23  ( 9)      62  (10)
Men who have sex with men 
  and inject drugs                    42  (17)     107  (17)
Hemophilia/coagulation disorder        6  ( 2)      16  ( 3)
Heterosexual contact:                  4  ( 2)      10  ( 2)
    Sex with injecting drug user         1             5
    Sex with person with hemophilia      -             -
    Born in Pattern-II country           -             -
    Sex with person born
      in Pattern-II country              -             -
    Sex with transfusion recipient
      with HIV infection                 -             -
    Sex with HIV-infected person, 
      risk not specified                 3             5
Receipt of blood transfusion, 
  blood components, or tissue          1  ( 0)       5  ( 1)
Risk not identified                   15  ( 6)      26  ( 4)

Total                                 249 (100)     614 (100) 


                                            Cumulative
                                            totals(4) 

                                    Oct. 1992-  Cumulative
                                    Sept. 1993    total 
Exposure category                    No.   (%)     No.   (%)

Men who have sex with men         46,025  (56) 183,344  (62)
Injecting drug use                19,142  (23)  60,835  (21)
Men who have sex with men 
  and inject drugs                 5,353  ( 7)  21,142  ( 7)
Hemophilia/coagulation disorder      990  ( 1)   2,890  ( 1)
Heterosexual contact:              3,328  ( 4)   9,361  ( 3)
    Sex with injecting drug user      1,102         3,539 
    Sex with person with hemophilia      10            22 
    Born in Pattern-II country          607         2,597 
    Sex with person born
      in Pattern-II country              43           150 
    Sex with transfusion recipient
      with HIV infection                 59           154 
    Sex with HIV-infected person, 
      risk not specified              1,507         2,899 
Receipt of blood transfusion, 
  blood components, or tissue        695  ( 1)   3,596  ( 1)
Risk not identified                6,174  ( 8)  12,474  ( 4)
 
Total                             81,707 (100) 293,642 (100)

1 Includes 9  months of data collected under the 1993 AIDS
surveillance case definition for adults and adolescents.
2 See technical notes.
3 "Risk not identified" refers to persons whose mode of exposure to 
HIV is unknown.  This includes persons under investigation; persons 
who died, were lost to follow-up, or declined interview; and
persons whose mode of exposure to HIV remains unidentified after
investigation.
4  Includes 573 men whose race/ethnicity is unknown.





Table 5. Female adult/adolescent AIDS cases by exposure category
and race/ethnicity, reported October 1992 through September 
1993,(1) and cumulative totals, through September 1993, United
States
                                                White, not
                                                 Hispanic 

                                           Oct. 1992-  Cumulative 
                                          Sept. 1993    total 
Exposure category                          No.   (%)     No.   (%)

Injecting drug use                        1,718  (46)   4,459  (43) 
Hemophilia/coagulation disorder              14  ( 0)      48  ( 0) 
Heterosexual contact:                     1,387  (37)   3,595  (35) 
    Sex with injecting drug user              586         1,703 
    Sex with bisexual male                    199           627 
    Sex with person with hemophilia            50           140 
    Born in Pattern-II(2) country               3             5 
    Sex with person born
      in Pattern-II country                     4            15 
    Sex with transfusion recipient
      with HIV infection                       49           176 
    Sex with HIV-infected person, 
      risk not specified                      496           929 
Receipt of blood transfusion, 
  blood components, or tissue               223  ( 6)   1,398  (14) 
Risk not identified(3)                      398  (11)     793  ( 8) 

Total                                     3,740 (100)  10,293 (100) 



                                                Black, not
                                                  Hispanic

                                           Oct. 1992-  Cumulative 
                                          Sept. 1993     total
Exposure category                          No.   (%)     No.   (%)

Injecting drug use                        3,861  (48)  11,386  (52) 
Hemophilia/coagulation disorder               7  ( 0)      15  ( 0) 
Heterosexual contact:                     2,884  (36)   7,864  (36) 
    Sex with injecting drug user              1,191         4,101 
    Sex with bisexual male                      150           428 
    Sex with person with hemophilia               9            21 
    Born in Pattern-II(2) country               316         1,143 
    Sex with person born
      in Pattern-II country                      26           110 
    Sex with transfusion recipient
      with HIV infection                         27            63 
    Sex with HIV-infected person, 
      risk not specified                      1,165         1,998 
Receipt of blood transfusion, 
  blood components, or tissue               167  ( 2)     571  ( 3) 
Risk not identified(3)                    1,089  (14)   1,892  ( 9) 

Total                                     8,008 (100)  21,728 (100) 



                                                Hispanic

                                           Oct. 1992-  Cumulative 
                                          Sept. 1993    total 
Exposure category                          No.   (%)     No.   (%)

Injecting drug use                        1,265  (44)   3,907  (47) 
Hemophilia/coagulation disorder               5  ( 0)       9  ( 0) 
Heterosexual contact:                     1,192  (41)   3,377  (41) 
    Sex with injecting drug user               667         2,337
    Sex with bisexual male                      60           162
    Sex with person with hemophilia              1             7
    Born in Pattern-II(2) country                4            11
    Sex with person born
      in Pattern-II country                      1             4
    Sex with transfusion recipient
      with HIV infection                        17            51
    Sex with HIV-infected person, 
      risk not specified                       442           805
Receipt of blood transfusion, 
  blood components, or tissue                88  ( 3)     349  ( 4) 
Risk not identified(3)                      327  (11)     631  ( 8) 


Total                                     2,877 (100)   8,273 (100) 



                                                Asian/Pacific 
                                                  Islander

                                           Oct. 1992-  Cumulative 
                                          Sept. 1993    total 
Exposure category                          No.   (%)     No.   (%)

Injecting drug use                          15  (15)      34  (15)
Hemophilia/coagulation disorder              1  ( 1)       1  ( 0)
Heterosexual contact:                       57  (58)     104  (45)
    Sex with injecting drug user              15            31
    Sex with bisexual male                    13            28
    Sex with person with hemophilia            -             2
    Born in Pattern-II country                 1             1
    Sex with person born
      in Pattern-II country                    -             -
    Sex with transfusion recipient
      with HIV infection                       8            11
    Sex with HIV-infected person, 
      risk not specified                      20            31
Receipt of blood transfusion, 
  blood components, or tissue               16  (16)      59  (26)
Risk not identified                         10  (10)      32  (14)

Total                                       99 (100)     230 (100)


                                            American Indian/
                                             Alaska Native

                                           Oct. 1992-    Cumulative 
                                          Sept. 1993      total 
Exposure category                          No.   (%)     No.   (%)

Injecting drug use                           17  (37)      52  (50) 
Hemophilia/coagulation disorder               -             - 
Heterosexual contact:                        20  (43)      32  (31) 
    Sex with injecting drug user               12            21 
    Sex with bisexual male                      1             3 
    Sex with person with hemophilia             1             1 
    Born in Pattern-II country                  -             - 
    Sex with person born
      in Pattern-II country                     -             - 
    Sex with transfusion recipient
      with HIV infection                        -             - 
    Sex with HIV-infected person, 
      risk not specified                        6             7 
Receipt of blood transfusion, 
  blood components, or tissue                 2  ( 4)       8  ( 8) 
Risk not identified                           7  (15)      11  (11) 

Total                                        46 (100)     103 (100) 


                                                  Cumulative
                                                   totals(4)

                                           Oct. 1992-    Cumulative 
                                          Sept. 1993      total 
Exposure category                          No.   (%)     No.   (%)

Injecting drug use                        6,891  (47)  19,878  (49) 
Hemophilia/coagulation disorder              27  ( 0)      73  ( 0) 
Heterosexual contact:                     5,545  (37)  14,997  (37) 
    Sex with injecting drug user               2,474         8,211
    Sex with bisexual male                       423         1,250
    Sex with person with hemophilia               61           171
    Born in Pattern-II country                   324         1,161
    Sex with person born
      in Pattern-II country                       31           129
    Sex with transfusion recipient
      with HIV infection                         101           302
    Sex with HIV-infected person, 
      risk not specified                       2,131         3,773
Receipt of blood transfusion, 
  blood components, or tissue               496  ( 3)   2,388  ( 6) 

Risk not identified                       1,833  (12)   3,366  ( 8) 


Total                                    14,792 (100)  40,702 (100) 


1 Includes 9 months of data collected under the 1993 AIDS 
surveillance case definition for adults and adolescents.
2 See technical notes.
3 "Risk not identified" refers to persons whose mode of exposure to 
HIV is unknown.  This includes persons under investigation; persons 
who died, were lost to follow-up, or declined interview; and
persons whose mode of exposure to HIV remains unidentified after
investigation.
4  Includes 75 women whose race/ethnicity is unknown. 





Table 6. Pediatric AIDS cases by exposure category and
race/ethnicity, reported October 1992 through September 1993, and 
cumulative totals, through September 1993, United States

                                                White, not
                                                 Hispanic 

                                           Oct. 1992-    Cumulative 
                                          Sept. 1993      total 
Exposure category                          No.   (%)     No.   (%)

Hemophilia/coagulation disorder              13  ( 9)     141  (14) 
Mother with/at risk for HIV 
        infection:                          118  (84)     663  (68) 
    Injecting drug use                         38           290 
    Sex with injecting drug user               22           132 
    Sex with bisexual male                      4            39 
    Sex with person with hemophilia             2            13 
    Born in Pattern-II1 country                 -             3 
    Sex with person born
      in Pattern-II country                     -             - 
    Sex with transfusion recipient
      with HIV infection                        1             6 
    Sex with HIV-infected person, 
      risk not specified                       10            45 
    Receipt of blood transfusion, 
      blood components, or tissue               6            29 
    Has HIV infection,
      risk not specified                       35           106 
Receipt of blood transfusion, 
  blood components, or tissue                 9  ( 6)     167  (17) 
Risk not identified(2)                        1  ( 1)       9  ( 1) 

Total                                       141 (100)     980 (100) 



                                                  Black, not
                                                   Hispanic 

                                            Oct. 1992-     Cumulative
                                           Sept. 1993        total
Exposure category                           No.   (%)       No. (%) 

Hemophilia/coagulation disorder                1  ( 0)      24  (1) 
Mother with/at risk for HIV 
      infection:                             489  (97)   2,556 (95) 
   Injecting drug use                          153         1,133
   Sex with injecting drug user                 70           390
   Sex with bisexual male                        2            28
   Sex with person with hemophilia               -             5
   Born in Pattern-II1 country                  37           300
   Sex with person born 
     in Pattern-II country                       5            22
   Sex with transfusion recipient 
     with HIV infection                          1             5
   Sex with HIV-infected person,
     risk not specified                         57           148
   Receipt of blood transfusion,
     blood components, or tissue                12            43
   Has HIV infection, 
     risk not specified                        152           482
Receipt of blood transfusion, 
  blood components, or tissue                  6  ( 1)      74  (3) 
Risk not identified(2)                         8  ( 2)      29  (1) 

Total                                        504 (100)   2,683(100) 


                                                  Hispanic

                                           Oct. 1992-    Cumulative 
                                          Sept. 1993      total 

Exposure category                          No.   (%)     No.   (%)

Hemophilia/coagulation disorder              4  ( 2)      33  ( 3)
Mother with/at risk for HIV 
       infection:                          197  (93)   1,074  (90)
    Injecting drug use                        69           483
    Sex with injecting drug user              40           318
    Sex with bisexual male                     3            20
    Sex with person with hemophilia            1             3
    Born in Pattern-II(1) country              -             2
    Sex with person born
      in Pattern-II country                    -             1
    Sex with transfusion recipient
      with HIV infection                       1             8
    Sex with HIV-infected person, 
      risk not specified                      27            77
    Receipt of blood transfusion, 
      blood components, or tissue              5            25
    Has HIV infection,
      risk not specified                      51           137
Receipt of blood transfusion, 
  blood components, or tissue                7  ( 3)      76  ( 6)
Risk not identified(2)                       4  ( 2)      11  ( 1)

Total                                      212 (100)   1,194 (100)


                                                  Asian/Pacific 
                                                     Islander 

                                            Oct. 1992-  Cumulative
                                           Sept. 1993    total

Exposure category                           No.   (%)     No.   (%) 

Hemophilia/coagulation disorder               -             3  (14) 
Mother with/at risk for HIV 
       infection:                             2  (50)      10  (45) 
    Injecting drug use                          1             3 
    Sex with injecting drug user                -             2 
    Sex with bisexual male                      -             1 
    Sex with person with hemophilia             -             - 
    Born in Pattern-II country                  -             - 
    Sex with person born
      in Pattern-II country                     -             - 
    Sex with transfusion recipient
      with HIV infection                        -             - 
    Sex with HIV-infected person, 
      risk not specified                        1             1 
    Receipt of blood transfusion, 
      blood components, or tissue               -             1 
    Has HIV infection,
      risk not specified                        -             2 
Receipt of blood transfusion, 
  blood components, or tissue                 2  (50)       9  (41) 

Risk not identified                           -             - 

Total                                         4 (100)      22 (100) 



                                                American Indian/
                                                  Alaska Native 

                                           Oct. 1992-    Cumulative 
                                          Sept. 1993      total 

Exposure category                          No.   (%)     No.   (%)
Hemophilia/coagulation disorder              -             1  ( 7)
Mother with/at risk for HIV 
       infection:                            2 (100)      13  (93)
    Injecting drug use                          1             6 
    Sex with injecting drug user                1             2 
    Sex with bisexual male                      -             - 
    Sex with person with hemophilia             -             - 
    Born in Pattern-II country                  -             - 
    Sex with person born
      in Pattern-II country                     -             - 
    Sex with transfusion recipient
      with HIV infection                        -             - 
    Sex with HIV-infected person, 
      risk not specified                        -             2 
    Receipt of blood transfusion, 
      blood components, or tissue               -             - 
    Has HIV infection,
      risk not specified                        -             3 
Receipt of blood transfusion, 
  blood components, or tissue                   -             - 
Risk not identified                             -             - 

Total                                       2 (100)      14 (100) 


                                                  Cumulative
                                                   totals(3)

                                           Oct. 1992-    Cumulative 

                                          Sept. 1993      total 
Exposure category                          No.   (%)     No.   (%)

Hemophilia/coagulation disorder              18  ( 2)     202  ( 4) 

Mother with/at risk for HIV 
  infection:                                814  (94)   4,328  (88) 

    Injecting drug use                         264         1,920
    Sex with injecting drug user               133           846
    Sex with bisexual male                       9            88
    Sex with person with hemophilia              3            21
    Born in Pattern-II country                  37           305
    Sex with person born
      in Pattern-II country                      5            23
    Sex with transfusion recipient
      with HIV infection                         3            19
    Sex with HIV-infected person, 
      risk not specified                        96           275
    Receipt of blood transfusion, 
      blood components, or tissue               23            98
    Has HIV infection,
      risk not specified                       241           733
Receipt of blood transfusion, 
  blood components, or tissue                24  ( 3)     327  ( 7) 

Risk not identified                          13  ( 1)      49  ( 1) 

Total                                       869 (100)   4,906 (100) 


1 See technical notes.
2 "Risk not identified" refers to persons whose mode of exposure to 
HIV is unknown.  This includes persons under investigation; persons 
who died, were lost to follow-up, or declined interview; and
persons whose mode of exposure to HIV remains unidentified after
investigation.
3  Includes 13 children whose race/ethnicity is unknown.




Table 7. AIDS cases in adolescents and adults under age 25, by sex
and exposure category, reported October 1991 through September
1992, October 1992 through September 1993,(1) and cumulative totals 
through September 1993, United States 

                                        13-19 years old 

                              Oct. 1991-   Oct. 1992-   Cumulative
                              Sept. 1992   Sept. 1993     total 

Male
exposure category              No.   (%)    No.   (%)    No.   (%)

Men who have sex with men       36  (35)     91  (28)    319  (33)
Injecting drug use               4  ( 4)     14  ( 4)     62  ( 6)
Men who have sex with men 
  and inject drugs               5  ( 5)      8  ( 2)     45  ( 5)
Hemophilia/coagulation disorder 47  (46)    172  (52)    440  (45)
Heterosexual contact:            3  ( 3)     13  ( 4)     29  ( 3)
   Sex with injecting drug user  1            6           11
   Sex with person with 
     hemophilia                  -            1            1
   Born in Pattern-II(2)
    country                      -            1            8
   Sex with person born 
     in Pattern-II country       -            -            1
   Sex with transfusion recipient 
     with HIV infection          -            -            -
   Sex with HIV-infected person,
     risk not specified          2            5            8
Receipt of blood transfusion, 
  blood components, or tissue    5  ( 5)     12  ( 4)     42  ( 4)

Risk not identified(3)           2  ( 2)     19  ( 6)     40  ( 4)

Male subtotal                  102  (100)   329  (100)   977  (100) 



Female
exposure category 


Injecting drug use               12  (20)     14  ( 8)     86 (20)
Hemophilia/coagulation
 disorder                         1  ( 2)      1  ( 1)      5 
( 1)
Heterosexual contact:            34  (58)    105  (62)    236 (54)
   Sex with injecting drug user  20           37          127 

   Sex with bisexual male         1            7           11 

   Sex with person with 
     hemophilia                   2            1             6
   Born in Pattern-II country     1            4            11

   Sex with person born 
      in Pattern-II country       -            1             2
   Sex with transfusion recipient 
     with HIV infection           -            2             3
   Sex with HIV-infected person,
      risk not specified         10           53           76 

Receipt of blood transfusion, 
   blood components, or tissue    1  ( 2)     14  ( 8)     41( 9) 
Risk not identified              11  (19)     36  (21)     67(15) 

Female subtotal                  59 (100)    170 (100)    435 (100) 

Total                           161          499          1,412 



                                      20-24 years old 
                            Oct. 1991-   Oct. 1992-   Cumulative
                           Sept. 1992   Sept. 1993     total
Male
exposure category            No.   (%)    No.   (%)    No.   (%)

Men who have sex with men    694  (63)  1,489  (60)  6,485  (64)
Injecting drug use           146  (13)    282  (11)  1,245  (12)
Men who have sex with men 
  and inject drugs           110  (10)    204  ( 8)  1,063  (11)
Hemophilia/coagulation
 disorder                     42  ( 4)    154  ( 6)    385  ( 4)
Heterosexual contact:         55  ( 5)    118  ( 5)    363  ( 4)
   Sex with injecting 
 drug user                    24           40          135
   Sex with person with 
 hemophilia                    -            -            1
   Born in Pattern-II(2)
 country                       8           17           98
   Sex with person born 
     in Pattern-II country     -            2            2
   Sex with transfusion recipient 
     with HIV infection        1            4            9
   Sex with HIV-infected person,
     risk not specified       22           55          118
Receipt of blood transfusion, 
  blood components, or tissue  6  ( 1)     22  ( 1)     85  ( 1)
Risk not identified(3)        53  ( 5)    220  ( 9)    445  ( 4)

Male subtotal              1,106 (100)  2,489 (100) 10,071 (100)

Female
exposure category 

Injecting drug use           123  (32)    283  (30)    931  (35)
Hemophilia/coagulation
 disorder                      1  ( 0)      4  ( 0)      9  ( 0)
Heterosexual contact:        206  (54)    483  (51)  1,329  (50)
   Sex with injecting drug
 user                        118          233          754
   Sex with bisexual male     14           32          108
   Sex with person with 
 hemophilia                    2            7           27
   Born in Pattern-II country  5           11           64
   Sex with person born 
     in Pattern-II country     -            1           12
   Sex with transfusion recipient 
     with HIV infection        -            2            7
   Sex with HIV-infected person,
     risk not specified       67          197          357
Receipt of blood transfusion, 
  blood components, or tissue,12  ( 3)     19  ( 2)     81  (3) 
Risk not identified           40  (10)    167  (17)    291  (11)

Female subtotal              382 (100)    956 (100)  2,641 (100)

Total                      1,488        3,445       12,712

1  Includes 9 months of data collected under the 1993 AIDS
surveillance case definition for adults and adolescents.
2  See technical notes. 
3  "Risk not identified" refers to persons whose mode of exposure 
to HIV is unknown.  This includes persons under investigation;
persons who died, were lost to follow-up, or declined interview;
and persons whose mode of exposure to HIV remains unidentified
after investigation.



Table 8. AIDS cases by sex, age at diagnosis, and race/ethnicity, 
reported through September 1993,(1) United States 

                        White, not      Black, not
                       Hispanic        Hispanic         Hispanic

Male
Age at diagnosis (years) No.   (%)       No.   (%)       No. (%)

Under 5                   329  ( 0)     1,167  ( 1)       478 ( 1)
5-12                      248  ( 0)       183  ( 0)       155 ( 0)
13-19                     473  ( 0)       299  ( 0)       186 ( 0)
20-24                   4,735  ( 3)     3,282  ( 4)     1,938 ( 4)
25-29                  23,298  (14)    12,067  (14)     7,742 (16)
30-34                  37,653  (23)    19,017  (23)    11,723 (24)
35-39                  35,879  (22)    19,483  (23)    10,671 (22)
40-44                  25,717  (16)    13,213  (16)     7,088 (15)
45-49                  15,223  ( 9)     6,869  ( 8)     3,793 ( 8)
50-54                   8,173  ( 5)     3,800  ( 5)     2,012 ( 4)
55-59                   4,671  ( 3)     2,121  ( 3)     1,174 ( 2)
60-64                   2,775  ( 2)     1,155  ( 1)       587 ( 1)
65 or older             2,328  ( 1)       869  ( 1)       437 ( 1)

Male subtotal         161,502 (100)    83,525 (100)    47,984 (100) 



Female
Age at diagnosis (years)

Under 5                   320  ( 3)     1,143  ( 5)       455 ( 5)
5-12                       81  ( 1)       189  ( 1)       106 ( 1)
13-19                     102  ( 1)       262  ( 1)        68 ( 1)
20-24                     672  ( 6)     1,347  ( 6)       594 ( 7)
25-29                   1,875  (18)     3,801  (16)     1,699 (19)
30-34                   2,455  (23)     5,618  (24)     2,126 (24)
35-39                   1,918  (18)     5,094  (22)     1,707 (19)
40-44                   1,093  (10)     2,826  (12)       988 (11)
45-49                     594  ( 6)     1,187  ( 5)       472 ( 5)
50-54                     359  ( 3)       706  ( 3)       273 ( 3)
55-59                     344  ( 3)       381  ( 2)       168 ( 2)
60-64                     249  ( 2)       248  ( 1)        87 ( 1)
65 or older               632  ( 6)       258  ( 1)        91 ( 1)

Female subtotal        10,694 (100)    23,060 (100)     8,834 (100) 

Total (2)             172,196         106,585          56,818 


                       Asian/Pacific   American Indian/ 
                        Islander       Alaska Native       Total(2) 

Male
Age at diagnosis (years)  No.   (%)         No.   (%)       No. (%) 

Under5                     8  ( 0)           8  ( 1)     1,992 (1)
5-12                       7  ( 0)           1  ( 0)       594 (0)
13-19                     11  ( 1)          11  ( 2)       980 (0)
20-24                     75  ( 4)          23  ( 4)    10,071 (3)
25-29                    267  (13)         123  (20)    43,576 (15) 
30-34                    420  (21)         173  (28)    69,100 (23) 
35-39                    443  (22)         126  (20)    66,742 (23) 
40-44                    346  (17)          85  (14)    46,548 (16) 
45-49                    218  (11)          34  ( 5)    26,191 ( 9) 
50-54                    108  ( 5)          17  ( 3)    14,140 ( 5) 
55-59                     62  ( 3)           9  ( 1)     8,066 ( 3) 
60-64                     20  ( 1)          10  ( 2)     4,551 ( 2) 
65 or older               37  ( 2)           3  ( 0)     3,680 ( 1) 

Male subtotal          2,022 (100)         623 (100)   296,231(100) 


Female
Age at diagnosis (years)

Under 5                    1  ( 0)           5  ( 5)     1,933 (4)
5-12                       6  ( 3)           -             384 (1)
13-19                      1  ( 0)           1  ( 1)       435 (1)
20-24                     12  ( 5)          10  ( 9)     2,641 (6)
25-29                     23  (10)          23  (21)     7,430 (17) 
30-34                     48  (20)          34  (31)    10,300 (24) 
35-39                     38  (16)          14  (13)     8,792 (20) 
40-44                     37  (16)           9  ( 8)     4,961 (12) 
45-49                     21  ( 9)           5  ( 5)     2,286 (5)
50-54                     14  ( 6)           2  ( 2)     1,356 (3)
55-59                      8  ( 3)           1  ( 1)       903 ( 2) 
60-64                     12  ( 5)           3  ( 3)       599 ( 1) 
65 or older               16  ( 7)           1  ( 1)       999 ( 2) 

Female subtotal          237 (100)         108 (100)    43,019(100) 

Total (2)              2,259               731         339,250

1  Includes 9 months of data collected under the 1993 AIDS
surveillance case definition for adults and adolescents.
2  Includes 575 males and 86 females whose race/ethnicity is
unknown.



Table 9. AIDS cases, case-fatality rates,(1) and deaths, by 
half-year and age group, through September 1993,(2) United States 

                            Adults/adolescents

            Cases diagnosed    Case-fatality    Deaths occurring
Half-year   during interval         rate        during interval 

Before 1981               92              81.5                30
1981 Jan. - June          98              89.8                37
     July - Dec.         208              91.3                87
1982 Jan. - June         407              92.6               155
     July - Dec.         707              91.1               290
1983 Jan. - June       1,312              93.2               526
     July - Dec.       1,654              93.2               939
1984 Jan. - June       2,581              92.8             1,406
     July - Dec.       3,408              92.8             1,981
1985 Jan. - June       4,970              92.0             2,825
     July - Dec.       6,379              91.6             3,904
1986 Jan. - June       8,413              90.4             5,109
     July - Dec.      10,026              88.3             6,568
1987 Jan. - June      13,115              88.6             7,613
     July - Dec.      14,574              85.7             8,013
1988 Jan. - June      16,836              83.4             9,397
     July - Dec.      17,425              83.1            10,764
1989 Jan. - June      20,096              78.7            12,379
     July - Dec.      20,434              76.5            14,231
1990 Jan. - June      22,629              70.8            14,404
     July - Dec.      22,128              66.3            15,265
1991 Jan. - June      25,769              58.7            15,902
     July - Dec.      27,410              49.4            17,497
1992 Jan. - June      30,925              36.1            17,431
     July - Dec.      31,177              23.4            17,555
1993 Jan. - June      27,847              11.4            14,787
     July - Sept.      3,724               5.5             2,410

Total (3)            334,344              60.3           201,775



                                   Children < 13 years old

               Cases diagnosed    Case-fatality    Deaths occurring 
Half-year      during interval         rate        during interval

Before 1981               6              66.7                 1 
1981 Jan. - June         11              81.8                 2 
     July - Dec.          5             100.0                 6 
1982 Jan. - June         13              84.6                 9 
     July - Dec.         16              81.3                 5 
1983 Jan. - June         32             100.0                13 
     July - Dec.         42              90.5                16 
1984 Jan. - June         51              84.3                26 
     July - Dec.         62              87.1                22 
1985 Jan. - June         99              76.8                45 
     July - Dec.        128              82.8                69 
1986 Jan. - June        138              81.9                65 
     July - Dec.        189              70.9                91 
1987 Jan. - June        218              72.0               117 
     July - Dec.        257              67.7               168 
1988 Jan. - June        258              64.7               134 
     July - Dec.        338              61.2               174 
1989 Jan. - June        352              60.2               171 
     July - Dec.        333              57.4               184 
1990 Jan. - June        357              52.9               191 
     July - Dec.        377              43.0               190 
1991 Jan. - June        357              42.3               163 
     July - Dec.        325              35.7               199 
1992 Jan. - June        384              32.3               168 
     July - Dec.        318              27.0               197 
1993 Jan. - June        213              18.3               161 
     July - Sep.         27               7.4                26 

Total (3)             4,906              53.3             2,615 

1  Case-fatality rates are calculated for each half-year by date of 
  diagnosis.  Each 6-month case-fatality rate is the number of
deaths ever reported among cases diagnosed in that period 
(regardless of the year of death), divided by the number of total 
cases diagnosed in that period, multiplied by 100.  For example,
during the interval January through June 1982, AIDS was diagnosed 
in 407 adults/adolescents.  Through September 1993, 377 of these
407 were reported as dead.  Therefore, the case fatality rate is
92.6 (377 divided by 407, multiplied by 100). 
 The case-fatality rates shown here may be underestimates because 
of incomplete reporting of deaths.  Reported deaths are not 
necessarily caused by HIV-related disease.
2  Includes 9  months of data collected under the 1993 AIDS 
surveillance case defintions for adults and adolescents.
3  Death totals include 270 adults/adolescents and 2 children known 
to have died, but whose dates of death are unknown. 




Table 10. AIDS cases by year of diagnosis and definition category,
diagnosed through September 1993,(1) United States
                                     Period of diagnosis
                            Before      Oct. 1989-    Oct. 1990-
                          Sept. 1989    Sept. 1990    Sept. 1991
Definition category         No.  (%)      No.  (%)      No.  (%)

Pre-1987 definition     106,479  (79)  28,634  (64)  29,523  (58) 
1987 definition          26,788  (20)  13,559  (30)  16,078  (31) 
1993 definition(2)        1,610  ( 1)   2,402  ( 5)   5,467  (11) 
    Severe HIV-related
    immunosuppression(3)  1,181        2,021         4,669
    Pulmonary tuberculosis  362          333           706
    Recurrent pneumonia      55           44            85
    Invasive cervical cancer 16            8            13

Total                   134,877 (100)  44,595 (100)  51,068 (100) 


                                      Period of diagnosis 
                          Oct. 1991-    Oct. 1992-     Cumulative 
                          Sept. 1992    Sept. 1993        total 
Definition category         No.  (%)      No.  (%)       No.  (%) 

Pre-1987 definition      28,340  (47)  13,876  (29)  206,852  (61)
1987 definition          17,521  (29)   9,537  (20)   83,483  (25)
1993 definition(2)       15,032  (25)  24,404  (51)   48,915  (14)
    Severe HIV-related
   immunosuppression(3)  13,587        22,718         44,176
  Pulmonary tuberculosis  1,195         1,115          3,711
    Recurrent pneumonia     223           541            948
  Invasive cervical cancer   38            48            123

Total                    60,893 (100)  47,817 (100)  339,250 (100)

1  Includes 9  months of data collected under the 1993 AIDS 
surveillance case definition for adults and adolescents.
2  Persons who meet only the 1993 AIDS case definition and whose
date of diagnosis is before January 1993 were diagnosed 
retrospectively.  The sum of diagnoses listed for the four
conditions under the 1993 definition do not equal the 1993
definition total because some persons have more than one diagnosis
from the added conditions of pulmonary tuberculosis, recurrent
pneumonia, and invasive cervical cancer.
3  Defined as CD4+ T-lymphocyte count of less than 200 cells/uL or
a CD4+ percentage less than 14 in persons with laboratory 
confirmation of HIV infection.




Table 11.  Health-care workers with documented and possible 
occupationally acquired AIDS/HIV infection, by occupation, reported 
through September 1993, United States(1)

                           Documented               Possible
                           occupational             occupational
                           transmission(2)        transmission(3) 
occupation                       No.                      No. 

Dental worker, including dentist   -                        6 
Embalmer/morgue technician         -                        3 
Emergency medical technician
 /paramedic                        -                        8 
Health aide/attendant              1                        9 
Housekeeper/maintenace worker      1                        6 
Laboratory technician, clinical   15                       14 
Laboratory technician,nonclinical  1                        1 
Nurse                             13                       15 
Physician, nonsurgical             5                        8 
Physician, surgical                -                        2 
Respiratory therapist              1                        2 
Technician, dialysis               1                        1 
Technician, surgical               1                        1 
Technician/therapist, 
other than those listed above      -                        3 
Other health-care occupations      -                        2 

Total                             39                       81 

1  Health-care workers are defined as those persons, including
students and trainees, who have worked in a health-care, clinical,
or HIV laboratory setting at any time since 1978.  See MMWR 
1992;41:823-5.
2  Health-care workers who had documented HIV seroconversion after
occupational exposure: 34 had percutaneous exposure, 4 had
mucocutaneous exposure, 1 had both percutaneous and mucocutaneous 
exposures. Thirty-six exposures were to blood from an HIV-infected
person, 1 to visibly bloody fluid, 1 to an unspecified fluid, and 
1 to a concentrated virus in a laboratory.  Eleven of these 
health-care workers have developed  AIDS. 
3  These health-care workers have been investigated and are without 
identifiable behavioral or transfusion risks; each reported 
percutaneous or mucocutaneous occupational exposures to blood or
body fluids, or lab oratory solutions containing HIV, but HIV 
seroconversion specifically resulting from an occupational exposure 
was not documented. 



Table 12. Adult/adolescent AIDS cases by single and multiple
exposure categories, reported through September 1993, United States 

                                                     AIDS cases 
Exposure category                                    No.    (%) 
Single mode of exposure 
  Men who have sex with men                        176,793    (53)
  Injecting drug use                                68,029    (20)
  Hemophilia/coagulation disorder                    2,212    ( 1)
  Heterosexual contact                              23,536    ( 7)
  Receipt of transfusion(1)                          5,978    ( 2)
  Receipt of transplant of tissues/organs(2)             6    ( 0)
  Other(3)                                              16    ( 0)

  Single mode of exposure subtotal                 276,567    (83)

Multiple modes of exposure

  Men who have sex with men;injecting drug use      18,885    ( 6)
  Men who have sex with men;
   hemophilia/coagulation disorder                      82    ( 0)
  Men who have sex with men;heterosexual contact     3,718    ( 1)
  Men who have sex with men;receipt of
   transfusion/transplant                            2,554    ( 1)
  Injecting drug use;hemophilia/
   coagulation disorder                                 88    ( 0)
  Injecting drug use;heterosexual contact           11,003    ( 3)
  Injecting drug use;receipt of 
   transfusion/transplant                            1,114    ( 0)
  Hemophilia/coagulation disorder;
   heterosexual contact                                 29    ( 0)
  Hemophilia/coagulation disorder;
   receipt of transfusion/transplant                   704    ( 0)
  Heterosexual contact;receipt of 
   transfusion/transplant                              822    ( 0)
  Men who have sex with men;
   injecting drug use;hemophilia/ 
   coagulation disorder                                 20    ( 0)
  Men who have sex with men;injecting drug use; 
   heterosexual contact                              1,764    ( 1)
  Men who have sex with men;injecting drug use; 
   receipt of transfusion/transplant                   392    ( 0)
  Men who have sex with men;hemophilia/coagulation
   disorder;heterosexual contact                         4    ( 0)
  Men who have sex with men;hemophilia/coagulation
   disorder;receipt of transfusion/transplant           27    ( 0)
  Men who have sex with men;heterosexual contact; 
   receipt of transfusion/transplant                   163    ( 0)
  Injecting drug use;hemophilia/coagulation 
   disorder;heterosexual contact                        20    ( 0)
  Injecting drug use;hemophilia/coagulation 
   disorder;receipt of transfusion/transplant           28    ( 0)
  Injecting drug use;heterosexual contact;
   receipt of transfusion/transplant                   421    ( 0)
  Hemophilia/coagulation disorder;heterosexual
   contact;receipt of transfusion/transplant            18    ( 0)
  Men who have sex with men;injecting drug use; 
   hemophilia/coagulation disorder;heterosexual contact  4    ( 0)
  Men who have sex with men;injecting drug use; 
   hemophilia/coagulation disorder; 
   receipt of transfusion/transplant                      5   ( 0)
  Men who have sex with men;
   injecting drug use;heterosexual contact; receipt of
   transfusion/transplant                                71   ( 0)
  Men who have sex with men;
   hemophilia/coagulation disorder;heterosexual contact;
   receipt of transfusion/transplant                      3   ( 0)
  Injecting drug use;hemophilia/
   coagulation disorder;heterosexual contact; 
   receipt of transfusion/transplant                     10   ( 0)
  Men who have sex with men;injecting drug use; 
   hemophilia/coagulation disorder;heterosexual contact;
   receipt of transfusion/transplant                      1   ( 0)

Multiple modes of exposure subtotal                  41,950   (13)

Risk not identified(4)                               15,823   ( 5)

Total                                               334,344  (100)

1 Includes 27 adult/adolescents and 2 children who developed AIDS 
after receiving blood screened negative for HIV antibody. 
2 Six adults developed AIDS after receiving tissue from 
HIV-infected donors. Three of the 6 received tissue or organs from
a donor who was negative for HIV antibody at the time of donation.
See N Engl J Med 1992;326:726-32. 
3 "Other" refers to 11 health-care workers who developed AIDS after 
occupational exposure to HIV-infected blood as documented by
evidence of seroconversion; to 4 patients who developed AIDS after
exposure to HIV within the health-care setting, as documented by
laboratory studies; to 1 person who acquired HIV infection
perinatally and was diagnosed with AIDS after age 13; and to 1
person with intentional self-inoculation of blood from an HIV-infected person.
4 "Risk not identified" refers to persons whose mode of exposure to 
HIV is unknown.  This includes persons under investigation; persons 
who died, were lost to follow-up, or declined interview; and
persons whose mode of exposure to HIV remains unidentified after
investigation.


TECHNICAL NOTES:  HIV/AIDS SURVEILLANCE REPORT


Surveillance and Reporting of AIDS

All 50 states, the District of Columbia, U.S dependencies and possessions,
and independent nations in free association with the U.S. (1) report AIDS
cases to CDC using a uniform case definition and case report form.  The
original  definition was modified in 1985 (MMWR 1985;34:373-5) and
again in 1987 (MMWR 1987;36 [suppl. no. 1S]:1S-15S).  The revisions
incorporated a broader range of AIDS indicator diseases and conditions and
used human immunodeficiency virus (HIV) diagnostic tests to improve the
sensitivity and specificity of the definition.  For persons with laboratory-
confirmed HIV infection, the 1987 revision incorporated HIV
encephalopathy, wasting syndrome, and other indicator diseases that are
diagnosed presumptively (i.e., without confirmatory laboratory evidence of
the opportunistic disease).  AIDS cases that meet the criteria of both the pre-
1987 and 1987 definitions are classified in the pre-1987 definition category. 
Compared with patients who meet the pre-1987 case definition, a higher
proportion of patients who meet only the 1987 case definition were female,
black, or Hispanic, or were intravenous drug users (MMWR 1989;38:229-
36).

Each issue of this update includes information received and tabulated by
CDC through the last day of the previous month.  Data are tabulated by date
of report to CDC unless otherwise noted.  Data for U.S. dependencies and
possessions and for associated independent nations are included in the totals.

Age group tabulations are based on the person's age at diagnosis of AIDS: 
adult/adolescent cases include persons 13 years of age and older; pediatric
cases include children under 13 years of age.  Age group tabulations in
Table 13 (only included in the year-end edition) are based on age at death.

Metropolitan areas are defined as the Metropolitan Statistical Areas (MSA)
for all areas except the 6 New England states.  For these states, the New
England County Metropolitan Areas (NECMA) are used.  Metropolitan areas
are named for a central city in the MSA or NECMA, may include several
cities and counties, and may cross state boundaries.  For example, AIDS
cases and annual rates presented for the District of Columbia in Table 1
include only persons residing within the geographic boundaries of the
District.  AIDS cases and annual rates for Washington, D.C., in Table 2
include persons residing within several counties in the metropolitan area.
State or metropolitan data tabulations are based on the person's residence at
diagnosis of the first AIDS-indicator disease(s).  The cities and counties
which comprise each metropolitan area in Table 2 are listed in the Bureau of
Census publication, "State and Metropolitan Area Data Book, 1986."

Data in this report are provisional.  Fifty percent of patients are reported to
CDC within 3 months of diagnosis.  However, reporting delays vary widely
and have been as long as several years for some cases.  The median delay in
reporting appears to have increased, from about 2 months in 1982 to about 3
months in 1988; however, recent analyses suggests that reporting delay may
be decreasing.

Completeness of reporting of diagnosed cases to state and local health
departments varies by geographic region and patient population; however,
mortality studies suggest that 70 to 90 percent of HIV-related deaths in men
25-44 years old are identified through national surveillance of AIDS
(MMWR 1989;38:561-3).  In addition, multiple routes of exposure,
opportunistic diseases diagnosed after the initial case report was submitted
to CDC, and vital status may not be determined or reported for all cases. 
Caution should be used in interpreting case-fatality rates because reporting
of deaths is known to be incomplete.

Exposure Categories

For surveillance purposes, AIDS cases are counted only once in a hierarchy
of exposure categories.  Persons with more than one reported mode of
exposure to HIV are classified in the exposure category listed first in the
hierarchy, except for persons with a history of both homosexual/bisexual
contact and intravenous drug use.  They make up a separate exposure
category.

"Homosexual/bisexual contact" cases include men who report sexual contact
with other men.  "Heterosexual contact" cases include persons who report
either specific heterosexual contact with a person with, or at increased risk
for, HIV infection (e.g., an intravenous drug user), or persons presumed to
have acquired HIV infection through heterosexual contact because they were
born in countries with a distinctive pattern of transmission termed "Pattern
II" by the World Health Organization (MMWR 1988;37:286-8, 293-5). 
Pattern II transmission is observed in areas of sub-Saharan Africa and in
some Caribbean countries.  In these countries, most of the reported cases
occur in heterosexuals and the male-to-female ratio is approximately 1:1. 
Intravenous drug use and homosexual transmission either do not occur or
occur at a low level.

"Undetermined" cases are persons with no reported history of exposure to
HIV through any of the routes listed in the hierarchy of exposure categories. 
Undetermined cases include persons who are currently under investigation
by local health department officials; persons whose exposure history is
incomplete because of death, refusal to be interviewed, or loss to follow-up;
and persons who were interviewed or for whom follow-up information was
available and no exposure mode was identified.  Persons who have an
exposure mode identified at the time of follow-up are reclassified into the
appropriate exposure category.

Rates

Rates are on an annual basis per 100,000 population.  The denominator for
computing rates in Table 1 and Table 2 are extrapolations based on U.S.
Bureau of Census data from the 1980 census and from 1988 post-census
estimates.  Each 12-month rate is the number of cases for a 12 month period
divided by the 1989 or 1990 extrapolation, multiplied by 100,000.

The denominators for computing race-specific rates (Table 9, included only
in the year-end edition) are based on 1990 census projections published in
U.S. Bureau of Census publications, "Projections of the Population of the
United States, by Age, Sex, and Race, 1988 to 2080," and "Projections of
the Hispanic Population, 1983 to 2080."  Race-specific rates are the number
of cases reported for a particular race/ethnicity during the preceding 12-
month period divided by the 1990 census projection for that race/ethnicity,
multiplied by 100,000.

Case-fatality rates are on a semiannual basis by date of diagnosis.  Each 6-
month case-fatality rate is the number of fatal cases reported, divided by the
number of total cases, diagnosed in that period, multiplied by 100.  

Trends in AIDS Incidence

Tabulations of AIDS cases by date of report give a general description of
AIDS cases, but analyses by date of diagnosis give a more accurate
description of trends.  Delays in reporting, however, can have a substantial
impact on tabulated numbers of cases diagnosed in recent time periods. 
About half of all cases are reported within 3 months of diagnosis, but about
15% are reported more than 1 year after diagnosis.  Delays are substantially
longer for pediatric cases and for transfusion-associated cases in adults.

Figure 5 (included only in the year-end edition report) shows trends in AIDS
incidence by month of diagnosis.  The points on the plot show the estimated
numbers of cases diagnosed, after adjusting for estimated reporting delays. 
The smooth curve is computed using the Lowess procedure (J.M. Chaber,
W.S. Cleveland, B. Kleiner, and P.A. Tukey.  "Graphical Methods for Data
Analysis."  Duxbury Press, Boston, 1983, Chapter 4).

Reporting delays were estimated by a maximum likelihood statistical
procedure for each HIV exposure category (J.M. Karon, O.J. Devine, and
W.M. Morgan "Predicting AIDS incidence by extrapolating from recent
trends."  In:  C. Castillo-Chavex, ed. "Mathematical and Statistical
Approaches to AIDS Epidemiology.  Lecture Notes in Biomathematics," vol.
83, Springer Verlag, Berlin, 1989).  The adjusted incidence used in Figure 5
is the sum of the adjusted incidences for each HIV exposure group.

The Lowess procedure makes no assumption about the overall trends in the
data.  A fitted value is computed for each month by weighted least squares
regression using only the adjusted number of cases diagnosed during an
interval about the month (in Figure 5, the 30% of months closest to the
chosen month); the weights decrease for times further from the chosen
month.  The procedure assumes that incidence during the interval about each
month is approximately a linear function of time.  Lowess tends to produce
a curve that is linear at each end, as observed in the figure; predictions of
future numbers of cases should not be made by extrapolating the Lowest
curve.

The Lowess curve should be considered a description of the overall trend in
AIDS cases.  This curve emphasizes that the rate of increase in incidence
slowed during the middle of 1987.  See MMWR 1990:39:81-86.

(1) Included among the dependencies, possessions, and independent nations
are Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, the
Republic of Palau, the Republic of the Marshall Islands, the Commonwealth
of the Northern Mariana Islands, and the Federated States of Micronesia. 
The latter 5 comprise the category "Pacific Islands, U.S." listed in Table 1.
