In January, 1993, the Centers for Disease Control and Prevention (CDC) expanded the definition of AIDS to more accurately reflect the clinical syndromes that are associated with the condition. The definition was expanded to include individuals with the human immunodeficiency virus and one of the following conditions: a CD4+ T-lymphocyte count of fewer than 200 cells per microliter; a CD4+ T-cell percentage under 14; pulmonary tuberculosis; recurrent pneumonia (within a 12 month period); or invasive cervical cancer (CDC, 1992).

The number of AIDS cases newly diagnosed in New Jersey residents in 1997 and reported as of December 31, 1998 was 2,321 (Table C1 and Figure C1). These cases include 712 reported under the pre-1993 definition and 1,609 identified under the expanded 1993 AIDS definition. Cases of AIDS diagnosed in 1997 and reported through the end of 1998 are presented by county in Table C9 (Division of AIDS Prevention and Control, 1999b).

Due to the time lag in reporting newly diagnosed cases of AIDS, the number of cases for any year will continue to increase for several years past the end of the calendar year. In recent prior issues of this report, AIDS incidence was defined as cases for the diagnosis year reported during the year of diagnosis and for two years past the end of the diagnosis year. Caution should be exercised in comparing incidence data for 1996 and 1997 presented in the respective years' reports with comparable data for earlier years presented in prior reports in the series, as the incidence figures for 1996 and 1997 were presented after only a one-year lag past the end of the diagnosis year.

In 1997 almost all of the cases (94.5%) identified under the expanded 1993 AIDS definition were classified as having a CD4+ T-lymphocyte count of fewer than 200 cells per microliter or a CD4+T cell percentage of less than 14 (Table C2). An additional 3.4 percent of the cases reported under the new definition were due to recurrent pneumonia, while the remainder were due to pulmonary tuberculosis (2.1%). The 1,521 cases attributed to CD4+ categories represented 65.5% of all new cases diagnosed in 1997 (Division of AIDS Prevention and Control, 1999a).

By December, 1998, the cumulative number of AIDS cases ever diagnosed and reported in New Jersey through the end of 1997 was 36,321. New Jersey continued to rank fifth in the nation in the cumulative number of AIDS cases and had the third highest reported AIDS incidence rate per 100,000 population in 1997, after New York State and Florida. Analyses of the characteristics of New Jersey's AIDS cases contained in this chapter are based on the population of all cases diagnosed in 1997 and reported to the state through December 31, 1998, unless otherwise noted. Comparable incidence data for 1997 for the nation reported through the end of 1998 are used for purposes of comparison (Division of AIDS Prevention and Control, 1998, Centers for Disease Control and Prevention, 1999).

The distribution of mode of transmission of New Jersey AIDS cases for persons 13 or more years of age differs considerably from the risk factors associated with the transmission of AIDS in adults and adolescents in the nation as a whole (Figure C2 and Table C7). Nationally, of all adult and adolescent cases diagnosed in 1997, 30.1 percent were injecting-drug users, while 35.0 percent of New Jersey cases diagnosed in 1997 reported they were injecting-drug users. In the country as a whole, 41.1 percent of AIDS cases were men who have sex with men (MSM), while in New Jersey only 13.7 percent of AIDS cases reported this means of transmission. The proportion of New Jersey AIDS cases attributed to heterosexual transmission is similar to that in the nation as a whole (18.8% and 22.1%, respectively).

For those cases diagnosed in persons 13 or more years of age, New Jersey has a higher percentage of female AIDS cases than does the nation as a whole. The percentage of adult and adolescent cases diagnosed in New Jersey in 1997 included 34.5 percent who were females, compared to 23.1 percent of female cases in the U.S. (Table C7).

Residents under twenty years of age accounted for 1.0 percent of total cases diagnosed in 1997 and reported by December 31, 1998 in New Jersey. Among both males and females, 30 through 39 year olds continue to be the most frequent age group at diagnosis. However, for males, the rate for 40 through 49 year olds was highest (Tables C8A and C8B).

The incidence of AIDS in New Jersey differs greatly by race and ethnicity (Tables C8A and C8B). Almost two-thirds (61.8%) of New Jersey cases diagnosed in 1997 and reported through 1998 were among non-Hispanic blacks, while only 13.2 percent of the population is comprised of non-Hispanic blacks. An additional 17.1 percent of these diagnoses were made among New Jersey's Hispanics who make up 11.9 percent of the state population (Tables C8, P1, and P23).

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