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New Jersey Health Statistics
1997

Morbidity
Communicable Diseases
Acquired Immunodeficiency Syndrome

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).

TABLE C1. AIDS CASES BY YEAR OF DIAGNOSIS AND CUMULATIVE CASES
REPORTED THROUGH DECEMBER 31, 1998
NEW JERSEY, 1981 - 1997
YEAR NUMBER OF CASES
(PRE-1993 DEFINITION)
NUMBER OF CASES
(1993 DEFINITION)
TOTAL CASES
(BOTH DEFINITIONS)
CUMULATIVE
CASES
PRIOR TO 1986 1,441 10 1,451 1,451
1986 1,267 5 1,272 2,723
1987 1,808 17 1,825 4,548
1988 1,951 49 2,000 6,548
1989 2,434 133 2,567 9,115
1990 2,382 227 2,609 11,724
1991 2,463 378 2,841 14,565
1992 2,573 975 3,548 18,113
1993 2,672 2,363 5,035 23,148
1994 1,859 2,191 4,050 27,198
1995 1,386 2,346 3,732 30,930
1996 1,043 2,027 3,070 34,000
1997 712 1,609 2,321 36,321
SOURCE: NEW JERSEY DEPARTMENT OF HEALTH AND SENIOR SERVICESDIVISION OF AIDS PREVENTION AND CONTROL

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.

Figure C1

TABLE C2. AIDS CASES BY YEAR OF DIAGNOSIS AND VITAL STATUS
REPORTED THROUGH DECEMBER 31, 1998
NEW JERSEY, 1981 - 1997
YEAR TOTAL
CASES
DECEASED
CASES
SURVIVING
CASES
PRIOR TO 1986 1,451 1,390 61
1986 1,272 1,174 98
1987 1,825 1,717 108
1988 2,000 1,858 142
1989 2,567 2,275 292
1990 2,609 2,267 342
1991 2,841 2,452 389
1992 3,548 2,809 739
1993 5,035 3,350 1,685
1994 4,050 2,216 1,834
1995 3,732 1,437 2,295
1996 3,070 688 2,382
1997 2,321 385 1,936
CUMULATIVE
THROUGH 12/31/98
36,321 24,018 12,303
SOURCE: NEW JERSEY DEPARTMENT OF HEALTH AND SENIOR SERVICES
DIVISION OF AIDS PREVENTION AND CONTROL

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).

TABLE C3. DISTRIBUTION OF CLASSIFICATION OF AIDS CASES
IDENTIFIED THROUGH EXPANDED 1993 DEFINITION
DIAGNOSED DURING 1997 AND REPORTED THROUGH DECEMBER 31, 1998
NEW JERSEY
CLASSIFICATION NUMBER PERCENT
PULMONARY TUBERCULOSIS 33 2.1
RECURRENT PNEUMONIA 55 3.4
LOW CD4+T-LYMPHOCYTE COUNT 1,521 94.5
SOURCE: NEW JERSEY DEPARTMENT OF HEALTH AND SENIOR SERVICES
DIVISION OF AIDS PREVENTION AND CONTROL

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).

Figure C2

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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