AIDS Pandemic - By Region - Americas - United States and Canada

United States and Canada

The adult prevalence rate in this region is 0.7% with over 1 million people currently infected with HIV. In the United States from 2001–2005, the highest transmission risk behaviors were sex between men (40–49% of new cases) and high risk heterosexual sex (32–35% of new cases). Currently, rates of HIV infection in the US are highest in the eastern and southern regions, with the exception of California. Currently, 35,000–40,000 new infections occur in the USA every year. AIDS is one of the top three causes of death for African American men aged 25–54 and for African American women aged 35–44 years in the United States of America. In the United States, African Americans make up about 48% of the total HIV-positive population and make up more than half of new HIV cases, despite making up only 12% of the population. The main route of transmission for women is through unprotected heterosexual sex. African American women are 19 times more likely to contract HIV than other women. Experts attribute this to "AIDS fatigue" among younger people who have no memory of the worst phase of the epidemic in the 1980s and early 1990s, as well as "condom fatigue" among those who have grown tired of and disillusioned with the unrelenting safer sex message. This trend is of major concern to public health workers.

In the United States in particular, a new wave of infection is being blamed on the use of methamphetamine, known as crystal meth. Research presented at the 12th Annual Retrovirus Conference in Boston in February 2005 concluded that using crystal meth or cocaine is the biggest single risk factor for becoming HIV+ among US gay men, contributing 29% of the overall risk of becoming positive and 28% of the overall risk of being the receptive partner in anal sex. In addition, several renowned clinical psychologists now cite methamphetamine as the biggest problem facing gay men today, including Michael Majeski, who believes meth is the catalyst for at least 80% of seroconversions currently occurring across the United States, and Tony Zimbardi, who calls methamphetamine the number one cause of HIV transmission, and says that high rates of new HIV infection are not being found among non-crystal users. In addition, various HIV and STD clinics across the United States report anecdotal evidence that 75% of new HIV seroconversions they deal with are methamphetamine-related; indeed, in Los Angeles, methamphetamine is regarded as the main cause of HIV seroconversion among gay men in their late thirties. The chemical "methamphetamine", in and of itself, can not infect someone with the AIDS virus.

Washington, D.C., the nation's capital, also has the nation's highest rate of infection, at 3%. This rate is comparable to what is seen in west Africa, and is considered a severe epidemic.

In Canada, nearly 60,000 people were living with HIV/AIDS in 2005. The HIV-positive population continues to increase in Canada, with the greatest increases amongst aboriginal Canadians. As in Western Europe, the death rate from AIDS in North America fell sharply with the introduction of combination AIDS therapies (HAART).

In the United States, young African-American women are also at high risk for HIV infection. African Americans make up 10% of the population but about half of the HIV/AIDS cases nationwide. This is due in part to a lack of information about AIDS and a perception that they are not vulnerable, as well as to limited access to health-care resources and a higher likelihood of sexual contact with at-risk male sexual partners. There are also geographic disparities in AIDS prevalence in the United States, where it is most common in the large metropolitan areas of the east coast and California and in urban areas of the deep south.