title: Epidemiology of HIV infection in large urban areas in the United States.
abstract: BACKGROUND
  While the U.S. HIV epidemic continues to be primarily concentrated in urban area, local epidemiologic profiles may differ and require different approaches in prevention and treatment efforts. We describe the epidemiology of HIV in large urban areas with the highest HIV burden.
  
  
  RESULTS
  We used data from national HIV surveillance for 12 metropolitan statistical areas (MSAs) to determine disparities in HIV diagnoses and prevalence and changes over time. Overall, 0.3% to 1% of the MSA populations were living with HIV at the end of 2007. In each MSA, prevalence was >1% among blacks; prevalence was >2% in Miami, New York, and Baltimore. Among Hispanics, prevalence was >1% in New York and Philadelphia. The relative percentage differences in 2007 HIV diagnosis rates, compared to whites, ranged from 239 (San Francisco) to 1239 (Baltimore) for blacks and from 15 (Miami) to 413 (Philadelphia) for Hispanics. The epidemic remains concentrated, with more than 50% of HIV diagnoses in 2007 attributed to male-to-male sexual contact in 7 of the 12 MSAs; heterosexual transmission surpassed or equaled male-to-male sexual transmission in Baltimore, Philadelphia, and Washington, DC. Yet in several MSAs, including Baltimore and Washington, DC, AIDS diagnoses increased among men-who-have sex with men in recent years.
  
  
  CONCLUSIONS
  These data are useful to identify local drivers of the epidemic and to tailor public health efforts for treatment and prevention services for people living with HIV.
authors.affiliation: Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America. ixh1@cdc.gov
authors.forename: H Irene
authors.initials: HI
authors.lastname: Hall
authors.forename: Lorena
authors.initials: L
authors.lastname: Espinoza
authors.forename: Nanette
authors.initials: N
authors.lastname: Benbow
authors.forename: Yunyin W
authors.initials: YW
authors.lastname: Hu
mesh_terms: D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology / Q000635:transmission; D006801:Humans; D008297:Male; D015995:Prevalence; D014481:United States / Q000453:epidemiology / Q000208:ethnology; D014504:Urban Health