title: Estimating the Number of Heterosexual Persons in the United States to Calculate National Rates of HIV Infection.
abstract: BACKGROUND
  This study estimated the proportions and numbers of heterosexuals in the United States (U.S.) to calculate rates of heterosexually acquired human immunodeficiency virus (HIV) infection. Quantifying the burden of disease can inform effective prevention planning and resource allocation.
  
  
  METHODS
  Heterosexuals were defined as males and females who ever had sex with an opposite-sex partner and excluded those with other HIV risks: persons who ever injected drugs and males who ever had sex with another man. We conducted meta-analysis using data from 3 national probability surveys that measured lifetime (ever) sexual activity and injection drug use among persons aged 15 years and older to estimate the proportion of heterosexuals in the United States population. We then applied the proportion of heterosexual persons to census data to produce population size estimates. National HIV infection rates among heterosexuals were calculated using surveillance data (cases attributable to heterosexual contact) in the numerators and the heterosexual population size estimates in the denominators.
  
  
  RESULTS
  Adult and adolescent heterosexuals comprised an estimated 86.7% (95% confidence interval: 84.1%-89.3%) of the U.S. population. The estimate for males was 84.1% (CI: 81.2%-86.9%) and for females was 89.4% (95% CI: 86.9%-91.8%). The HIV diagnosis rate for 2013 was 5.2 per 100,000 heterosexuals and the rate of persons living with diagnosed HIV infection in 2012 was 104 per 100,000 heterosexuals aged 13 years or older. Rates of HIV infection were >20 times as high among black heterosexuals compared to white heterosexuals, indicating considerable disparity. Rates among heterosexual men demonstrated higher disparities than overall population rates for men.
  
  
  CONCLUSIONS
  The best available data must be used to guide decision-making for HIV prevention. HIV rates among heterosexuals in the U.S. are important additions to cost effectiveness and other data used to make critical decisions about resources for prevention of HIV infection.
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.
authors.forename: Amy
authors.initials: A
authors.lastname: Lansky
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.
authors.forename: Christopher
authors.initials: C
authors.lastname: Johnson
authors.affiliation: ICF International at the 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.
authors.forename: Emeka
authors.initials: E
authors.lastname: Oraka
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.
authors.forename: Catlainn
authors.initials: C
authors.lastname: Sionean
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.
authors.forename: M Patricia
authors.initials: MP
authors.lastname: Joyce
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.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: DiNenno
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.
authors.forename: Nicole
authors.initials: N
authors.lastname: Crepaz
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission*; D020010:Heterosexuality; D006801:Humans; D008297:Male; D012307:Risk Factors; D012737:Sex Factors; D014481:United States / Q000453:epidemiology