Estimated proportion of heterosexual persons in the United States, by survey and combined by meta-analysis.

<p>* I² = 81.1; Q = 10.6, p = 0.005</p><p>^† I² = 88.1; Q = 16.8, p <0.001</p><p>^§ I² = 91.6; Q = 23.7, p < 0.001. CI = confidence interval. GSS = General Social Survey (2010); NHANES = National Health and Nutrition Examination Survey (2009–2010); NSFG = National Survey of Family Growth (2006–2010). See <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0133543#pone.0133543.t001" target="_blank">Table 1</a> for description of each survey.</p><p>Estimated proportion of heterosexual persons in the United States, by survey and combined by meta-analysis.</p

Adult and adolescent heterosexuals living with diagnosed HIV infection- United States, 2012.

<p>*Number of cases attributable to heterosexual contact, statistically adjusted to account for reporting delays and missing risk factor information, but not for incomplete reporting.</p><p>^†Per 100,000 heterosexuals.</p><p>^§ Hispanics/Latinos may be of any race.</p><p>^¶ Other race includes American Indian/Alaska Native, Native Hawaiian/Other Pacific Islander, unknown race/ethnicity, and multiple races.</p><p>** Relative standard error >30% for meta-analysis estimate of the population proportion heterosexual for this group.</p><p>Note. Data include persons age 13 years and older with a diagnosis of HIV infection regardless of stage of disease at diagnosis. CI = confidence interval</p

Diagnoses of HIV infection among adult and adolescent heterosexuals, by selected characteristics—United States, 2013.

<p>*Number of cases attributable to heterosexual contact, statistically adjusted to account for reporting delays and missing risk factor information, but not for incomplete reporting.</p><p>^†Per 100,000 heterosexuals.</p><p>^§ Hispanics/Latinos may be of any race.</p><p>^¶ Other race includes American Indian/Alaska Native, Native Hawaiian/Other Pacific Islander, unknown race/ethnicity, and multiple races.</p><p>** Relative standard error >30% for meta-analysis estimate of the population proportion heterosexual for this group.</p><p>Note. Data include persons age 13 years and older with a diagnosis of HIV infection regardless of stage of disease at diagnosis. CI = confidence interval</p

Estimated proportion of heterosexual persons in the United States, by sex, race/ethnicity, and age group--meta-analysis of 3 national surveys^*.

<p>*Surveys used in the meta-analysis: General Social Survey (2010); NHANES = National Health and Nutrition Examination Survey (2009–2010); NSFG = National Survey of Family Growth (2006–2010). See <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0133543#pone.0133543.t001" target="_blank">Table 1</a> for description of each survey.</p><p>^† Relative Standard Error (RSE) = 30–49%.</p><p>CI = confidence interval.</p

Description of 3 national household surveys of the non-institutionalized population of the United States used in meta-analysis.

<p>* Interview method is for the sexual and drug use behavior questions.</p><p>^† Question wording includes all questions used to determine heterosexual (ever had sex with opposite sex partner, did not ever inject drugs, did not ever have sex with same-sex partner [males]). Note that for NSFG the questions on injection drug use were not used.</p><p>^§ Analyses were limited to those aged 18–69 years to match the upper age limit of NHANES.</p><p>^¶ Data were available for respondents aged 14–69 years. Analyses were limited to those aged 15–69 years to match the lower age limit of NSFG.</p><p>CAPI = Computer-Assisted Personal Interview; ACASI = Audio, Computer-Assisted Self Interview</p

Estimating the Number of Heterosexual Persons in the United States to Calculate National Rates of HIV Infection

<div><p>Background</p><p>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.</p><p>Methods</p><p>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.</p><p>Results</p><p>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 2012was 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.</p><p>Conclusions</p><p>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.</p></div

HIV-positive participants with DBS available for testing.

<p>HIV-positive participants with DBS available for testing.</p

Recency test results using, 25%, 30% and 35% avidity indices.

<p>Recency test results using, 25%, 30% and 35% avidity indices.</p

Drug resistance mutation testing of DBS specimens.

<p>Drug resistance mutation testing of DBS specimens.</p