Prevalence, incidence, and risks for HIV-1 infection in female sex workers in Miami, Florida.
Annual cross-sectional prevalence, incidence of new infection, and risks for human immunodeficiency virus type 1 (HIV-1) infection were studied in 607 women convicted of prostitution between October 1987 and December 1990 and tested for HIV under court order. Cross-sectional prevalence was stable for 4 years (23-24% positivity in 1987-1991, p = 0.6). However, the incidence of new infections (rate of seroconversion) in 264 women tested more than once increased significantly each year from 12 per 100 person-years in 1987-1988 to 19 per 100 person-years in 1991 (p < 0.03). Seroconverters were more likely to be young black women with a prior history of syphilis or gonorrhea. A new episode of syphilis or rectal gonorrhea during the follow-up period predicted HIV seroconversion in a survival analysis model. Female sex workers are at great risk of acquiring HIV infection. Although HIV prevalence in cross-sectional samples was stable, incidence was increasing. Interpretation of prevalence trends from convenience samples, such as screening programs, may be difficult because changes in incidence may not be detected.
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Division of HIV/AIDS, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Klaskala
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Morgan
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Withum
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D000328:Adult; D005260:Female; D005431:Florida; D015658:HIV Infections / Q000453:epidemiology* / Q000209:etiology; D015497:HIV-1; D006801:Humans; D015994:Incidence; D015995:Prevalence; D012307:Risk Factors; D011477:Sex Work