title: HIV infection and risk behaviors among heterosexuals in alcohol treatment programs.
abstract: OBJECTIVE
  To measure the prevalence of human immunodeficiency virus (HIV) infection and high-risk behaviors among heterosexuals in alcohol treatment.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  Five public alcohol treatment centers.
  
  
  METHODS
  Consecutive sample of 888 heterosexual clients entering treatment between October 1990 and December 1991. Respondents were 51% black, 10% Hispanic, 33% white, and 76% male. The overall response rate was 68%.
  
  
  METHODS
  Structured interview and serotesting for HIV antibodies.
  
  
  RESULTS
  The overall seroprevalence of HIV infection was 5% (95% confidence interval, 3% to 6%). There were no significant differences in rates of infection by age, gender, or race. The prevalence of infection in heterosexual respondents without a history of injection drug use was 3% in men and 4% in women, several times higher than published estimates from a similar community-based heterosexual sample. Unsafe sexual practices were common: 54% of respondents reported multiple sexual partners in the previous year, 97% of nonmonogamous respondents did not use condoms during all sexual encounters, and few respondents consistently asked new sexual partners about previous high-risk behaviors.
  
  
  CONCLUSIONS
  There is a substantial prevalence of HIV infection among heterosexual clients in San Francisco (Calif) alcohol treatment programs, much of which is not associated with injection drug use. Because of this and the high prevalence of unsafe sexual behaviors, there is a relatively high likelihood of heterosexual spread of HIV among the large population of clients seeking treatment for alcohol dependency. Interventions to prevent HIV spread should become a standard part of alcohol treatment programs.
authors.affiliation: Division of General Internal Medicine, San Francisco General Hospital, CA.
authors.forename: A L
authors.initials: AL
authors.lastname: Avins
authors.forename: W J
authors.initials: WJ
authors.lastname: Woods
authors.forename: C P
authors.initials: CP
authors.lastname: Lindan
authors.forename: E S
authors.initials: ES
authors.lastname: Hudes
authors.forename: W
authors.initials: W
authors.lastname: Clark
authors.forename: S B
authors.initials: SB
authors.lastname: Hulley
mesh_terms: D015492:AIDS Serodiagnosis; D000328:Adult; D000437:Alcoholism / Q000523:psychology / Q000534:rehabilitation*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control / Q000523:psychology / Q000635:transmission; D006801:Humans; D008297:Male; D015995:Prevalence; D012309:Risk-Taking; D012495:San Francisco / Q000453:epidemiology; D012725:Sexual Behavior; D012959:Socioeconomic Factors; D016320:Substance Abuse Treatment Centers / Q000592:standards / Q000706:statistics & numerical data*