title: The underrecognition of HIV infection in women in an inner-city emergency room.
abstract: OBJECTIVE
  This study analyzed the recognition of human immunodeficiency virus (HIV) infection and associated factors in women and men attending an emergency room in the Bronx, New York, NY.
  
  
  METHODS
  From April 16, 1989, to May 5, 1989, the emergency room records of 2102 consecutive patients 13 years of age or older were reviewed and, for 856 patients undergoing venipuncture, linked anonymously to results of HIV antibody tested in excess blood.
  
  
  RESULTS
  HIV seroprevalence was 7.8% in women and 14.6% in men. Among seropositive women, 5.0% had acquired immunodeficiency syndrome (AIDS), compared with 26.0% of men. Excluding patients with AIDS, HIV infection was recognized in 13.2% of women and 27.0% of men. HIV infection was recognized only in women aged 25 through 44 years. In men, recognition occurred in all age groups. Clinical presentation did not distinguish the seropositive from seronegative women. Risk assessments were recorded less frequently for women (11.2%) than men (15.9%). For 92.5% of persons with any behavioral risk assessment, injecting drug use was the only behavior assessed.
  
  
  CONCLUSIONS
  HIV infection is underrecognized in women, in part, because of a lower prevalence of AIDS. Universal HIV risk assessment, which includes heterosexual behaviors, may help increase recognition of HIV in women and opportunities for early intervention.
authors.affiliation: Montefiore Medical Center/Albert Einstein College of Medicine, Department of Epidemiology and Social Medicine, Bronx, New York 10467.
authors.forename: E E
authors.initials: EE
authors.lastname: Schoenbaum
authors.forename: M P
authors.initials: MP
authors.lastname: Webber
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital; D005260:Female; D006679:HIV Seropositivity / Q000453:epidemiology*; D015528:HIV Seroprevalence; D006801:Humans; D008297:Male; D008875:Middle Aged; D009518:New York; D012307:Risk Factors; D012737:Sex Factors; D014505:Urban Population