title: Declining seroprevalence in a very large HIV epidemic: injecting drug users in New York City, 1991 to 1996.
abstract: OBJECTIVE
  This study assessed recent trends in HIV seroprevalence among injecting drug users in New York City.
  
  
  METHODS
  We analyzed temporal trends in HIV seroprevalence from 1991 through 1996 in 5 studies of injecting drug users recruited from a detoxification program, a methadone maintenance program, research storefronts in the Lower East Side and Harlem areas, and a citywide network of sexually transmitted disease clinics. A total of 11,334 serum samples were tested.
  
  
  RESULTS
  From 1991 through 1996, HIV seroprevalence declined substantially among subjects in all 5 studies: from 53% to 36% in the detoxification program, from 45% to 29% in the methadone program, from 44% to 22% at the Lower East Side storefront, from 48% to 21% at the Harlem storefront, and from 30% to 21% in the sexually transmitted disease clinics (all P < .002 by chi 2 tests for trend).
  
  
  CONCLUSIONS
  The reductions in HIV seroprevalence seen among injecting drug users in New York City from 1991 through 1996 indicate a new phase in this large HIV epidemic. Potential explanatory factors include the loss of HIV-seropositive individuals through disability and death and lower rates of risk behavior leading to low HIV incidence.
authors.affiliation: Chemical Dependency Institute, Beth Israel Medical Center, New York, NY 10003, USA. dcdesjarla@aol.com
authors.forename: D C
authors.initials: DC
authors.lastname: Des Jarlais
authors.forename: T
authors.initials: T
authors.lastname: Perlis
authors.forename: S R
authors.initials: SR
authors.lastname: Friedman
authors.forename: S
authors.initials: S
authors.lastname: Deren
authors.forename: T
authors.initials: T
authors.lastname: Chapman
authors.forename: J L
authors.initials: JL
authors.lastname: Sotheran
authors.forename: S
authors.initials: S
authors.lastname: Tortu
authors.forename: M
authors.initials: M
authors.lastname: Beardsley
authors.forename: D
authors.initials: D
authors.lastname: Paone
authors.forename: L V
authors.initials: LV
authors.lastname: Torian
authors.forename: S T
authors.initials: ST
authors.lastname: Beatrice
authors.forename: E
authors.initials: E
authors.lastname: DeBernardo
authors.forename: E
authors.initials: E
authors.lastname: Monterroso
authors.forename: M
authors.initials: M
authors.lastname: Marmor
mesh_terms: D000328:Adult; D005260:Female; D015528:HIV Seroprevalence / Q000639:trends*; D015438:Health Behavior; D006801:Humans; D008297:Male; D009519:New York City / Q000453:epidemiology; D016017:Odds Ratio; D011159:Population Surveillance; D044469:Racial Groups; D012307:Risk Factors; D012309:Risk-Taking; D015819:Substance Abuse, Intravenous / Q000150:complications*; D014504:Urban Health / Q000639:trends*