HIV seroprevalence across the rural/urban continuum.
While the first decade of the AIDS epidemic was characterized by high prevalence rates of AIDS infection in urban areas, there is increasing recognition of the spread of HIV into rural communities in the United States. Data from the Miami CARES cohort collected on 3,555 chronic drug users from 1988 to 1994 provide a unique opportunity to assess sociodemographic characteristics, drug-using behaviors and HIV risk behaviors related to HIV seropositivity in three communities across the rural-urban continuum: Miami, Florida; Belle Glade, Florida and Immokalee, Florida. The three very different communities studied demonstrate that HIV is no respecter of ecological site. The spread of HIV between areas and within areas is specifically correlated with the risk factors including injection drug use, use of crack cocaine, exchange of sex for money, and the rates for sexually transmitted diseases. All of these factors are shown to increase the risk of HIV so that the constellation of these practices helps determine the differential rates and spread of HIV in the three different areas.
McCoy
C B
CB
Comprehensive Drug Research Center, Department of Epidemiology and Public Health, University of Miami School of Medicine, Florida 33136, USA. cmccoy@mednet.med.miami.edu
Metsch
L R
LR
McCoy
H V
HV
Weatherby
N L
NL
D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D015331:Cohort Studies; D016001:Confidence Intervals; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D005431:Florida / Q000453:epidemiology; D015528:HIV Seroprevalence; D006801:Humans; D013287:Illicit Drugs; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D012309:Risk-Taking; D012423:Rural Health / Q000706:statistics & numerical data*; D012737:Sex Factors; D012725:Sexual Behavior / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D015819:Substance Abuse, Intravenous / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology*; D014504:Urban Health / Q000706:statistics & numerical data*
D013287:Illicit Drugs