Trends in HIV prevalence among public sexually transmitted disease clinic attendees in the Western region of the United States (1989-1999).
OBJECTIVE
Using data from anonymous unlinked testing of routinely collected sera, trends in HIV are compared among sexually transmitted disease patients in 4 Western urban centers.


METHODS
Between 1989 and 1999, remnant sera obtained for routine syphilis testing from 256,819 patient visits to Denver, Los Angeles, San Francisco, and Seattle clinics were tested for HIV antibodies in an unlinked survey. HIV antibody test results were linked to anonymous demographic and risk information abstracted from the medical record.


RESULTS
Overall cumulative HIV seroprevalences among women and among men who had sex exclusively with women were < or = 2%, declined over time, and did not exceed 8% among those who injected drugs. In contrast, cumulative HIV seroprevalences among men who have sex with men ranged from 13% in Seattle to 30% in San Francisco and declined a mean of 2.1% (95% CI, 1.6, 2.6) to 2.8% (CI 2.6, 3.1) per year, after adjustment.


CONCLUSIONS
HIV infection declined over time across counties. Relative levels of HIV differed little by demographic and behavioral risk group despite differences in the severity of each county's epidemic. Because of the unique contribution of unlinked serosurveillance studies in monitoring these trends, their reinstitution in high-risk settings should be considered.
Los Angeles County Department of Health Services, CA 90005-4001, USA. nharawa@dhs.co.la.ca.us
Nina T
NT
Harawa
John
J
Douglas
Willi
W
McFarland
Hanne
H
Thiede
Timothy A
TA
Kellogg
Kelly
K
Vorhees
KaraAnn M
KM
Donovan
Trista A
TA
Bingham
D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities; D035041:Anonymous Testing; D002648:Child; D005260:Female; D015483:HIV Antibodies / Q000097:blood; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology*; D015528:HIV Seroprevalence / Q000639:trends*; D015497:HIV-1 / Q000276:immunology; D006801:Humans; D008297:Male; D015995:Prevalence; D012309:Risk-Taking; D012749:Sexually Transmitted Diseases / Q000517:prevention & control*; D015206:Southwestern United States / Q000453:epidemiology; D014861:Washington / Q000453:epidemiology
D015483:HIV Antibodies