Population prevalence of reported and unreported HIV and related behaviors among the household adult population in New York City, 2004.
BACKGROUND
Surveillance for HIV likely underestimates infection among the general population: 25% of US residents are estimated to be unaware of their HIV infection.


OBJECTIVE
To determine the prevalence of HIV infection and risk behaviors among New York City (NYC) adults and compare these with surveillance findings.


METHODS
The NYC Health and Nutrition Examination Survey (HANES) provided the first opportunity to estimate population-based HIV prevalence among NYC adults. It was conducted in 2004 among a representative sample of adults > 20 years. Previously reported HIV infection was identified from the NYC HIV/AIDS Surveillance Registry. A blinded HIV serosurvey was conducted on archived blood samples of 1626 NYC HANES participants. Data were used to estimate prevalence for HIV infection, unreported infections, high-risk activities, and self-perceived risk.


RESULTS
Overall, 18.1% engaged in one or more risky sexual/needle-use behaviors, of which 92.2% considered themselves at low or no risk of HIV or another sexually transmitted disease. HIV occurred in 21 individuals (prevalence 1.4%; 95% confidence interval (CI), 0.8-2.5]; one infection (5%; 95% CI, 0.7-29.9) was not reported previously and possibly undiagnosed. HIV infection was significantly elevated in those with herpes simplex virus 2 (4%), men who have sex with men (14%), and needle-users (21%) (P < 0.01).


CONCLUSIONS
Among NYC adults, HIV prevalence was consistent with surveillance findings overall. The proportion of unreported HIV was less than estimated nationally, but findings were limited by sample size. Most adults with risky behaviors perceived themselves to be at minimal risk, highlighting the need for risk reduction and routine HIV screening.
Nguyen
Trang Quyen
TQ
New York City Department of Health and Mental Hygiene, New York City, NY 10013, USA. tnguyen@health.nyc.gov
Gwynn
R Charon
RC
Kellerman
Scott E
SE
Begier
Elizabeth
E
Garg
Renu K
RK
Pfeiffer
Melissa R
MR
Konty
Kevin J
KJ
Torian
Lucia
L
Frieden
Thomas R
TR
Thorpe
Lorna E
LE
D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D005191:Family Characteristics; D005260:Female; D006678:HIV / Q000276:immunology*; D015658:HIV Infections / Q000097:blood* / Q000517:prevention & control*; D007722:Health Knowledge, Attitudes, Practice; D006561:Herpes Simplex / Q000097:blood / Q000517:prevention & control; D018258:Herpesvirus 2, Human / Q000276:immunology; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D015995:Prevalence; D018571:Sentinel Surveillance; D016036:Seroepidemiologic Studies; D012725:Sexual Behavior; D015819:Substance Abuse, Intravenous; D011795:Surveys and Questionnaires; D014505:Urban Population
D000914:Antibodies, Viral