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HIV seroincidence among patients at clinics for sexually transmitted
diseases in nine cities in the United States.
Journal of Acquired Immune Deficiency Syndromes 2002;29(5):478-483.
Weinstock H, Dale M, Gwinn M, Satten GA, Kothe D, Mei J, Royalty J,
Linley L,
Fridlund C, Parekh B, Rawal BD, Busch M, Janssen R.
Abstract
Although the numbers of newly reported diagnoses of AIDS decreased in the 1990s,
it is not clear whether they reflect a decreasing number of new HIV infections.
Direct measurement of HIV incidence through follow-up cohort studies is difficult
and costly. We estimated HIV incidence and trends in incidence among men
who have sex with men (MSM) and heterosexual men and women at clinics for
sexually transmitted diseases (STDs) by using a recently developed serologic
testing algorithm that requires only a single blood specimen. Cross-sectional
anonymous serosurveys were conducted at 13 STD clinics in nine cities in
the United States from 1991 through 1997. Before anonymous HIV testing, demographic
and clinical information was abstracted. Of 129,774 specimens tested, 362
(0.28%) were from persons estimated to be recently infected. Incidence among
MSM was 7.1% (95% confidence interval (CI): 4.8-10.3), 14 times higher than
that among heterosexuals, which was 0.5% (CI: 0.4- 0.7). Incidence among
MSM and heterosexuals remained unchanged during the time studied. Decreasing
rates of new AIDS diagnoses in the 1990s do not reflect stable rates of new
HIV infections among MSM and heterosexual patients attending these clinics.