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Journal of Urban Health

, Volume 90, Issue 4, pp 747–757 | Cite as

HIV Prevalence Overall and among High-HIV-Risk Behaviorally Defined Subgroups among Heterosexuals at Community-Based Venues in a Mid-Atlantic, US City

  • Sarah PolkEmail author
  • Jonathan M. Ellen
  • Caroline Fichtenberg
  • Steven Huettner
  • Jacky M. Jennings
Article

Abstract

A clear understanding of local transmission dynamics is a prerequisite for the design and implementation of successful HIV prevention programs. There is a tremendous need for such programs geared towards young African-American women living in American cities with syndemic HIV and injection drug use. In some of these American cities, including Baltimore, the HIV prevalence rate among young African-American women is comparable to that in some African nations. High-risk heterosexual sex, i.e., sex with an injection drug user or sex with someone known to have HIV, is the leading risk factor for these young women. Characterizing transmission dynamics among heterosexuals has been hampered by difficulty in identifying HIV cases in these settings. The case identification method described in this paper was designed to address challenges encountered by previous researchers, was based on the Priorities for Local AIDS Cases methodology, and was intended to identify a high number of HIV cases rather than achieve a representative sample (Weir et al., Sex Transm Infect 80(Suppl 2):ii63-8, 2004. Through a three-phase process, 87 venues characterized as heterosexual sex partner meeting sites were selected for participant recruitment in Baltimore, MD. One thousand six hundred forty-one participants were then recruited at these 87 venues, administered a behavioral risk questionnaire, and tested for HIV. The HIV prevalence was 3 % overall, 3 % among males, and 4 % among females and ranged from 1.7 to 22.6 % among high-HIV-risk subgroups. These findings indicate that attributing HIV transmission to high-risk heterosexual sex vs. other high-HIV-risk behaviors would be difficult. Moving beyond individual risk profiles to characterize the risk profile of venues visited by heterosexuals at high risk of HIV acquisition may reveal targets for HIV transmission prevention and should be the focus of future investigations.

Keywords

HIV Heterosexual Prevalence Disease transmission Infectious Drug user Adult 

Notes

Acknowledgments

The authors thank the men and women who participated in this study and the staff who collected the data. The National Institute of Child Health and Human Development (grant number R21HD052438) and National Institute of Drug Abuse (grant number KO1 DA022298-01A1) are gratefully acknowledged for their support.

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Copyright information

© The New York Academy of Medicine 2012

Authors and Affiliations

  • Sarah Polk
    • 1
    Email author
  • Jonathan M. Ellen
    • 1
    • 2
    • 3
  • Caroline Fichtenberg
    • 2
  • Steven Huettner
    • 1
  • Jacky M. Jennings
    • 1
    • 2
  1. 1.Division of General Pediatrics and Adolescent Medicine, Department of PediatricsJohns Hopkins University School of MedicineBaltimoreUSA
  2. 2.Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreUSA
  3. 3.Children’s Hospital, Johns Hopkins University School of MedicineBaltimoreUSA

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