HIV Prevalence Overall and among High-HIV-Risk Behaviorally Defined Subgroups among Heterosexuals at Community-Based Venues in a Mid-Atlantic, US City
- 369 Downloads
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.
KeywordsHIV Heterosexual Prevalence Disease transmission Infectious Drug user Adult
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.
- 2.The HPTN 064 (ISIS study)—HIV incidence in women at risk for HIV: US. 2012.Google Scholar
- 3.Centers for Disease Control and Prevention. HIV surveillance in adolescents and young adults. http://www.cdc.gov/hiv/topics/surveillance/resources/slides/adolescents/index.htm; Updated 2011–2012. Accessed July 6, 2012.
- 4.Denning P, DiNenno E. Communities in crisis: is there a generalized HIV epidemic in impoverished urban areas of the United States? 2010.Google Scholar
- 5.Towe VL, Sifakis F, Gindi RM, Sherman SG, Flynn C, Hauck H, et al. Prevalence of HIV infection and sexual risk behaviors among individuals having heterosexual sex in low income neighborhoods in Baltimore, MD: the BESURE study. J Acquir Immune Defic Syndr 2010; 53(4): 522–528.PubMedCrossRefGoogle Scholar
- 8.Jackson L. Baltimore's HIV/AIDS epidemic, a unique challenge. Poster exhibition: the XV International AIDS Conference: abstract no. MoPeE4266Google Scholar
- 9.Simon D, Burns E. The corner: a year in the life of an inner-city neighborhood. 1st ed. New York: Broadway; 1997. Accessed June 20, 2012.Google Scholar
- 10.Agar M, Reisinger H. Numbers and trends: heroin indicators and what they represent. Hum Organization. 1999; 58: 365–374.Google Scholar
- 12.United States Census Bureau. Census 2000, summary file 3 (SF 3). 2003. <http://www.geolytics.com/Default.asp>. Updated 2003. Accessed February 12.
- 16.Craig T. Drugs worsen in city, U.S. says: traffic in cocaine, heroin, ecstasy assessed by DEA. Baltimore Sun. 2000.Google Scholar
- 17.Associated Press. Baltimore leads in ER cases tied to drugs. Baltimore Sun. 1998.Google Scholar
- 18.United States. National Drug Intelligence Center. Heroin in the northeast. 2003.Google Scholar
- 19.Centers for Disease Control and Prevention. Diagnoses of HIV infection among adults and adolescents, by sex and age group, 2008-37 states and 5 U.S. dependent areas. http://www.cdc.gov/hiv/topics/surveillance/resources/slides/adolescents/slides/Adolescents_6.pdf.
- 21.Centers for Disease Control and Prevention. HIV prevalence estimates—United States. MMWR Morb Mortal Wkly Rep. 2008; 57(39): 1073–1076.Google Scholar