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American Journal of Epidemiology Vol. 137, No. 8: 909-915
Copyright © 1993 by The Johns Hopkins University School of Hygiene and Public Health

research-article

Epidemiology of Human Immunodeficiency Virus Type 1 Infection among Homosexual Men Participating in Hepatitis B Vaccine Trials in Amsterdam, New York City, and San Francisco, 1978–1990

Godfried J. P. van Griensven1,, Nancy A. Hessol2, Beryl A. Koblin3, Robert H. Byers4, Paul M. O'Malley2, Nel Albrecht-van Lent1, Susan P. Buchbinder2, Patricia E. Taylor3, Cladd E. Stevens3 and Roel A. Coutinho1

1Municipal Health Service, Department of Public Health Amsterdam, The Netherlands
2AIDS Office, Department of Public Health, City and County of San Francisco San Francisco, CA
3Wolf Szmuness Laboratory of Epidemiology, The New York Blood Center New York, NY
4Division of HIV/AIDS, National Center for Infectious Diseases, Centers for Disease Control Atlanta, GA

Reprint requests to Dr. Godfried J. P. van Griensven, Municipal Health Service, Department of Public Health, Nieuwe Achtergracht 100, 1018 WT Amsterdam, The Netherlands.

Homosexual/bisexual men from Amsterdam, The Netherlands, New York, New York, and San Francisco, California, were entered into trials of the efficacy of hepatitis B vaccine shortly before the acquired immunodeficiency syndrome (AIDS) epidemic was recognized (1978–1980). The authors analyzed data, including serial blood samples tested for antibody to human immunodeficiency virus type 1 (HIV-1) as well as demographic and behavioral information, to characterize the spread of HIV-1 infection within the cohorts. By the end of 1982, the cumulative incidence of HIV-1 infection was 7.5% in Amsterdam, 26.8% in New York City, and 42.6% in San Francisco. Covariate analysis showed that differences in sexual activity (number of male sexual partners) and correlates of sexual activity (age and hepatitis B incidence) accounted for the differences in incidence of HIV-1 infection between the New York City and San Francisco cohorts. These covariates did not explain the lower incidence in the Amsterdam cohort. In conclusion, significant differences were found in the spread of HIV-1 in cohorts of homosexual men in Amsterdam, New York City, and San Francisco. These dissimilarities were probably due to a combination of differences in sexual activity at the time the epidemic began and a later introduction of HIV-1 in Amsterdam.

acquired immunodeficiency syndrome; hepatitis B virus; HIV; homosexuality; sex behavior


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