American Journal of Epidemiology Vol. 153, No. 10 : 925-934
Copyright © 2001 by The Johns Hopkins University School of Hygiene and Public Health
ORIGINAL CONTRIBUTIONS |
Differences in the Temporal Trends of HIV Seroincidence and Seroprevalence among Sexually Transmitted Disease Clinic Patients, 1989–1998: Application of the Serologic Testing Algorithm for Recent HIV Seroconversion
1 San Francisco Department of Public Health, San Francisco, CA.
2 Blood Centers of the Pacific, San Francisco, CA.
3 California Department of Health Services, Berkeley, CA.
4 Centers for Disease Control and Prevention, Atlanta, GA.
The authors compared temporal trends in the prevalence and incidence of human immunodeficiency virus (HIV) infection based upon 34,866 specimens from patients who attended the San Francisco, California, municipal sexually transmitted disease clinic between 1989 and 1998. HIV infection data were collected during annual blinded HIV serologic surveys. Incidence was determined by applying a serologic testing algorithm for recent HIV seroconversion that uses both a sensitive and a less sensitive enzyme immunoassay to stored HIV positive sera. The HIV seroprevalence declined from 15.2% in 1989 to 7.2% in 1998 (odds ratio per year = 0.92, 95% confidence interval (CI): 0.91, 0.94). Among homosexual men, the HIV prevalence declined from 50.9% in 1989 to 19.9% in 1998 (odds ratio per year = 0.86, 95% CI: 0.85, 0.88). The pooled seroincidence was 1.6% and did not change significantly over time (odds ratio per year = 1.0, 95% CI: 0.98, 1.1). The pooled seroincidence among homosexual men was 6.6% per year and remained steady between 1989 and 1998 (odds ratio per year = 0.99, 95% CI: 0.92, 1.1). During a dramatic, 10-year decline in seroprevalence of HIV infection, the incidence of HIV infection remained remarkably stable.
acquired immunodeficiency syndrome; HIV; incidence; prevalence; sexually transmitted diseases
Abbreviations: CI, confidence interval; EIA, enzyme-linked immunosorbent assay; HIV, human immunodeficiency virus; HIV-1, human immunodeficiency virus type 1; IDU, injection drug user; LS, less sensitive; MSM, men who have sex with men; OR, odds ratio; STARHS, Serologic Testing Algorithm for Recent HIV Serocon-version; STD, sexually transmitted disease
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