Copyright © 2004 by the Johns Hopkins Bloomberg School of Public Health
ORIGINAL CONTRIBUTIONS |
Human Immunodeficiency Virus Infection in a Rural Community in the United States
1 Division of HIV/AIDS Prevention, Surveillance, and Epidemiology, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA.
2 Glades Health Initiative, Inc., Belle Glade, FL.
3 Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH.
4 Florida Department of Health, Tallahassee, FL.
5 Palm Beach County Health Department, Belle Glade, FL.
6 Department of Epidemiology, School of Public Health, Boston University, Boston, MA.
In 1986, a population-based survey of human immunodeficiency virus (HIV) infection in a rural Florida community showed that HIV prevalence was 28/877 (3.2%, 95% confidence interval (CI): 2.0, 4.4). In 1998–2000, the authors performed a second population-based survey in this community and a case-control study to determine whether HIV prevalence and risk factors had changed. After 609 addresses had been randomly selected for the survey, 516 (85%) residents were enrolled, and 447 (73%) were tested for HIV. HIV prevalence was 7/447 (1.6%, 95% CI: 0.4, 2.7) in western Palm Beach County and 5/286 (1.7%, 95% CI: 0.2, 3.3) in Belle Glade (p = 0.2 in comparison with 1986). Independent predictors of HIV infection in both 1986 and 1998–2000 were having a history of sexually transmitted disease, number of sex partners, and exchanging money or drugs for sex. A history of having sex with men was a risk factor among men in 1986 but not in 1998–2000; residence in specific neighborhoods was a risk factor in 1998–2000 but not in 1986. The authors conclude that heterosexually acquired HIV infection did not spread throughout the community between 1986 and 1998 but persisted at a low level in discrete neighborhoods. Interventions targeting HIV-endemic neighborhoods will be needed to further reduce HIV prevalence in this area.
acquired immunodeficiency syndrome; crack cocaine; HIV; HIV infections; risk factors; sexual behavior; sexually transmitted diseases
Abbreviations: Abbreviations: AIDS, acquired immunodeficiency syndrome; CI, confidence interval; HIV, human immunodeficiency virus.
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