TRENDS IN HIV SEROPREVALENCE AMONG PERSONS ATTENDING SEXUALLY-TRANSMITTED DISEASE CLINICS IN THE UNITED-STATES, 1988-1992

Trends in seroprevalence of the human immunodeficiency virus (HIV) were examined among patients attending sentinel clinics for sexually transmitted diseases (STDs) throughout the United States. Cross-sectional, unlinked (blinded) surveys of HIV seroprevalence were conducted annually within clinics in 40 metropolitan areas. From 1988 to 1999, 552,665 specimens were tested in 80 STD clinics. The overall HIV seroprevalence was 33% (range among metropolitan areas: 5-52%) among gay and bisexual men, 3% (range: 0.3-11%) among heterosexual men, 2% (range: 0.1-11%) among women, and 10% (range: 0.5-45%) among heterosexual injecting drug users (IDUs). Controlling for clinic, age, and race/ethnicity, HIV seroprevalence decreased among all gay and bisexual men, but especially among white gay and bisexual men from 32% in 1989 to 22% in 1992. Among heterosexual men and women, HIV seroprevalence decreased among whites and, to a lesser degree, Hispanics, but remained essentially stable among African-Americans over time. Among heterosexual IDUs, seroprevalence was also unchanged. These results reflect changes in the HIV epidemic, which is becoming increasingly characterized by infected heterosexuals and IDUs, especially within minority populations.