Human immunodeficiency virus infection among members of the Reserve Components of the US Army: prevalence, incidence and demographic characteristics

Article Abstract:

Every two years the Department of the Army tests all military personnel for antibody to human immunodeficiency virus (HIV); a positive test is interpreted as an indication of HIV infection and is referred to as seroconversion. The testing policy extends to members of the US Army Reserve (USAR) and the Army National Guard (ARNG), which are the Reserve Components (RC) of the US Army. Consequently, the current review of test results concerns a population that is neither regular military staff nor preselected on the basis of risk status, ethnicity, place of residence, or type of employment. These persons live and work in their civilian homes and occupations, except for approximately 10 percent of their time when they are required to participate in military pursuits. According to military regulations, intravenous drug abusers and persons with a homosexual lifestyle are barred from military service. Of the 677,463 RC persons tested, 1,063 had positive Western blots (which indicate antibody to HIV); of this HIV-positive group, 776 (73 percent) tested positive on a second Western blot. The remaining 27 percent resigned, retired, were scheduled for a second test, or were otherwise unavailable. The findings revealed that men had a two-fold greater risk than women for seroconversion. The prevalence of HIV infection was greater in blacks than in other ethnic groups; while blacks made up about 20 percent of the RC population, 56.6 percent of those with HIV-positive results were black. There was a strong association between living in close proximity to a major urban center with a high level of AIDS and having a positive Western blot. The findings also suggest that poverty is a risk factor for seroconversion, and that the incidence of HIV infection is increasing among women and in nonmetropolitan and small urban centers. Additional statistics and demographic data are reported. The authors believe that the true incidence and prevalence of HIV infection are underreported in both the civilian and RC populations. When coupled with civilian and other military epidemiologic data, this report may be useful in planning preventive, educational, and clinical services. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Military policy, HIV seropositivity, HIV positive, Serodiagnosis, Serologic tests, HIV seroprevalence

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Evidence for spread of the human immunodeficiency virus epidemic into low prevalence areas of the United States

Article Abstract:

There are reports that the number of AIDS cases occurring in small and medium-sized cites is increasing, indicating that the human immunodeficiency virus (HIV) is spreading into areas that did not previously have a high prevalence. For analysis of current infection rates, the number of individuals that are infected with HIV must be estimated, rather than those with AIDS. Individuals who applied to join the military were examined for the prevalence of HIV infection. (Before joining the military, individuals are routinely tested for HIV infection.) This subgroup of individuals excluded homosexual and bisexual men and intravenous drug users. The data from the military records over a two-year period, from 1985 to 1987, were used to examine the rates and trends of HIV infection in various geographic areas. The data included 435,000 applicants from the seven most populated states, New York, California, Texas, Pennsylvania, Illinois, Ohio, and Florida, and four metropolitan areas located within those states, New York City, Miami, Houston, and San Francisco. Over the two-year period, the number of individuals who had antibodies against HIV, indicating infection with the virus, increased in white and black individuals in regions of the United States that do not have epidemic infection rates. Significant increases in the incidence of HIV infection occurred in Florida, California, Texas, Illinois, and Ohio. The increased incidence of infectivity was greatest among those under the age of 25, and was higher in blacks than in whites. In the epidemic urban areas, an increase in the incidence of HIV infection was seen only in young black individuals. This study of HIV infection shows that the prevalence of HIV infection is not limited to a few cities, as it was earlier, and an increase in the rate of infection is occurring nonurban regions of the United States. (Consumer Summary produced by Reliance Medical Information, Inc.)

AIDS (Disease), Recruiting and enlistment, AIDS virus carriers, HIV carriers

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The current distribution of CD4+ T-lymphocyte counts among adults in the United States with human immunodeficiency virus infections: estimates based on the experience of the U.S. Army

Article Abstract:

The Public Health Service (PHS) recommends that persons with increased risk of developing human immunodeficiency virus (HIV-1) infection should be tested for antibody to HIV-1, which are specialized proteins that bind specifically to the virus. HIV-positive patients should be assessed every six months for levels of CD4+ T (T4) lymphocytes, a type of immune cell; those persons with under 200 T4 lymphodytes per cubic millimeter (mm) should receive drug therapy to prevent Pneumocystis carinii pneumonia (PCP). Information about the distribution of T4 cell counts among HIV-infected Americans is sparce, and is needed to plan for resources to implement PHS recommendations. Hence, the current distribution of T4 cell counts among infected individuals in the population was estimated on the basis of U.S. Army screening and clinical evaluation data routinely collected since 1985. The results show that 17 percent of HIV-infected patients have fewer than 200 T4 cells per cubic mm, and should be receiving treatment to prevent PCP. An additional 41 percent have between 200 and 500 T4 cells per cubic mm and may benefit from treatment with AZT. The Army data may not reflect the current trends in HIV infection in the general population, and more studies are needed to estimate the disease stage distributions among currently infected Americans. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Measurement, Physiological aspects, Pneumocystis carinii pneumonia, T cells, Medicine, Military, Military medicine

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