Human immunodeficiency virus infection in disadvantaged adolescents: findings from the US Job Corps

Article Abstract:

The full impact of the human immunodeficiency virus (HIV) epidemic on teenagers in the US has not been evaluated. Most of the current epidemiologic information for this population has been obtained through HIV screening of civilians applying for miliary service. This is a select group for which high school graduation is a requirement, and a group from which homosexuals and drug users are excluded; this may have resulted in underestimation of the prevalence of HIV infection in teenagers. A study was undertaken to evaluate the extent of the HIV epidemic among disadvantaged young people. The results of mandatory HIV screening performed on Job Corps students, aged 16 to 21, were analyzed. The Job Corps is a federal training program for socially and economically disadvantaged young people; 84 percent of the students have not completed high school' 79 percent read below the 9th grade level; and average annual family income is $5,355. There were 137,209 students screened; 488 were HIV seropositive (blood tests showed evidence of antibody response to exposure to the HIV virus); this incidence of 3.6 per 1,000 people is higher than that found in military applicants of the same age. Overall, the rate was slightly higher in boys than girls, at 3.7 and 3.2 per 1,000, respectively. In subjects aged 16 and 17, however, the rate was higher in girls than boys, at 2.3 and 1.5 per 1,000, respectively. The HIV seroprevalence rate was 8.9 for 21-year-old subjects. Black and Hispanic 21-year-olds from urban areas of the northeast had a rate of 24.8 per 1,000 (1 in 40). The rate was disproportionately high for students in the southeast who were from rural and small towns. The prevalence of HIV infection was much higher among females than expected, based on other studies of AIDS patients in the US. These findings show that disadvantaged, out of school youth are at high risk for HIV infection, and the epidemic is shifting markedly toward young females. Epidemic control measures must reach teenagers early and must extend beyond the system of formal schooling. Broad public health programs should be initiated to reach this group of young people at risk. Every health contact with a teenager presents an opportunity for the physician to discuss the risks of HIV and to explain ways to reduce those risks. (Consumer Summary produced by Reliance Medical Information, Inc.)

Risk factors, HIV seropositivity, HIV positive, HIV seroprevalence

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Seroprevalence rates of human immunodeficiency virus infection at sentinel hospitals in the United States

Article Abstract:

Since AIDS develops years after infection with HIV, the AIDS virus, it is critical for public health officials to obtain accurate estimates of the prevalence of HIV infection in the population. This turns out to be exceptionally difficult to do, since the seriousness of the disease and the associated social stigma cause many individuals to be reluctant to volunteer for testing. To provide some estimate for HIV seroprevalence, that is, the prevalence of HIV antibodies in the serum, anonymous assays were performed on blood samples taken at 26 hospitals in 21 major cities. Samples from patients with disorders possibly related to AIDS were not included, so that the sample would not be biased in that way. The overall rate of prevalence for the populations tested was 1.3 percent; the rate in particular hospitals varied from 0.1 to 7.8 percent. The median male-to-female ratio was 7.0, but this ratio decreased with increasing prevalence. That is, the higher the prevalence in a particular location, the more women were positive in relation to a set number of men. In the areas of highest prevalence, the male-to-female ratio was 2.9. HIV infection was more common among blacks in the population tested, with a mean ratio of 1.8 blacks per white. However, this ratio, too, was influenced by the overall prevalence, and the ratio of blacks to whites was higher in areas where the overall prevalence was higher. As might be expected, the prevalence of AIDS was greatest among patients between 25 and 45 years of age. (Consumer Summary produced by Reliance Medical Information, Inc.)

AIDS virus carriers, HIV carriers

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HIV infection among patients in U.S. acute care hospitals: strategies for the counseling and testing of hospital patients

Article Abstract:

Routine voluntary testing of hospital patients between 15 and 64 years old for HIV infection may identify a significant number of HIV-positive individuals. Of 195,829 blood samples that were tested for HIV infection at 20 different hospitals in 15 cities, 9,286 (4.7%) were positive for HIV infection. Among the 20 hospitals, the percentage of patients who tested HIV-positive ranged from 0.2% to 14.2%. Patients with infectious diseases or with drug-related illnesses were more likely to be HIV-positive than other patients. Thirty-two percent of the HIV-positive patients experienced symptoms of HIV infection or AIDS at the time of admission to the hospital. Early diagnosis and treatment of individuals infected with HIV may delay the onset of AIDS. Early counseling and education of HIV-infected individuals may also prevent transmission of the infection to other individuals.

Diagnosis, Testing, HIV patients, Hospital patients

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