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Decreasing prevalence hides a high HIV incidence: Miami
T A Peterman1, A A Zaidi, J Wroten
1Division of STD/HIV Prevention, Centers for Disease Control, Atlanta, Georgia 30333, USA.
AIDS (London, England)
|August 1, 1995
Summary
Analyzing HIV trends in STD clinics requires separating data for previously tested and new patients. While overall prevalence decreased, incidence remained high, especially among Black women.
Area of Science:
- Epidemiology
- Public Health
- Infectious Diseases
Background:
- Sexually transmitted disease (STD) clinics are critical for monitoring HIV trends.
- Understanding HIV seroprevalence and incidence is vital for public health interventions.
- Previous assessments in high-prevalence areas like Miami may be confounded by repeat testing.
Purpose of the Study:
- To evaluate methods for assessing HIV trends in STD clinics.
- To analyze HIV seroprevalence and incidence data from Miami STD clinics between 1987-1992.
- To identify potential confounding factors in trend analysis.
Main Methods:
- Cross-sectional and retrospective cohort study design.
- Analysis of computerized records from four Miami STD clinics (1987-1992).
- Examination of HIV testing data, including repeat testing rates and seroconversion.
Main Results:
- Over 70,000 tests were conducted on over 53,000 individuals.
- Initial HIV positivity was 13%, declining to 7% overall by 1992.
- Repeat testing of previously negative individuals (35% by 1992) masked true incidence trends.
- HIV incidence remained stable at 2.5% annually, with Black women showing the highest retesting positivity (4.3%).
Conclusions:
- Routine HIV testing data requires separate analysis for previously tested versus new patients.
- Overall HIV prevalence in these clinics decreased, but incidence remained persistently high.
- Black women represent a key demographic with high HIV incidence requiring targeted interventions.