HUMAN IMMUNODEFICIENCY VIRUS-TYPE-1 INFECTION IN AN INNER-CITY ALCOHOL TREATMENT PROGRAM

The human immunodeficiency virus (HIV) infection rate was examined in a selected cohort of healthy clients of an inner-city alcohol treatmen t center from 1990 through 1993. These subjects were also participatin g in a research protocol (n = 258) designed to assess immunity and HIV risk behaviors in inner city alcohol-dependent persons. Healthy alcoh ol-abusing heterosexual clients (165) had HIV testing conducted in an inner-city ambulatory alcohol treatment center between September 1990 and December 1993. Respondents were 93.9% African-American and 3.6% Hi spanic; 72.1% were male, Anonymous HIV-1 antibody testing was conducte d retrospectively for an additional 80 subjects who participated in th e research protocol during the same interval, but for whom HIV-1 antib ody testing was not conducted clinically at the time. HIV infection ra te among the clinic-tested subjects (n = 165) was 4.4% far individuals who were exclusively alcohol-dependent, 1.4% for non-injecting drug u se (IDU) mixed substance abusers, and 46.8% for clients with a history of IDU. Rates did not differ among cohorts tested in different years. Among non-injecting drug users tested in the clinic, all infected res pondents (n = 3) were women (p = 0.03). Among those tested anonymously (n = 80), however, infection rate for exclusively alcohol-dependent p ersons was 16.7%, non-IDU mixed abusers 11.1%, and injecting drug user s 48.3%, with seropositive males as well as females in each group. HIV infection rates for the pooled samples (n = 245) were 8.7% for exclus ively alcohol-dependent persons, 5.1% for mixed abusers, and 54.5% for injecting drug users. Among non-injecting drug users, exclusively alc ohol-dependent women had a significantly higher (p < 0.01) infection r ate (20.0%) than the remaining females and males. Infection rates amon g exclusively alcohol-dependent males, male and female polysubstance n on-IDU abusers, and injecting drug users were comparable with that see n in an earlier screening in the same clinic in 1989, with apparently little diffusion of infection from the IDU population to other substan ce abusers. An exception seemed to be exclusively alcohol-dependent fe males, who show substantially elevated rates. Age, housing, and other social differences may help segregate substance-abusing populations in the relatively small Newark metropolitan area, although not protectin g exclusively alcohol-dependent females.