GEOGRAPHIC-VARIATION IN HUMAN-IMMUNODEFICIENCY-VIRUS SEROCONVERSION RATES IN THE UNITED-STATES-NAVY

The Navy population is centered around 19 U.S. home ports and several inland duty stations. This is a study of variation in human immunodefi ciency virus (HIV) seroconversions in Navy enlisted men by location in the United States, based on 949,570 enzyme-linked immunosorbent assay s and 812 seroconversions during 1987-90. Seroconversion rates were hi gher in personnel in San Francisco (p = 0.0004), Washington, D.C. (p = 0.001), and Orlando, FL (p = 0.04) than in other areas. They were low er in Charleston, SC, New London, CT, Seattle; and Brunswick, ME (p < 0.05). Black men had triple the seroconversion rate of all other men ( p < 0.0001). After adjustment for race, age, marital status, and occup ation, risk of seroconversion remained high in San Francisco (p = 0.02 ) and Orlando (p = 0.03). The risk of seroconversion in San Francisco was twice that of other areas in a cohort that did not change location (p = 0.01). In contrast to declining trends overall in the Navy, rate s did not decrease in Washington, D.C., a result consistent with previ ous calculations indicating a delayed second wave of HIV infection in the region.