HIV-1 SEROPREVALENCE IN AN INNER-CITY PUBLIC HOSPITAL

In a hospital-based seroprevalence survey for human immunodeficiency v irus type 1 (HIV-1) infection, a stratified sampling method based on a ge and gender was used to collect 5429 blood samples at an inner-city hospital. Sentinel Hospital Surveillance System (SHSS) criteria develo ped by the Centers for Disease Control and Prevention were used to cla ssify patient diagnoses into two categories by the likelihood of being associated with HIV-1 infection. The two categories were those with h igh likelihood of association with HIV-1 (SHSS-ineligible) and those w ith low likelihood of association with HIV-1 infection (SHSS-eligible) . Of the 5429 blood samples, 4262 were SHSS-eligible and 1167 were SHS S-ineligible. After personal identifiers were removed, specimens were tested by ELISA and confirmed by Western blot analysis. The overall pr evalence rate of HIV-1 infection was 0.98%. The seroprevalence rate wa s almost 2.6 times higher in high-association patients compared with l ow-association patients (1.89% versus 0.73%, P<.001). Results from thi s study indicate a high unsuspected HIV-1 seroprevalence rate in a sub population (SHSS-eligible) considered to have diagnoses with low likel ihood of association with HIV-1 infection. These patients may better a pproximate HIV-1 seroprevalence in the general population of the area served by the hospital than would a sample of all patients. Monitoring HIV-1 seroprevalence in the SHSS-eligible group will be a useful meas ure for community serosurveillance for HIV-1 infection.