HIV-INFECTION AMONG HOMELESS ADULTS AND RUNAWAY YOUTH, UNITED-STATES,1989-1992

Objectives: Homeless persons have an increased risk of HIV infection b ecause of a high prevalence of HIV-related risk behaviors. These inclu de drug use, sexual contact with persons at risk for HIV infection, an d the exchange of sex for drugs. The objectives of this investigation were to describe HIV seroprevalence rates in homeless adults and runaw ay youth. Methods: In 1989, the Centers for Disease Control and Preven tion began collaboration with state and local health departments to co nduct HIV seroprevalence surveys in homeless populations. Unlinked HIV seroprevalence surveys were conducted in 16 sites; 11 provided medica l services primarily to homeless adults, and five to runaway youth age d <25 years. Results: From January 1989 through December 1992, annual surveys were conducted in 16 sites in 14 cities. Site-specific seropre valence rates ranged from 0-21.1% (median, 3.3%). Among homeless adult s in three sites, rates were higher among men who had sex with other m en and those who injected drugs than among persons with other risk exp osures (28.9 versus 5.3%). In general, rates were higher for heterosex ual men than for women and higher among African Americans than whites. In sites providing services to homeless youth, HIV seroprevalence rat es ranged from 0-7.3% (median, 2.3%). Conclusions: These data indicate that HIV infection among homeless adults and runaway youth is an impo rtant public health problem. HIV prevention and treatment should be in tegrated into comprehensive health and medical programs serving homele ss populations.