SENTINEL SURVEILLANCE OF HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION IN WOMEN SEEKING REPRODUCTIVE HEALTH-SERVICES IN THE UNITED-STATES, 1988-1989

Cases of AIDS among women of reproductive age have increased dramatica lly since 1981; nearly a third of all cases among females were reporte d in 1990 alone. Surveillance of human immunodeficiency virus (HIV) in fection among women is essential for monitoring the spread of HIV over time and identifying specific populations and geographic areas in nee d of HIV counseling, testing, and prevention services. Blinded (unlink ed) serologic surveys were conducted in the United States and Puerto R ico in sentinel clinics providing reproductive health services to wome n, including family planning, prenatal care, and abortion services. Se venty-eight of 94 clinics (83%) in 30 cities conducting surveys during 1988 and 1989 detected at least one HIV-positive woman. Clinic-specif ic prevalence ranged from 0-2.28% (median 0.22%), with rates over 1% o ccurring in clinics predominantly on the East Coast and in Puerto Rico . Seroprevalence varied by primary type of service, race-ethnicity, an d age group. Median rates were higher in clinics offering prenatal ser vices and lower in abortion and family planning clinics in the same ci ties. In general, women 25-29 years of age showed the highest median r ate of infection (0.32%), and rates were higher among black women (med ian 0.34%) than among Hispanic (median 0.11%) and white women (median 0%). Our data indicate the need to educate women about recognizing and reducing their risk of HIV infection. Reproductive health clinics wit h high seroprevalence should implement voluntary HIV counseling and te sting with appropriate follow-up clinical evaluation and referral for infected women. Clinics with low prevalence should seize the opportuni ty to enhance HIV education and prevention efforts.