HIV seroincidence and risk factors among patients repeatedly tested for HIV attending sexually transmitted disease clinics in the United States, 1991to 1996

To assess the incidence of HIV infection and risk factors associated with H IV seroconversion among patients attending clinics for sexually transmitted diseases (STD), medical record reviews were conducted in 12 clinics in 7 U .S. cities. The records of all patients who initially tested negative for H IV from 1991 through 1996 and who received at least one additional HIV rest during the study period were reviewed. In each of 7 cities, 5 to 112 patie nts seroconverted. Of the 286 seroconverters identified in total, 53% (152 of 286) were heterosexual men and 28% (81 of 286) were women. HIV incidence rates among men who have sex with men (MSM) ranged by city from 0.81 to 7. 0 new infections/100 person-years. Rates among heterosexual men and women r anged from 0.018 to 1.2 infections/100 person-years. Multivariate analyses showed that drugs use was associated with HIV seroconversion only among het erosexuals. Most new HIV infections in these clinics are being transmitted heterosexually and are associated with drug use. Nevertheless, MSM, particu larly young MSM, are at greatest risk for HIV in this population: 1 of 47 s eroconvert/year. The effective use of targeted prevention efforts depends u pon the continued ability to monitor the incidence of HIV infection.