Is there really a heterosexual AIDS epidemic in the United States? Findings from a multisite validation study, 1992-1995

The objective of this study was to verify the mode of exposure to the human immunodeficiency virus (HIV) among cases who obtained acquired immunodefic iency syndrome (AIDS) through heterosexual contact and to determine the pro portion of cases initially reported with no risk but whose exposure may hav e been heterosexual. Adults aged greater than or equal to 13 years with AID S, diagnosed from 1992 through 1995 with heterosexual risk or no risk at si x US study sites (Alabama, California, Florida, New Jersey, New York City, and Texas), were eligible. Heterosexual risk was validated in 82% (1,610/1, 952) of the heterosexual cases. Men were more likely than women to have a r isk other than heterosexual (24% vs. 13%, chi(2) p < 0.01). An HIV risk was identified for 351 (55%) of those cases with no risk, and men were more li kely than women to remain without risk (48% vs. 38%, chi(2) p = 0.02). Of t he 415 men with no risk, 215 (52%) were reclassified: 94 (44%) were men who had sex with men, 61 (28%) were injection drug users, 48 (22%) had a heter osexual risk, and 12 (6%) had other exposures. Of the 219 women with no ris k, 136 (62%) were reclassified: 82 (60%) had a heterosexual risk, 47 (35%) were injection drug users, and 6 (4%) had infection associated with transfu sion. In conclusion, most cases reported with heterosexually acquired AIDS had valid heterosexual risk exposures.