EPIDEMIOLOGY OF HIV-1 INFECTION IN RURAL GEORGIA - DEMOGRAPHIC-TRENDSAND ANALYSIS AT THE MEDICAL-COLLEGE OF GEORGIA

We have conducted a retrospective study of 100 HN-infected patients en rolled in an AZT monotherapy clinical study at the Medical College of Georgia (MCG) in Augusta, Georgia. When compared to the national trend s, our results confirm previous studies that describe an overall incre ase in the burden of HN infections among blacks, and, in particular, b lack women in the rural Southeast. In our cohort, infections due to ho mosexual contact accounted for approximately 40% of all cases while he terosexual contact and intravenous drug use (IDU) comprised 33% and 13 %, respectively. Infections attributable to all other risk factors acc ounted for the remaining 14%. Relative to national surveillance data, we observed an increase in the prevalence of HIV infections among blac ks, and heterosexually acquired infections, particularly among black w omen. Our analysis illustrates the dynamic nature of the current U.S. epidemic which appears to be shifting both in terms of its demographic and epidemiological profile. These data may indicate that national su rveillance data may not reflect the dynamic nature of current demograp hic trends in HIV incidence, particularly as evidenced in the rural So utheast. This suggests that hospital or laboratory based cross-section al studies, like ours, that analyze demographic variables of HIV-infec ted clinic attendees may be necessary to more accurately assess the le ading edge of the HN epidemic in rural, nonmetropolitan areas.