CHANGING HIV-INFECTION RATES AND RISK IN AN AFRICAN-AMERICAN COMMUNITY COHORT

This longitudinal study of a homogeneously urban African-American comm unity cohort drawn from the metropolitan New York area (USA) analyzed three-year change in HIV-I antibody prevalence and self-reported risk practices separately for men and women. Specifically, risk practices r eported on personal interviews and results from blood sere-assay in 19 89-1990 were compared to similar interview reports of risk practices a nd HN assay from saliva samples in 1993. Results showed: (1) women's i nfection rates increased more than men's, resulting in a male to femal e infection ratio of 1.5:1; (2) heterosexual transmission accounted fo r most of women's new infection; (3) in multivariate analysis, multipl e partners was a significant heterosexual risk indicator for both men and women, increasing infection odds five-fold; and (4) buying sex als o increased heterosexual men's infection odds approximately five-fold. Results document increasing rates of African-American HIV infection l inked largely to heterosexual exposure risk, that the African-American male-female infection ratio resembles the global rather than North Am erican one, and also the utility of an expanded classification of hete rosexual exposure risk.