Prevalence of HIV-1 among recent arrestees in Los Angeles County, California: Serial cross-sectional study, 1991 to 1995

Injection drug users (IDU), crack smokers, and commercial sex workers engag e in illegal activities that place them at risk for HIV infection. The marg inalized nature of these groups often Limits use of customary sampling meth ods to assess HIV prevalence. We tested urine samples of recent arrestees t o evaluate HIV prevalence of at-risk populations that are difficult to acce ss using standard surveillance methods. We tested for HIV-I antibodies in u rine specimens of recent Los Angeles County (California, U.S.A.) arrestees as part of the Drug Use Forecasting (DUF) Program funded by the U. S. Natio nal Institute of Justice. Data are presented for 5 years of a serial cross- sectional study of arrestees. Results from 1991 through 1995 indicate a sli ght HIV prevalence increase among crack smokers (from 4% to 6%). Prevalence estimates were relatively stable for IDU (6%), male (3%) and female arrest ees (3%), arrestees who share needles (9%), and commercial sex workers (6%) . HIV status was independently associated with injection drug use,crack smo king,and ever having exchanged sex for money or drugs. Prevalence of HIV am ong arrestee subgroups may reflect prevalence in the community. However the benefit of using the DUF sample must be weighed against bias introduced fr om using nonrandom samples to estimate prevalence.