HIV infection and risk behaviors in two cross-sectional surveys of heterosexuals in alcoholism treatment

Objective: To measure the prevalence of human immunodeficiency virus (HIV) infection and high-risk behaviors among heterosexuals in alcoholism treatme nt, comparing two cross-sectional surveys completed 2 to 3 years apart. Met hod: Two groups of entrants to alcoholism treatment clinics were recruited, between October 1990 and December 1991 (n = 860: 639 men) and between Janu ary 1993 and March 1994 (n = 752: 520 men). Participants underwent a struct ured interview including an assessment of demographics, substance abuse cha racteristics and sexual behaviors, as well as serotesting for HIV antibodie s. Associations were examined between HIV serostatus and several factors, i ncluding demographic variables, substance use and high-risk sexual behavior s. Results: The overall HIV seroprevalence in the first and second samples was 5% (95% CI: 3-6%) and 5% (95% CI: 3-7%). When the two samples were comp ared, there were no significant differences in prevalence of HIV infection by categories of gender, race, income and most other demographic characteri stics with-in either sample: history of injection drug use (IDU) was signif icantly related to HIV serostatus in both samples. Unsafe sexual practices were common in both samples. When samples were combined, those 30 years of age or older were more Likely to be HIV infected, and men and women with no reported history of IDU still had an HN prevalence of 3% and 2%, respectiv ely. More than half of the respondents had two or more partners in the prev ious 6 months and reported a history of a sexually transmitted disease. Con clusions: There was no change in the substantial prevalence of HIV infectio n and high-risk behavior among heterosexual clients entering alcoholism tre atment programs over the 3.5-year study period The HIV prevalence among non -IDU clients remained several times higher than published estimates from si milar community-based heterosexual samples. These data reinforce the concep t that heterosexual noninjection dnr,a users are at high risk for HIV and m ay benefit from intervention programs.