Session 8Oral Abstract Presentations Epidemiology Session Day and Time: Tuesday 10 am - 12:15 pm Presentation Time: 10:30 Room: 302-306
38 HIV Incidence, Prevalence, and Behavior of Inner City Individuals Attending the Johns Hopkins Emergency Department C. Henson*1, O. Laeyendecker2, B. J. Horne1, R. E. Rothman1, G. D. Kelen1, J. B. Shahan1, K. Ketlogetswe1, T. C. Quinn2 1Johns Hopkins Univ, Baltimore, MD and 2Natl Inst of Allergy and Infectious Diseases, Bethesda, MD
Background: An anonymous sero-survey was used in the summer of 2001 at the Johns Hopkins Univ Emergency Dept (JHU ED) to determine HIV incidence, prevalence, and behavioral information.
Methods: From 6-29-01 to 8-16-01, 1,613 subjects entering the JHU ED were enrolled by interview-based, identity unlinked sero-survey. Sera were tested for HIV by enzyme immunoassay (EIA), western blot, and if positive, for HIV RNA by Roche Amplicor v1.5. The STARHS assay was used to determine recent HIV infection. Survey information was used to determine demographic and risk behavior.
Results: The HIV prevalence rate was 11.3% (183/1,613) with a majority of the HIV+ individuals being African American (AA) males 57.5%, followed by AA women 33%, white males 8.5%, and white women 1.9%. Of the HIV-infected subjects, 23.8% did not know they were infected. There was no difference in median viral load between subjects who knew their HIV status and those who did not (median 1.7 x 104 vs 1.1 x 104, respectively). The 183 HIV+ subjects were tested by STARHS; 8/183 individuals were infected within the previous 170 days and 7/8 did not know their infection status. The HIV-incident rate was estimated to be 1.19% per yr in this cohort. A subset of 55 HIV-infected subjects who knew their infections status were questioned about their current habits with 30% admitting to continued drug use, 5.5% to sharing needles, and 23.6% unprotected sex.
Conclusion: These results suggest that inner city EDs may provide an opportunity to identify previously unrecognized HIV infection and, together with incidence testing, allow for "real-time" monitoring of the epidemic. In addition, the ED could serve as a venue for disseminating information to at risk individuals. Finally, this data represents an increase of both incidence (1.19% vs 0.72% per yr) and prevalence (11.3% vs 8.9%) in this population from last year's study.
