#86 Changes in hiv prevalence among emnt who have sex with men (Msm) Who attend public sexually transmitted disease clinics in the western region of the us (1989–1999)

Abstract

Abstract PURPOSE: To compare the distribution and trends in HIV infection among MSM STD clinic attendees in four Western urban counties. METHODS: As part of CDC's national HIV seroprevalence surveys, unlinked HIV testing was performed on sera routinely collected for syphilis screening between 1989 and 1999 from public STD clinics in Denver, Los Angeles, San Francisco, and Seattle. HIV test results were linked to demographic and risk information abstracted from clinic records. RESULTS: Greater than 70% of MSM attendees were between the ages of 20 and 39. The majority in 3 of 4 counties was white. HIV prevalence over the study period ranged from 13% in Seattle to 30% in San Francisco. In all counties, prevalence was highest among blacks, lowest among Asian/Pacific Islanders, and similar between whites and Hispanics. The 30–39 year-old age group was most likely to be infected. After adjustment for age, race, and injection drug use, mean annual declines in HIV prevalence from 1989 to 1999 ranged from 2.1% (95% CL 1.6, 2.6) in Seattle to 2.8% (95% CL 2.6, 3.1) in San Francisco. All counties except San Francisco saw larger adjusted declines among whites and Hispanics than among blacks. CONCLUSION: Despite variations in the severity of the HIV epidemic across the Western region counties, relative differences in prevalence by race and age were similar. Moreover, all four counties saw temporal declines in HIV prevalence. Trends in HIV prevalence among the MSM STD clinic attendees may not, however, reflect population trends in HIV incidence or prevalence. This may be due to more HIV-positive MSM becoming aware of their status and seeking STD treatment in other settings, thus biasing downward the HIV prevalence observed in public STD clinics, compared with prevalence in the general population.