Sentinel surveillance of human immunodeficiency virus infection in sexually transmitted disease clinics in the United States.

From April 1988 through December 1989, sera obtained for syphilis testing from consecutive patients attending 98 sexually transmitted disease (STD) clinics in 37 metropolitan areas were tested for antibodies to human immunodeficiency virus (HIV) in an unlinked (blinded) survey. HIV seroprevalence in STD clinics ranged from 0 to 38.5% (median, 2.3%), with the highest rates found in the Mid-Atlantic states, Florida, and Puerto Rico. The highest median rates were found in men who have sex with men (36.1%) and heterosexual intravenous (IV) drug users (4.1%). For heterosexual persons who do not report IV drug use, median rates were highest in the 35- to 39-year-old age group for men (6.4%) and the 30- to 34-year-old age group for women (0.9%). Among persons who do not report risk behaviors for HIV infection, men had substantially higher median rates of HIV infection than women (P less than 0.001, Wilcoxon Signed Rank test), and rates were positively correlated with HIV infection rates in IV drug users in the same clinic (Pearson correlation coefficient r] = 0.8; P less than 0.001). Among heterosexual STD clinic patients who do not report IV drug use, the median HIV infection rate for blacks (1.8%) was at least 2 times higher than the median infection rates for hispanics (0.9%) and whites (0.7%). The results of this study show that HIV infection in STD clinic patients varies by geographic area, sex, race and ethnic group, and risk behavior.(ABSTRACT TRUNCATED AT 250 WORDS)