TY - JOUR
T1 - HIV seroconversion among the homeless and marginally housed in San Francisco
T2 - A ten-year study
AU - Hahn, Judith A.
AU - Bangsberg, David R.
AU - McFarland, William
AU - Charlebois, Edwin D.
AU - Clark, Richard A.
AU - Moss, Andrew R.
PY - 2004/12/15
Y1 - 2004/12/15
N2 - HIV seroprevalence was previously found to be 9-11% among the urban homeless in San Francisco, with most infections among injection dsrug users, men who have sex with men, and those who exchange sex for money or drugs. In this study, HIV incidence and risk factors for seroconversion were estimated among persons who repeatedly participated in cross-sectional serosurveys over a period of 10 years. There were 6 seroconversions among 799 HIV-negative persons, for an incidence rate of 0.30% per person-year (95% CI: 0.12-0.61% per person-year). The seroconversion rate among men who had had recent sex with men was 1.22% per person-year (95% CI: 0.29-3.18) and was 0.52% per person-year (95% CI: 0.19-1.13% per person-year) among those who ever injected drugs. The seroconversion rate among those who were aged <30 years at baseline was 1.67% per person-year (95% CI: 0.40-4.36% per person-year), which was significantly higher than for those age ≥30 years. Policy implications are that HIV resources aimed at the more stable, older homeless population should probably focus on treatment, while prevention efforts, conversely, should probably be targeted to younger homeless persons.
AB - HIV seroprevalence was previously found to be 9-11% among the urban homeless in San Francisco, with most infections among injection dsrug users, men who have sex with men, and those who exchange sex for money or drugs. In this study, HIV incidence and risk factors for seroconversion were estimated among persons who repeatedly participated in cross-sectional serosurveys over a period of 10 years. There were 6 seroconversions among 799 HIV-negative persons, for an incidence rate of 0.30% per person-year (95% CI: 0.12-0.61% per person-year). The seroconversion rate among men who had had recent sex with men was 1.22% per person-year (95% CI: 0.29-3.18) and was 0.52% per person-year (95% CI: 0.19-1.13% per person-year) among those who ever injected drugs. The seroconversion rate among those who were aged <30 years at baseline was 1.67% per person-year (95% CI: 0.40-4.36% per person-year), which was significantly higher than for those age ≥30 years. Policy implications are that HIV resources aimed at the more stable, older homeless population should probably focus on treatment, while prevention efforts, conversely, should probably be targeted to younger homeless persons.
KW - HIV infections/epidemiology
KW - Homeless
KW - Incidence
KW - Younger
UR - http://www.scopus.com/inward/record.url?scp=10644253719&partnerID=8YFLogxK
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U2 - 10.1097/00126334-200412150-00015
DO - 10.1097/00126334-200412150-00015
M3 - Article
C2 - 15577419
AN - SCOPUS:10644253719
SN - 1525-4135
VL - 37
SP - 1616
EP - 1619
JO - Journal of Acquired Immune Deficiency Syndromes
JF - Journal of Acquired Immune Deficiency Syndromes
IS - 5
ER -