Document 0924
 DOCN  M94A0924
 TI    Rapid spread of HIV-1 infection among male commercial street sex workers
       in Miami, Florida.
 DT    9412
 AU    Klaskala W; Lai S; Shor-Posner G; Sfakianaki E; Gomez O; Baum M; Dept of
       Epidemiology, Univ of Miami, Dade County Public Health; Unit, FL.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(2):25 (abstract no. 392C). Unique
       Identifier : AIDSLINE ICA10/94371651
 AB    OBJECTIVE: To determine prevalence, incidence and risks for HIV-1 in
       male commercial street sex workers (CSSW) in Miami, Florida. METHODS:
       Male CSSW arrested for exchange of sex with men for money and/or drugs
       were tested for HIV-1 under mandatory legislated program. The incidence
       of new HIV-1 infection was examined in those men who were tested more
       than once. All sera reactive for HIV-1 were repeatedly tested with ELISA
       and confirmed with Western blot. RESULTS: Of 165 CSSW tested from Nov
       1987 to Dec 1991 for HIV-1 74 (44.8%) had HIV antibodies on their
       initial test. Over this period a total of 115 men were found to be HIV
       positive, which represents period prevalence of 69.7%. Cumulative
       incidence (seroconversion rate) increased rapidly from 45.6 at the
       second HIV testing to 83.3% at the third (final) HIV testing. Median
       seroconversion time was 22.5 months (CI 18.1-28.7 at 95%). Age at the
       first HIV testing was significantly associated with seroconversion time.
       Adjusted for calendar age, country of origin, state of residence and
       race, those who were older than 35 years, were 9.2 times (CI 2.2-39.0 at
       95%) more likely to become seroconverted compared to those who were
       younger than 35. Over 90% of the seroconverters had a history of
       contracting sexually transmitted diseases, mainly syphilis and
       gonorrhea. DISCUSSION AND CONCLUSIONS: Rapid rise of HIV-1 incidence
       among male CSSW suggests that among populations thought to have made
       significant advances in slowing the spread of HIV, such as men having
       sex with men, there is a possible slippage and increasing rate of new
       infection. New, innovative, targeted interventions are urgently needed
       to reduce HIV-1 transmission in this population.
 DE    AIDS Serodiagnosis/LEGISLATION & JURISPRUD  Comorbidity
       Florida/EPIDEMIOLOGY  Human  HIV Infections/*EPIDEMIOLOGY/TRANSMISSION
       HIV Seropositivity/EPIDEMIOLOGY  *HIV-1/IMMUNOLOGY  Incidence  Male
       Occupational Diseases/*EPIDEMIOLOGY  Prevalence
       Prostitution/*STATISTICS & NUMER DATA  Sexually Transmitted
       Diseases/EPIDEMIOLOGY  Urban Population  MEETING ABSTRACT

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).