HIV infection among young adults in the New York City area. Prevalence and incidence estimates based on antibody screening among civilian applicatants for military service

Since October 1985, the Department of Defense has screened civilian applicants for military service for antibody to the human immunodeficiency virus (HIV). Among young applicants from 15 New York and New Jersey counties in the New City Region, the overall seroprevalence rate was 7.1 per 1,000 (314/44,139). Seroprevalence rates were higher among men than women (male-female ratio, 1.4:1) and higher among black/non-Hispanic applicants than applicants from other racial/ethnic groups, and they increased almost linearly with age from the late teens through the twenties. Male-specific prevalence rates exceeded 0.5% in nine of the 15 counties, while female-specific prevalences exceeded 0.5% in seven. In Manhattan, the Bronx, and Brooklyn, there were geographic foci associated with significantly increase seroprevalences. Despite potential biases, applicant screening data provide unique insights into the current state and the dynamics of the HIV infection epidemic among young adults. Differences in infection risk based on demographic and geographic factors provide empirical bases for allocating prevention, intervention, and clinical services in the region.