Human Immunodeficiency Virus Infections among Civilian Applicants for United States Military Service, October 1985 to March 1986

During the six months from October 1985 through March 1986, blood samples from 306,061 civilian applicants for military service from the United States were tested for antibody to the human immunodeficiency virus (HIV). Four hundred sixty subjects were positive for the antibody as determined by Western (immune) blot reactivity. The mean prevalence of HIV infection in this population of teenagers and young adults was thus 1.50 per 1000. According to multivariate analysis, the following demographic factors were found to be significant independent predictors of a positive HIV-antibody test: age (adjusted odds ratio = 1.10 per year), black race (adjusted odds ratio = 2.04), male sex (adjusted odds ratio = 1.84), residence in a densely populated county (adjusted odds ratio = 1.05 per 1000 per square mile), and residence in a metropolitan area with a high incidence of the acquired immunodeficiency syndrome (adjusted odds ratio = 1.53). Antibody-positive applicants were identified in 43 of the 50 states. Counties with high prevalence rates for HIV (>5 per 1000) were located in New York State (four counties), New Jersey (three counties), California (two counties), Maryland (two counties), and Texas, Colorado, and Washington, D.C. (N Engl J Med 1987; 317:131–6.), THE acquired immunodeficiency syndrome (AIDS) is the clinically overt, end-stage manifestation of a prolonged infection with the human immunodeficiency virus (HIV).¹ The mean interval from infection to the development of AIDS is estimated to be four to five years, but it may be longer.^2,3 Just as the epidemiology of AIDS today reflects the epidemiology of HIV transmission several years ago, current data on HIV prevalence may be used to predict the future course and changes in the epidemiologic features of the AIDS epidemic. The demographic and behavioral factors associated with AIDS — the end stage of HIV infection — have…