Temporal trends of human immunodeficiency virus type 1 (HIV-1) infection among inmates entering a statewide prison system, 1985-1987

David Vlahov, Ford Brewer, Alvaro Muñoz, Druscilla Hall, Ellen Taylor, B. Frank Polk

Research output: Contribution to journalArticle

Abstract

Acquired immune deficiency syndrome (AIDS) became the leading cause of death among Maryland State prisoners in 1985. To identify the prevalence, risk factors, and temporal trends for infection with the human immunodeficiency virus type 1 (HIV-1) in the statewide prison system, excess sera were obtained from incoming male inmates during specified periods between April and June 1985, 1986, and 1987. Correctional medical personnel also provided demographic variables of age, race, offense category, sentence, jurisdiction, and an indicator of intravenous drug use. Once rendered anonymous, specimens were assayed for antibody to HIV-1, using ELIS A and Western blot techniques. For data from April to June 1985, 1986, and 1987, the crude prevalence of anti-HIV-1 was 7.1, 7.7, and 7.0%, respectively. Although one-third of incoming inmates were identified as intravenous drug users (IVDUs), the drug use variable was missing for 70% of the 1985 sample, and 40% of the 1986 sample. Several strategies were used to examine temporal trends in the context of missing data. Univariate analyses suggested no substantial change over time for either HIV-1 seroprevalence or risk of infection among IVDUs. Three logistic regression models were constructed: (a) only those variables present for all inmates, (b) adding the drug use variable but restricting the sample to inmates with this variable record, and (c) utilizing all incoming inmates and including the drug use variable with imputed values for drug use provided to those inmates with this variable missing. All approaches yielded consistent results in that no significant change over time was observed in seroprevalence or risk of HIV-1 infection by subgroup. This apparent stability in the prevalence of infection at intake should reassure correctional program planners. Furthermore, if incoming inmates represent a means to sample the surrounding community, these data suggest that transmission of HIV-1 infection may be occurring at a slower rate among Maryland drug users compared to other geographic locales.

Original languageEnglish (US)
Pages (from-to)283-290
Number of pages8
JournalJournal of acquired immune deficiency syndromes
Volume2
Issue number3
StatePublished - Jun 1989

Keywords

  • Epidemiology
  • HIV-1
  • Intravenous drug abuse
  • Prison inmates
  • Seroprevalence
  • Substance abuse

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

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