Tracking the spread of the hiv infection epidemic among young adults in the united states: Results of the first four years of screening among civilian applicants for U.S. military service

J. F. Brundage, D. S. Burke, L. I. Gardner, J. G. McNeil, M. Goldenbaum, R. Visintine, R. R. Redfield, M. Peterson, R. N. Miller

Research output: Contribution to journalArticle

Abstract

Because the period from infection to clinically apparent disease is long, variable, and changing as new therapies are developed and applied, AIDS data are inadequate for tracking current values of critical parameters of HIV infection epidemics: prevalence of infection, rate of acquisition of new infections (incidence rate), and direction and rate of change of infection incidence over time (acceleration). These "vital signs" of infection epidemics can be tracked using serial cross-sectional seroprevalence data, however. From October 1985 through September 1989, more than 2.3 million applicants for U.S. military service were screened for antibody to HIV. The overall seroprevalence was 1.31 per 1, 000 (3, 014/2, 300, 675). Seroprevalences were highest near urban centers of the AIDS epidemic and were independently associated with age, race/ethnicity, and gender. Based on age seroprevalence trends, it was crudely estimated that at least one of 2, 000 young men and one of 7, 000 young women are infected with HIV annually in the U.S. Infection incidence rates, estimated from age and temporal trends, were estimated to be highest among black males (1.40/1, 000/year) and lowest among white females (0.03/1, 000/year). Poisson regression analysis of seroprevalence trends suggested that infection incidence rates accelerated among black females during the first 3 years of screening. Since selection factors undoubtedly changed over the period, estimates based on these data probably underestimate actual values in the general population, particularly near urban AIDS epicenters. Nonetheless, even crude estimates of these critical values, particularly among adolescents and young adults, are useful to guide policy development, to allocate resources, and to monitor program effects.

Original languageEnglish (US)
Pages (from-to)1168-1180
Number of pages13
JournalJournal of Acquired Immune Deficiency Syndromes
Volume3
Issue number12
StatePublished - 1990
Externally publishedYes

Fingerprint

Young Adult
Seroepidemiologic Studies
Infection
Acquired Immunodeficiency Syndrome
Incidence
HIV Antibodies
Vital Signs
Policy Making
HIV Infections
Regression Analysis
HIV
Population

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)
  • Immunology and Allergy
  • Virology

Cite this

Tracking the spread of the hiv infection epidemic among young adults in the united states : Results of the first four years of screening among civilian applicants for U.S. military service. / Brundage, J. F.; Burke, D. S.; Gardner, L. I.; McNeil, J. G.; Goldenbaum, M.; Visintine, R.; Redfield, R. R.; Peterson, M.; Miller, R. N.

In: Journal of Acquired Immune Deficiency Syndromes, Vol. 3, No. 12, 1990, p. 1168-1180.

Research output: Contribution to journalArticle

Brundage, JF, Burke, DS, Gardner, LI, McNeil, JG, Goldenbaum, M, Visintine, R, Redfield, RR, Peterson, M & Miller, RN 1990, 'Tracking the spread of the hiv infection epidemic among young adults in the united states: Results of the first four years of screening among civilian applicants for U.S. military service', Journal of Acquired Immune Deficiency Syndromes, vol. 3, no. 12, pp. 1168-1180.
Brundage, J. F. ; Burke, D. S. ; Gardner, L. I. ; McNeil, J. G. ; Goldenbaum, M. ; Visintine, R. ; Redfield, R. R. ; Peterson, M. ; Miller, R. N. / Tracking the spread of the hiv infection epidemic among young adults in the united states : Results of the first four years of screening among civilian applicants for U.S. military service. In: Journal of Acquired Immune Deficiency Syndromes. 1990 ; Vol. 3, No. 12. pp. 1168-1180.
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abstract = "Because the period from infection to clinically apparent disease is long, variable, and changing as new therapies are developed and applied, AIDS data are inadequate for tracking current values of critical parameters of HIV infection epidemics: prevalence of infection, rate of acquisition of new infections (incidence rate), and direction and rate of change of infection incidence over time (acceleration). These {"}vital signs{"} of infection epidemics can be tracked using serial cross-sectional seroprevalence data, however. From October 1985 through September 1989, more than 2.3 million applicants for U.S. military service were screened for antibody to HIV. The overall seroprevalence was 1.31 per 1, 000 (3, 014/2, 300, 675). Seroprevalences were highest near urban centers of the AIDS epidemic and were independently associated with age, race/ethnicity, and gender. Based on age seroprevalence trends, it was crudely estimated that at least one of 2, 000 young men and one of 7, 000 young women are infected with HIV annually in the U.S. Infection incidence rates, estimated from age and temporal trends, were estimated to be highest among black males (1.40/1, 000/year) and lowest among white females (0.03/1, 000/year). Poisson regression analysis of seroprevalence trends suggested that infection incidence rates accelerated among black females during the first 3 years of screening. Since selection factors undoubtedly changed over the period, estimates based on these data probably underestimate actual values in the general population, particularly near urban AIDS epicenters. Nonetheless, even crude estimates of these critical values, particularly among adolescents and young adults, are useful to guide policy development, to allocate resources, and to monitor program effects.",
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