Skip to main content

Some NLM-NCBI services and products are experiencing heavy traffic, which may affect performance and availability. We apologize for the inconvenience and appreciate your patience. For assistance, please contact our Help Desk at info@ncbi.nlm.nih.gov.

American Journal of Public Health logoLink to American Journal of Public Health
. 1996 May;86(5):642–654. doi: 10.2105/ajph.86.5.642

The estimated prevalence and incidence of HIV in 96 large US metropolitan areas.

S D Holmberg 1
PMCID: PMC1380471  PMID: 8629714

Abstract

OBJECTIVES: This study sought to estimate the size and direction of the human immunodeficiency virus (HIV) epidemic in US metropolitan statistical areas (MSAs) with populations greater than 500,000. METHODS: A "components model" from review of more than 350 documents, several large datasets, and information from 220 public health personnel was used. Data review focused on injection drug users, men who have sex with men, and high-risk heterosexual men and women. RESULTS: In the 96 MSAs, there are, broadly, an estimated 1.5 million injection drug users, 1.7 million gay and bisexual men, and 2.1 million at-risk heterosexuals, and, among them, an estimated 565,000 prevalent and 38,000 incident HIV infections. This implies about 700,000 prevalent and 41,000 new HIV infections yearly in the United States. Roughly half of all estimated new infections are occurring among injection drug users, most of them in northeastern cities, Miami, and San Juan. Gay and bisexual men still represent most prevalent HIV infections, although incidence--except in young and minority gay men--is much lower now than it was a decade ago. Relatively high prevalences of HIV in at-risk heterosexual persons in several cities indicate the potential for an increase in transmission among them. CONCLUSIONS: This review and synthesis outline the comparative epidemiology of HIV in major US cities and identify populations for interventions.

Full text

PDF
642

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Abeni D. D., Brancato G., Perucci C. A. Capture-recapture to estimate the size of the population with human immunodeficiency virus type 1 infection. Epidemiology. 1994 Jul;5(4):410–414. doi: 10.1097/00001648-199407000-00006. [DOI] [PubMed] [Google Scholar]
  2. Alcabes P., Vlahov D., Anthony J. C. Correlates of human immunodeficiency virus infection in intravenous drug users: are treatment-program samples misleading? Br J Addict. 1992 Jan;87(1):47–54. doi: 10.1111/j.1360-0443.1992.tb01899.x. [DOI] [PubMed] [Google Scholar]
  3. Aldrich M. R., Mandel J., Newmeyer J. A. A spreadsheet for AIDS: estimating heterosexual injection drug user population size from AIDS statistics in San Francisco. J Psychoactive Drugs. 1990 Jul-Sep;22(3):343–349. doi: 10.1080/02791072.1990.10472558. [DOI] [PubMed] [Google Scholar]
  4. Allen D. M., Onorato I. M., Green T. A. HIV infection in intravenous drug users entering drug treatment, United States, 1988 to 1989. The Field Services Branch of the Centers for Disease Control. Am J Public Health. 1992 Apr;82(4):541–546. doi: 10.2105/ajph.82.4.541. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Anderson J. E., Dahlberg L. L. High-risk sexual behavior in the general population. Results from a national survey, 1988-1990. Sex Transm Dis. 1992 Nov-Dec;19(6):320–325. [PubMed] [Google Scholar]
  6. Battjes R. J., Pickens R. W., Amsel Z. HIV infection and AIDS risk behaviors among intravenous drug users entering methadone treatment in selected U.S. cities. J Acquir Immune Defic Syndr. 1991;4(11):1148–1154. [PubMed] [Google Scholar]
  7. Berrios D. C., Hearst N., Coates T. J., Stall R., Hudes E. S., Turner H., Eversley R., Catania J. HIV antibody testing among those at risk for infection. The National AIDS Behavioral Surveys. JAMA. 1993 Oct 6;270(13):1576–1580. [PubMed] [Google Scholar]
  8. Billy J. O., Tanfer K., Grady W. R., Klepinger D. H. The sexual behavior of men in the United States. Fam Plann Perspect. 1993 Mar-Apr;25(2):52–60. [PubMed] [Google Scholar]
  9. Caussy D., Weiss S. H., Blattner W. A., French J., Cantor K. P., Ginzburg H., Altman R., Goedert J. J. Exposure factors for HIV-1 infection among heterosexual drug abusers in New Jersey treatment programs. AIDS Res Hum Retroviruses. 1990 Dec;6(12):1459–1467. doi: 10.1089/aid.1990.6.1459. [DOI] [PubMed] [Google Scholar]
  10. Chiasson M. A., Stoneburner R. L., Hildebrandt D. S., Ewing W. E., Telzak E. E., Jaffe H. W. Heterosexual transmission of HIV-1 associated with the use of smokable freebase cocaine (crack). AIDS. 1991 Sep;5(9):1121–1126. doi: 10.1097/00002030-199109000-00011. [DOI] [PubMed] [Google Scholar]
  11. Chirgwin K., DeHovitz J. A., Dillon S., McCormack W. M. HIV infection, genital ulcer disease, and crack cocaine use among patients attending a clinic for sexually transmitted diseases. Am J Public Health. 1991 Dec;81(12):1576–1579. doi: 10.2105/ajph.81.12.1576. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Chitwood D. D. HIV risk and injection drug users--evidence for behavioral change. Am J Public Health. 1994 Mar;84(3):350–350. doi: 10.2105/ajph.84.3.350. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Chu S. Y., Peterman T. A., Doll L. S., Buehler J. W., Curran J. W. AIDS in bisexual men in the United States: epidemiology and transmission to women. Am J Public Health. 1992 Feb;82(2):220–224. doi: 10.2105/ajph.82.2.220. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Churchill G. A., Giovannoni J. J., Tanksley S. D. Pooled-sampling makes high-resolution mapping practical with DNA markers. Proc Natl Acad Sci U S A. 1993 Jan 1;90(1):16–20. doi: 10.1073/pnas.90.1.16. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Curtis J. L., Crummey F. C., Baker S. N., Foster R. E., Khanyile C. S., Wilkins R. HIV screening and counseling for intravenous drug abuse patients. Staff and patient attitudes. JAMA. 1989 Jan 13;261(2):258–262. [PubMed] [Google Scholar]
  16. Des Jarlais D. C., Friedman S. R., Choopanya K., Vanichseni S., Ward T. P. International epidemiology of HIV and AIDS among injecting drug users. AIDS. 1992 Oct;6(10):1053–1068. doi: 10.1097/00002030-199210000-00001. [DOI] [PubMed] [Google Scholar]
  17. Des Jarlais D. C., Friedman S. R., Sotheran J. L., Wenston J., Marmor M., Yancovitz S. R., Frank B., Beatrice S., Mildvan D. Continuity and change within an HIV epidemic. Injecting drug users in New York City, 1984 through 1992. JAMA. 1994 Jan 12;271(2):121–127. [PubMed] [Google Scholar]
  18. Doll L. S., Judson F. N., Ostrow D. G., O'Malley P. M., Darrow W. W., Hadler S. C., Byers R. H., Penley K. A., Altman N. L. Sexual behavior before AIDS: the hepatitis B studies of homosexual and bisexual men. AIDS. 1990 Nov;4(11):1067–1073. [PubMed] [Google Scholar]
  19. Drucker E., Vermund S. H. Estimating population prevalence of human immunodeficiency virus infection in urban areas with high rates of intravenous drug use: a model of the Bronx in 1988. Am J Epidemiol. 1989 Jul;130(1):133–142. doi: 10.1093/oxfordjournals.aje.a115304. [DOI] [PubMed] [Google Scholar]
  20. Earl W. L. Married men and same sex activity: a field study on HIV risk among men who do not identify as gay or bisexual. J Sex Marital Ther. 1990 Winter;16(4):251–257. doi: 10.1080/00926239008405461. [DOI] [PubMed] [Google Scholar]
  21. Easterbrook P. J., Chmiel J. S., Hoover D. R., Saah A. J., Kaslow R. A., Kingsley L. A., Detels R. Racial and ethnic differences in human immunodeficiency virus type 1 (HIV-1) seroprevalence among homosexual and bisexual men. The Multicenter AIDS Cohort Study. Am J Epidemiol. 1993 Sep 15;138(6):415–429. doi: 10.1093/oxfordjournals.aje.a116874. [DOI] [PubMed] [Google Scholar]
  22. Edlin B. R., Irwin K. L., Faruque S., McCoy C. B., Word C., Serrano Y., Inciardi J. A., Bowser B. P., Schilling R. F., Holmberg S. D. Intersecting epidemics--crack cocaine use and HIV infection among inner-city young adults. Multicenter Crack Cocaine and HIV Infection Study Team. N Engl J Med. 1994 Nov 24;331(21):1422–1427. doi: 10.1056/NEJM199411243312106. [DOI] [PubMed] [Google Scholar]
  23. Ekstrand M. L., Coates T. J., Guydish J. R., Hauck W. W., Collette L., Hulley S. B. Are bisexually identified men in San Francisco a common vector for spreading HIV infection to women? Am J Public Health. 1994 Jun;84(6):915–919. doi: 10.2105/ajph.84.6.915. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Ellerbrock T. V., Lieb S., Harrington P. E., Bush T. J., Schoenfisch S. A., Oxtoby M. J., Howell J. T., Rogers M. F., Witte J. J. Heterosexually transmitted human immunodeficiency virus infection among pregnant women in a rural Florida community. N Engl J Med. 1992 Dec 10;327(24):1704–1709. doi: 10.1056/NEJM199212103272402. [DOI] [PubMed] [Google Scholar]
  25. Fernando N. H., Petersen L. R., Conway G. A., Critchley S. E. Prevalence of antibody to the human immunodeficiency virus among clinical laboratory specimens: findings from a survey of primary care physicians. J Acquir Immune Defic Syndr. 1994 Feb;7(2):177–181. [PubMed] [Google Scholar]
  26. Fordyce E. J., Blum S., Balanon A., Stoneburner R. L. A method for estimating HIV transmission rates among female sex partners of male intravenous drug users. Am J Epidemiol. 1991 Mar 15;133(6):590–598. doi: 10.1093/oxfordjournals.aje.a115931. [DOI] [PubMed] [Google Scholar]
  27. Frischer M., Green S., Goldberg D. Prevalence of injecting drug use provides the context for epidemiology of HIV among injecting drug users. AIDS. 1993 Mar;7(3):442–443. doi: 10.1097/00002030-199303000-00028. [DOI] [PubMed] [Google Scholar]
  28. Gardner L. I., Jr, Brundage J. F., Burke D. S., McNeil J. G., Visintine R., Miller R. N. Evidence for spread of the human immunodeficiency virus epidemic into low prevalence areas of the United States. J Acquir Immune Defic Syndr. 1989;2(6):521–532. [PubMed] [Google Scholar]
  29. Green T. A., Karon J. M., Nwanyanwu O. C. Changes in AIDS incidence trends in the United States. J Acquir Immune Defic Syndr. 1992;5(6):547–555. [PubMed] [Google Scholar]
  30. Grinstead O. A., Faigeles B., Binson D., Eversley R. Data from the National AIDS Behavioral Surveys. I. Sexual risk for human immunodeficiency virus infection among women in high-risk cities. Fam Plann Perspect. 1993 Nov-Dec;25(6):252-6, 277. [PubMed] [Google Scholar]
  31. Hahn R. A., Onorato I. M., Jones T. S., Dougherty J. Prevalence of HIV infection among intravenous drug users in the United States. JAMA. 1989 May 12;261(18):2677–2684. [PubMed] [Google Scholar]
  32. Harnly M. E., Kelter A. The use of never-married status to approximate the homosexual population. J Infect Dis. 1986 Jul;154(1):191–193. doi: 10.1093/infdis/154.1.191. [DOI] [PubMed] [Google Scholar]
  33. Hartigan P. M., Hamilton J. D. Seroprevalence and seroincidence of HIV-1 in injection drug users using the VA system. AIDS Res Hum Retroviruses. 1994;10 (Suppl 2):S215–S217. [PubMed] [Google Scholar]
  34. Haverkos H. W. Reported cases of AIDS: an update. N Engl J Med. 1993 Aug 12;329(7):511–511. doi: 10.1056/NEJM199308123290719. [DOI] [PubMed] [Google Scholar]
  35. Hays R. B., Kegeles S. M., Coates T. J. High HIV risk-taking among young gay men. AIDS. 1990 Sep;4(9):901–907. doi: 10.1097/00002030-199009000-00011. [DOI] [PubMed] [Google Scholar]
  36. Heyward W. L., Osmanov S., Saba J., Esparza J., Belsey E., Stoneburner R., Kaldor J., Smith P. G. Preparation for phase III HIV vaccine efficacy trials: methods for the determination of HIV incidence. AIDS. 1994 Sep;8(9):1285–1291. doi: 10.1097/00002030-199409000-00011. [DOI] [PubMed] [Google Scholar]
  37. Hiatt R. A., Capell F. J., Ascher M. S. Seroprevalence of HIV-type 1 in a northern California health plan population: an unlinked survey. Am J Public Health. 1992 Apr;82(4):564–567. doi: 10.2105/ajph.82.4.564. [DOI] [PMC free article] [PubMed] [Google Scholar]
  38. Hong B. A., Berger S. G. Characteristics of individuals using different HIV/AIDS counseling and testing programs. AIDS. 1994 Feb;8(2):259–262. doi: 10.1097/00002030-199402000-00015. [DOI] [PubMed] [Google Scholar]
  39. Hser Y. I. Population estimates of intravenous drug users and HIV infection in Los Angeles County. Int J Addict. 1993 Jun;28(8):695–709. doi: 10.3109/10826089309062167. [DOI] [PubMed] [Google Scholar]
  40. Hu D. J., Fleming P. L., Mays M. A., Ward J. W. The expanding regional diversity of the acquired immunodeficiency syndrome epidemic in the United States. Arch Intern Med. 1994 Mar 28;154(6):654–659. [PubMed] [Google Scholar]
  41. Iguchi M. Y., Bux D. A., Lidz V., Kushner H., French J. F., Platt J. J. Interpreting HIV seroprevalence data from a street-based outreach program. J Acquir Immune Defic Syndr. 1994 May;7(5):491–499. [PubMed] [Google Scholar]
  42. Jaffe H. W., Choi K., Thomas P. A., Haverkos H. W., Auerbach D. M., Guinan M. E., Rogers M. F., Spira T. J., Darrow W. W., Kramer M. A. National case-control study of Kaposi's sarcoma and Pneumocystis carinii pneumonia in homosexual men: Part 1. Epidemiologic results. Ann Intern Med. 1983 Aug;99(2):145–151. doi: 10.7326/0003-4819-99-2-145. [DOI] [PubMed] [Google Scholar]
  43. Kelly J. A., Murphy D. A., Roffman R. A., Solomon L. J., Winett R. A., Stevenson L. Y., Koob J. J., Ayotte D. R., Flynn B. S., Desiderato L. L. Acquired immunodeficiency syndrome/human immunodeficiency virus risk behavior among gay men in small cities. Findings of a 16-city national sample. Arch Intern Med. 1992 Nov;152(11):2293–2297. [PubMed] [Google Scholar]
  44. Kelly J. A., St Lawrence J. S., Brasfield T. L., Stevenson L. Y., Diaz Y. E., Hauth A. C. AIDS risk behavior patterns among gay men in small southern cities. Am J Public Health. 1990 Apr;80(4):416–418. doi: 10.2105/ajph.80.4.416. [DOI] [PMC free article] [PubMed] [Google Scholar]
  45. Khabbaz R. F., Onorato I. M., Cannon R. O., Hartley T. M., Roberts B., Hosein B., Kaplan J. E. Seroprevalence of HTLV-1 and HTLV-2 among intravenous drug users and persons in clinics for sexually transmitted diseases. N Engl J Med. 1992 Feb 6;326(6):375–380. doi: 10.1056/NEJM199202063260604. [DOI] [PubMed] [Google Scholar]
  46. Kingsley L. A., Zhou S. Y., Bacellar H., Rinaldo C. R., Jr, Chmiel J., Detels R., Saah A., VanRaden M., Ho M., Muñoz A. Temporal trends in human immunodeficiency virus type 1 seroconversion 1984-1989. A report from the Multicenter AIDS Cohort Study (MACS). Am J Epidemiol. 1991 Aug 15;134(4):331–339. doi: 10.1093/oxfordjournals.aje.a116094. [DOI] [PubMed] [Google Scholar]
  47. Ku L., Sonenstein F. L., Pleck J. H. Young men's risk behaviors for HIV infection and sexually transmitted diseases, 1988 through 1991. Am J Public Health. 1993 Nov;83(11):1609–1615. doi: 10.2105/ajph.83.11.1609. [DOI] [PMC free article] [PubMed] [Google Scholar]
  48. Lam N. S., Liu K. B. Spread of AIDS in rural America, 1982-1990. J Acquir Immune Defic Syndr. 1994 May;7(5):485–490. [PubMed] [Google Scholar]
  49. Lange W. R., Snyder F. R., Lozovsky D., Kaistha V., Kaczaniuk M. A., Jaffe J. H. Geographic distribution of human immunodeficiency virus markers in parenteral drug abusers. Am J Public Health. 1988 Apr;78(4):443–446. doi: 10.2105/ajph.78.4.443. [DOI] [PMC free article] [PubMed] [Google Scholar]
  50. Leigh B. C., Temple M. T., Trocki K. F. The sexual behavior of US adults: results from a national survey. Am J Public Health. 1993 Oct;83(10):1400–1408. doi: 10.2105/ajph.83.10.1400. [DOI] [PMC free article] [PubMed] [Google Scholar]
  51. Lemp G. F., Hirozawa A. M., Givertz D., Nieri G. N., Anderson L., Lindegren M. L., Janssen R. S., Katz M. Seroprevalence of HIV and risk behaviors among young homosexual and bisexual men. The San Francisco/Berkeley Young Men's Survey. JAMA. 1994 Aug 10;272(6):449–454. [PubMed] [Google Scholar]
  52. Lemp G. F., Payne S. F., Rutherford G. W., Hessol N. A., Winkelstein W., Jr, Wiley J. A., Moss A. R., Chaisson R. E., Chen R. T., Feigal D. W., Jr Projections of AIDS morbidity and mortality in San Francisco. JAMA. 1990 Mar 16;263(11):1497–1501. [PubMed] [Google Scholar]
  53. Lewis D. K., Watters J. K. Sexual behavior and sexual identity in male injection drug users. J Acquir Immune Defic Syndr. 1994 Feb;7(2):190–198. [PubMed] [Google Scholar]
  54. Longshore D., Anglin M. D. Seroprevalence stable and seroconversions rare among injection drug users in Los Angeles. J Acquir Immune Defic Syndr. 1992;5(2):212–213. [PubMed] [Google Scholar]
  55. McQuillan G. M., Khare M., Ezzati-Rice T. M., Karon J. M., Schable C. A., Murphy R. S. The seroepidemiology of human immunodeficiency virus in the United States household population: NHANES III, 1988-1991. J Acquir Immune Defic Syndr. 1994 Nov;7(11):1195–1201. [PubMed] [Google Scholar]
  56. Metzger D. S., Woody G. E., McLellan A. T., O'Brien C. P., Druley P., Navaline H., DePhilippis D., Stolley P., Abrutyn E. Human immunodeficiency virus seroconversion among intravenous drug users in- and out-of-treatment: an 18-month prospective follow-up. J Acquir Immune Defic Syndr. 1993 Sep;6(9):1049–1056. [PubMed] [Google Scholar]
  57. Newmeyer J. A. The prevalence of drug use in San Francisco in 1987. J Psychoactive Drugs. 1988 Apr-Jun;20(2):185–189. doi: 10.1080/02791072.1988.10524493. [DOI] [PubMed] [Google Scholar]
  58. Nwanyanwu O. C., Chu S. Y., Green T. A., Buehler J. W., Berkelman R. L. Acquired immunodeficiency syndrome in the United States associated with injecting drug use, 1981-1991. Am J Drug Alcohol Abuse. 1993;19(4):399–408. doi: 10.3109/00952999309001630. [DOI] [PubMed] [Google Scholar]
  59. Osmond D. H., Page K., Wiley J., Garrett K., Sheppard H. W., Moss A. R., Schrager L., Winkelstein W. HIV infection in homosexual and bisexual men 18 to 29 years of age: the San Francisco Young Men's Health Study. Am J Public Health. 1994 Dec;84(12):1933–1937. doi: 10.2105/ajph.84.12.1933. [DOI] [PMC free article] [PubMed] [Google Scholar]
  60. Peterman T. A., Lui K. J., Lawrence D. N., Allen J. R. Estimating the risks of transfusion-associated acquired immune deficiency syndrome and human immunodeficiency virus infection. Transfusion. 1987 Sep-Oct;27(5):371–374. doi: 10.1046/j.1537-2995.1987.27587320525.x. [DOI] [PubMed] [Google Scholar]
  61. Peterson J. L., Coates T. J., Catania J. A., Middleton L., Hilliard B., Hearst N. High-risk sexual behavior and condom use among gay and bisexual African-American men. Am J Public Health. 1992 Nov;82(11):1490–1494. doi: 10.2105/ajph.82.11.1490. [DOI] [PMC free article] [PubMed] [Google Scholar]
  62. Rumley R. L., Esinhart J. D. AIDS in rural North Carolina. N C Med J. 1993 Oct;54(10):517–522. [PubMed] [Google Scholar]
  63. Rumley R. L., Shappley N. C., Waivers L. E., Esinhart J. D. AIDS in rural eastern North Carolina--patient migration: a rural AIDS burden. AIDS. 1991 Nov;5(11):1373–1378. doi: 10.1097/00002030-199111000-00015. [DOI] [PubMed] [Google Scholar]
  64. Salzberg A. M., Dolins S. L. The relation between AIDS cases and HIV prevalence. N Engl J Med. 1989 Apr 6;320(14):936–936. doi: 10.1056/NEJM198904063201412. [DOI] [PubMed] [Google Scholar]
  65. Samuel M. C., Hessol N., Shiboski S., Engel R. R., Speed T. P., Winkelstein W., Jr Factors associated with human immunodeficiency virus seroconversion in homosexual men in three San Francisco cohort studies, 1984-1989. J Acquir Immune Defic Syndr. 1993 Mar;6(3):303–312. [PubMed] [Google Scholar]
  66. Schoenbaum E. E., Hartel D., Selwyn P. A., Klein R. S., Davenny K., Rogers M., Feiner C., Friedland G. Risk factors for human immunodeficiency virus infection in intravenous drug users. N Engl J Med. 1989 Sep 28;321(13):874–879. doi: 10.1056/NEJM198909283211306. [DOI] [PubMed] [Google Scholar]
  67. Siegal H. A., Carlson R. G., Falck R., Forney M. A., Wang J., Li L. High-risk behaviors for transmission of syphilis and human immunodeficiency virus among crack cocaine-using women. A case study from the Midwest. Sex Transm Dis. 1992 Sep-Oct;19(5):266–271. doi: 10.1097/00007435-199209000-00005. [DOI] [PubMed] [Google Scholar]
  68. Stall R., Barrett D., Bye L., Catania J., Frutchey C., Henne J., Lemp G., Paul J. A comparison of younger and older gay men's HIV risk-taking behaviors: the Communication Technologies 1989 Cross-Sectional Survey. J Acquir Immune Defic Syndr. 1992;5(7):682–687. [PubMed] [Google Scholar]
  69. Taylor J. M., Muñoz A., Kingsley L. A., Chmiel J. S., Saah A. J. Two quick estimates of the HIV prevalence in homosexual men in Los Angeles, New York and San Francisco. The Multicenter AIDS Cohort Study. AIDS. 1990 Sep;4(9):921–922. doi: 10.1097/00002030-199009000-00015. [DOI] [PubMed] [Google Scholar]
  70. Tortu S., Beardsley M., Deren S., Davis W. R. The risk of HIV infection in a national sample of women with injection drug-using partners. Am J Public Health. 1994 Aug;84(8):1243–1249. doi: 10.2105/ajph.84.8.1243. [DOI] [PMC free article] [PubMed] [Google Scholar]
  71. Verghese A., Berk S. L., Sarubbi F. Urbs in rure: human immunodeficiency virus infection in rural Tennessee. J Infect Dis. 1989 Dec;160(6):1051–1055. doi: 10.1093/infdis/160.6.1051. [DOI] [PubMed] [Google Scholar]
  72. Webster L. A., Rolfs R. T. Surveillance for primary and secondary syphilis--United States, 1991. MMWR CDC Surveill Summ. 1993 Aug 13;42(3):13–19. [PubMed] [Google Scholar]
  73. Weedon J., Thomas P. HIV seroconversion among high-risk women in New York City. JAMA. 1994 Aug 10;272(6):432–433. doi: 10.1001/jama.272.6.432. [DOI] [PubMed] [Google Scholar]
  74. Whyte B. M., Carr J. C. Comparison of AIDS in women in rural and urban Georgia. South Med J. 1992 Jun;85(6):571–578. doi: 10.1097/00007611-199206000-00003. [DOI] [PubMed] [Google Scholar]
  75. Wilson M. J., Marelich W. D., Lemp G. F., Ascher M. S., Kerndt P., Kizer K. W. HIV-1 seroprevalence among women attending sexually transmitted disease clinics in California. California Family of Surveys and Sentinel Surveillance Consortia. West J Med. 1993 Jan;158(1):40–43. [PMC free article] [PubMed] [Google Scholar]
  76. Winkelstein W., Jr, Lyman D. M., Padian N., Grant R., Samuel M., Wiley J. A., Anderson R. E., Lang W., Riggs J., Levy J. A. Sexual practices and risk of infection by the human immunodeficiency virus. The San Francisco Men's Health Study. JAMA. 1987 Jan 16;257(3):321–325. [PubMed] [Google Scholar]
  77. Wood R. W., Krueger L. E., Pearlman T. C., Goldbaum G. HIV transmission: Women's risk from bisexual men. Am J Public Health. 1993 Dec;83(12):1757–1759. doi: 10.2105/ajph.83.12.1757. [DOI] [PMC free article] [PubMed] [Google Scholar]
  78. Woody G. E., Metzger D. S. Causes of death in injection-drug users. N Engl J Med. 1993 Nov 25;329(22):1661–1661. doi: 10.1056/NEJM199311253292220. [DOI] [PubMed] [Google Scholar]
  79. Young R. A., Feldman S., Brackin B. T., Thompson E. Seroprevalence of human immunodeficiency virus among adolescent attendees of Mississippi sexually transmitted disease clinics: a rural epidemic. South Med J. 1992 May;85(5):460–463. doi: 10.1097/00007611-199205000-00003. [DOI] [PubMed] [Google Scholar]

Articles from American Journal of Public Health are provided here courtesy of American Public Health Association

RESOURCES