Document 0727
 DOCN  M9480727
 TI    HIV and tuberculosis infection in San Francisco's homeless adults.
       Prevalence and risk factors in a representative sample.
 DT    9410
 AU    Zolopa AR; Hahn JA; Gorter R; Miranda J; Wlodarczyk D; Peterson J;
       Pilote L; Moss AR; Department of Epidemiology and Biostatistics,
       University of; California-San Francisco 94143-1347.
 SO    JAMA. 1994 Aug 10;272(6):455-61. Unique Identifier : AIDSLINE
       MED/94315724
 AB    OBJECTIVE--To determine the prevalence and risk factors for human
       immunodeficiency virus (HIV) and tuberculosis (TB) infection and
       investigate the relationship between these two infections in homeless
       adults. DESIGN--Cross-sectional study. SETTING--Inner-city shelters and
       free meal programs. PARTICIPANTS--A representative sample of 1226 adults
       (> or = 18 years) were enrolled from community sites. MAIN OUTCOME
       MEASURES--Serum HIV-1 antibody status and tuberculin skin test
       reactivity. RESULTS--Human immunodeficiency virus seroprevalence was
       8.5% (95% confidence interval [CI], 7.0% to 10.1%) and the prevalence of
       TB infection was 32% (95% CI, 30% to 37%). Nineteen percent of the
       HIV-seropositive subjects had positive tuberculin skin tests.
       Independent risk factors for HIV infection included younger age, black
       race, male homosexual contact, injection drug use, use of injection
       drugs in shooting galleries, and selling sex. Tuberculosis infection was
       associated with the duration of homelessness and living in crowded
       shelters or single-room-occupancy hotels. Injection drug use, a risk
       factor for HIV, was also a risk factor for TB, with a particularly
       strong association in women. No evidence of an association between TB
       and HIV infection was found, even after accounting for anergy.
       CONCLUSIONS--The homeless population in the United States should be
       considered a group at high risk for HIV infection and TB. Given the
       constellation of risk factors present, the high prevalence of infection,
       and lack of access to medical services, we anticipate that these
       communicable diseases in this population will represent a growing public
       health problem.
 DE    Adult  Comorbidity  Cross-Sectional Studies  Female  Homeless
       Persons/*STATISTICS & NUMER DATA  Human  HIV Infections/*EPIDEMIOLOGY
       HIV Seroprevalence/TRENDS  Logistic Models  Male  Middle Age
       Multivariate Analysis  Odds Ratio  Prevalence  Risk Factors  San
       Francisco/EPIDEMIOLOGY  Support, Non-U.S. Gov't  Support, U.S. Gov't,
       P.H.S.  Tuberculin Test  Tuberculosis/*EPIDEMIOLOGY  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).