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HIV Incidence and Prevalence among Low-Income Hotel Residents in Los Angeles

Nina T. Harawa, MPH, PhD, B. Marcela Fernandez, Mondel E. Pettaway, Qiana R. Butler, MPH, and Trista A Bingham, MPH, MS. HIV Epidemiology Program, Los Angeles County Department of Health Services, 600 S. Commonwealth Avenue, Suite 1920, Los Angeles, CA 90005, 213 351-8654, nharawa@dhs.co.la.ca.us

Objectives To estimate HIV incidence and prevalence of unrecognized HIV infection among residents of low-income hotels in Los Angeles.

Methods From January through October 2003, residents from 33 single-room occupancy and other residential hotels in the downtown “skid row” area were sampled. Participants were administered HIV testing and counseling and a brief interview. HIV incidence was calculated using the serologic testing algorithm for recent HIV seroconversion.

Results Of 1,098 previously HIV-negative or -unknown residents (70% black, 12% Latino, 14% white), 18 (1.6%) tested HIV positive. All but one of the HIV-infected participants was black. Among black males, prevalence of unrecognized HIV infection was 2.3% (n=524) and HIV incidence was 2.1% (95% CL = 0 - 4.4%). Among black females (n=240), unrecognized HIV prevalence was 2.1%, and no incident cases were detected. Among blacks, unrecognized HIV prevalence was 17% among men reporting recent sex with men (n=24) and 3.3% among men who had recently paid for sex (n=90); 4.1% among men and women who had recently received money or drugs for sex (n=48); and 3.5%, 3.2%, and 2.2%, respectively, among men and women with a recent history of an STD (n=115), sharing needles (n=187), or using crack cocaine (n=135).

Conclusions HIV incidence and prevalence among marginally housed individuals in Los Angeles appears to be concentrated among black men and women in well-known risk groups. In order to reduce HIV transmission associated with unrecognized infection, local prevention and care programs should expand outreach, testing, and referral services for low-income hotel residents.

Learning Objectives:

Keywords: HIV/AIDS, Homeless

Related Web page: www.lapublichealth.org/hiv

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

HIV/AIDS Prevention Research

The 132nd Annual Meeting (November 6-10, 2004) of APHA