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Am J Public Health. 1993 March; 83(3): 363–368.
PMCID: PMC1694640

The underrecognition of HIV infection in women in an inner-city emergency room.

Abstract

OBJECTIVES. This study analyzed the recognition of human immunodeficiency virus (HIV) infection and associated factors in women and men attending an emergency room in the Bronx, New York, NY. METHODS. From April 16, 1989, to May 5, 1989, the emergency room records of 2102 consecutive patients 13 years of age or older were reviewed and, for 856 patients undergoing venipuncture, linked anonymously to results of HIV antibody tested in excess blood. RESULTS. HIV seroprevalence was 7.8% in women and 14.6% in men. Among seropositive women, 5.0% had acquired immunodeficiency syndrome (AIDS), compared with 26.0% of men. Excluding patients with AIDS, HIV infection was recognized in 13.2% of women and 27.0% of men. HIV infection was recognized only in women aged 25 through 44 years. In men, recognition occurred in all age groups. Clinical presentation did not distinguish the seropositive from seronegative women. Risk assessments were recorded less frequently for women (11.2%) than men (15.9%). For 92.5% of persons with any behavioral risk assessment, injecting drug use was the only behavior assessed. CONCLUSIONS. HIV infection is underrecognized in women, in part, because of a lower prevalence of AIDS. Universal HIV risk assessment, which includes heterosexual behaviors, may help increase recognition of HIV in women and opportunities for early intervention.

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  • Volberding PA, Lagakos SW, Koch MA, Pettinelli C, Myers MW, Booth DK, Balfour HH, Jr, Reichman RC, Bartlett JA, Hirsch MS, et al. Zidovudine in asymptomatic human immunodeficiency virus infection. A controlled trial in persons with fewer than 500 CD4-positive cells per cubic millimeter. The AIDS Clinical Trials Group of the National Institute of Allergy and Infectious Diseases. N Engl J Med. 1990 Apr 5;322(14):941–949. [PubMed]
  • Rothenberg R, Woelfel M, Stoneburner R, Milberg J, Parker R, Truman B. Survival with the acquired immunodeficiency syndrome. Experience with 5833 cases in New York City. N Engl J Med. 1987 Nov 19;317(21):1297–1302. [PubMed]
  • Friedland GH, Saltzman B, Vileno J, Freeman K, Schrager LK, Klein RS. Survival differences in patients with AIDS. J Acquir Immune Defic Syndr. 1991;4(2):144–153. [PubMed]
  • Stein MD, Leibman B, Wachtel TJ, Carpenter CC, Fisher A, Durand L, O'Sullivan PS, Mayer KH. HIV-positive women: reasons they are tested for HIV and their clinical characteristics on entry into the health care system. J Gen Intern Med. 1991 Jul-Aug;6(4):286–289. [PubMed]
  • Chu SY, Buehler JW, Berkelman RL. Impact of the human immunodeficiency virus epidemic on mortality in women of reproductive age, United States. JAMA. 1990 Jul 11;264(2):225–229. [PubMed]
  • Kelen GD, Fritz S, Qaqish B, Brookmeyer R, Baker JL, Kline RL, Cuddy RM, Goessel TK, Floccare D, Williams KA, et al. Unrecognized human immunodeficiency virus infection in emergency department patients. N Engl J Med. 1988 Jun 23;318(25):1645–1650. [PubMed]
  • Brookmeyer R. Reconstruction and future trends of the AIDS epidemic in the United States. Science. 1991 Jul 5;253(5015):37–42. [PubMed]
  • Healy B. The Yentl syndrome. N Engl J Med. 1991 Jul 25;325(4):274–276. [PubMed]
  • Steingart RM, Packer M, Hamm P, Coglianese ME, Gersh B, Geltman EM, Sollano J, Katz S, Moyé L, Basta LL, et al. Sex differences in the management of coronary artery disease. Survival and Ventricular Enlargement Investigators. N Engl J Med. 1991 Jul 25;325(4):226–230. [PubMed]
  • Ayanian JZ, Epstein AM. Differences in the use of procedures between women and men hospitalized for coronary heart disease. N Engl J Med. 1991 Jul 25;325(4):221–225. [PubMed]
  • Tobin JN, Wassertheil-Smoller S, Wexler JP, Steingart RM, Budner N, Lense L, Wachspress J. Sex bias in considering coronary bypass surgery. Ann Intern Med. 1987 Jul;107(1):19–25. [PubMed]
  • Kjellstrand CM. Age, sex, and race inequality in renal transplantation. Arch Intern Med. 1988 Jun;148(6):1305–1309. [PubMed]
  • Kinney EL, Trautmann J, Gold JA, Vesell ES, Zelis R. Underrepresentation of women in new drug trials. Ann Intern Med. 1981 Oct;95(4):495–499. [PubMed]
  • Ellerbrock TV, Bush TJ, Chamberland ME, Oxtoby MJ. Epidemiology of women with AIDS in the United States, 1981 through 1990. A comparison with heterosexual men with AIDS. JAMA. 1991 Jun 12;265(22):2971–2975. [PubMed]

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