Review of human immunodeficiency virus infection in women in the United States.

In this review, available human immunodeficiency virus (HIV) seroprevalence data are presented for United States women attending clinics related to reproductive health and for women in other settings. At family planning clinics, prenatal clinics, and in delivery room settings (cord blood testing), studies that have not targeted women at high risk for HIV infection have shown prevalence rates ranging from 0-4.3%. Higher rates (greater than 1%) have been observed in more urban areas--Newark, New York City, Baltimore, Miami, and San Juan; rates at settings outside these areas have generally been below 1%. Filter-paper testing for maternal HIV antibodies from neonatal heel-stick specimens has been conducted statewide in Massachusetts and New York; prevalence rates were 0.3% in Massachusetts in 1987, and 0.2% in upstate New York and 1.3% in New York City in 1987-1988. Prevalence rates of female military applicants and female blood donors are below 0.03% and 0.1%, respectively, and have been relatively stable over time. Where age data are available, prevalence rates are near 0 in women below age 20 years, are higher for young adult and early middle-aged women, and decline thereafter. Studies have also been conducted using blood samples from women undergoing premarital testing for syphilis serology, from women attending sexually transmitted disease clinics and drug treatment centers, and from patients at sentinel hospital sites. Information on the prevalence of HIV infection in United States women is useful to identify specific populations at risk for HIV infection and to target and evaluate education and prevention efforts.