HIV antibody in persons screened for syphilis: prevalence in a New York City emergency room and primary care clinics.

An anonymous human immunodeficiency virus (HIV) seroprevalence survey was performed on bloods sent for syphilis serologic testing from the general medical or pediatric clinics or emergency room of a municipal hospital in the Bronx, New York City. From July-December 1987, 549 sera from persons aged 15-54 were collected. HIV antibody was detected in 29/549 (5.3%) sera, increased with age from 0% in the group under 20 to 16.7% in those aged 35-39, and was significantly higher in men (27/230, 11.7%) compared to women (2/319, 0.6%) (P less than .05). Among men aged 35-39, 10/29 (34.5%) were HIV infected. The HIV seroprevalence in emergency room sera was 8/61 (13.1%) versus 21/488 (4.3%) from the out-patient clinics (P less than .05). The presence of a reactive syphilis serology was strongly associated with HIV infection independent of gender (Mantel-Haenszel summary odds ratio (OR) 4.1, 95% CI [1.8, 7.7]) but was stronger for women with reactive syphilis serologies (OR 45.5, 95% CI 5.3, 387.6) than for men (OR 2.6, 95% CI 1.2, 5.8). AIDS prevention strategies may reach at-risk sexually active individuals by focusing on hospital-based emergency rooms and out-patients clinics in areas with high HIV seroprevalence.