OBJECTIVES: This study quantified AIDS incidence in Massachusetts in relation to economic deprivation. METHODS: Using 1990 census block-group data, 1990 census population counts, and AIDS surveillance registry data for the years 1988 through 1994, we generated yearly and cumulative AIDS incidence data for the state of Massachusetts stratified by sex and by neighborhood measures of economic position for the total, Black, Hispanic, and White populations. RESULTS: Incidence of AIDS increased with economic deprivation, with the magnitude of these trends varying by both race/ethnicity and sex. The cumulative incidence of AIDS in the total population was nearly 7 times higher among persons in block-groups where 40% or more of the population was below the poverty line (362 per 100,000) than among persons in block-groups where less than 2% of the population was below poverty (53 per 100,000). CONCLUSIONS: Observing patterns of disease burden in relation to neighborhood levels of economic well-being elucidates further the role of poverty as a population-level determinant of disease burden. Public health agencies and researchers can use readily available census data to describe neighborhood-level socioeconomic conditions. Such knowledge expands options for disease prevention and increases the visibility of economic inequality as an underlying cause of AIDS.

In this multispecialty group practice, a positive test for GC and CT coupled with ICD-9 code 614.9 could be used to enhance reporting of cases of PID.

Because non-name-based case registries have recently been used for reporting human immunodeficiency virus infection, this study attempted to define the sensitivity, specificity and accuracy of case registry matches using non-name-based registries. The AIDS, sexually transmitted disease (STD), and tuberculosis (TB) case registries were matched using all available information to establish the standard. The registries were then matched again using five increasingly less specific criteria to compare sensitivity, specificity and accuracy. The registries were then also transformed into non-name-based codes as if they were the HIV registry and matched again. With name-based registries, sensitivities increased as the matching criteria became less exacting, while the accuracy declined slightly. Specificities remained close to 100% due to the relatively small number of matched cases. Results from matches of non-name-based registry matches were similar to those of the name-based registry matches. Non-name reporting can be used for data matching with acceptable accuracy.

The prevalence of Chlamydia trachomatis among 3,026 asymptomatic males tested on urine with the ligase chain reaction (LCR) was Journal of Correctional Health Care 5.9%. Only 13.7%, 5.6%, and 1.5% of men reported having, respectively, two or more sex partners, a new sex partner, or an STD contact in the last 60 days. Age was an important predictor of infection. Compared to universal testing, screening all men less than 30 years of age and only older men with risk factors identified 90.4% of infections while testing 56.9% of males. Adopting this screening strategy will result in significant savings while identifying the majority of infections.

Objectives: To determine the test performance characteristics of the leukocyte esterase test (LET) in detecting Chlamydia trachomatis (CT) infections in asymptomatic men entering a county jail. Methods: First-void urine of 2,176 men was simultaneously tested for urethral inflammation by the LET and for CT by the ligase chain reaction (LCR). Results: Using the LCR as reference standard, the sensitivity, specificity, and positive and negative predictive values of the LET with confidence intervals were 6.1% (2.7, 12.7), 98.5% (97.9, 99.0), 18.4% (8.3, 34.9), and 95.1% (94.0, 95.9), respectively. Conclusion: The LET lacks sensitivity in detecting asymptomatic chlamydial infection among men entering a correctional facility. Alternatives should be sought as cost-saving strategies.