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PubMed2002

Changing sexual behavior among gay male repeat testers for HIV: a randomized, controlled trial of a single-session intervention.

CONTEXT: High-risk sexual behavior is increasingly prevalent among men who have sex with men (MSM) and among men with a history of repeat testing for HIV. OBJECTIVES: The study assessed whether one counseling intervention session focusing on self-justifications (thoughts, attitudes, or beliefs that allow the participant to engage in high-risk sexual behaviors) at most recent unprotected anal intercourse (UAI) is effective in reducing future high-risk behaviors among HIV-negative men. DESIGN, SETTING, AND PARTICIPANTS: A randomized, controlled, counseling intervention trial was conducted at an anonymous testing site in San Francisco, California, between May 1997 and January 2000. Participants were 248 MSM with a history of at least one previous negative HIV test result and self-reported UAI (receptive or insertive) in the previous 12 months with partners of unknown or discordant HIV status. Two intervention groups received standard HIV test counseling plus a cognitive-behavioral intervention, and two control groups received only standard HIV test counseling. Follow-up evaluation was at 6 and 12 months. MAIN OUTCOME MEASURE: Number of episodes of UAI with nonprimary partners (of unknown or discordant HIV status) in the 90 days preceding the interview was measured via self-report during face-to-face interview. RESULTS: A novel counseling intervention focusing on self-justifications significantly decreased the proportion of participants reporting UAI with nonprimary partners of unknown or discordant HIV status at 6 and 12 months (from 66% to 21% at 6 months and to 26% at 12 months, p =.002; p <.001) as compared with a control group when added to standard client-centered HIV counseling and testing. CONCLUSIONS: A specific, single-session counseling intervention focusing on a reevaluation of a person's self-justifications operant during a recent occasion of high-risk behavior may prove useful in decreasing individual risk behavior and thus limiting community-level HIV transmission.

Adult↗
PubMed1998

Hepatitis C virus antibody prevalence among injecting drug users in Glasgow has fallen but remains high.

Few data have been published on the prevalence of hepatitis C virus (HCV) among injecting drug users (IDUs) in the United Kingdom. This study compares the prevalence of antibody against HCV (anti-HCV) among IDUs in Glasgow in 1990 (when Glasgow's needle/syringe exchange programme had become established) with that in 1995. Serum left over from specimens taken for named HIV antibody testing was tested anonymously for anti-HCV. The prevalence of anti-HCV fell significantly between 1990 and 1995 among IDUs of all ages (90% to 77%), IDUs aged 15 to 19 years (92% to 29%), and IDUs aged 20 to 24 years (91% to 65%). This study suggests that the incidence of HCV infection among young IDUs fell in the early to mid 1990s, after the establishment of Glasgow's needle/syringe exchange scheme between 1988 and 1990. Since almost a third of injectors under 20 years of age when tested in 1995 had been infected with HCV, however, other interventions may be needed to prevent the spread of HCV in this high risk group.

Adolescent↗
PubMedDate not supplied

Re-evaluating current public health policy: alternative public health nursing approaches to sexually transmitted infection testing for teens and males who have sex with males.

OBJECTIVE: Due to a recent increase in the rates of reportable sexually transmitted infections (STI) across Canada, and the movement of public health nursing initiatives to a health promotion/illness prevention model, this paper proposes alternative strategies to current public health initiatives to encourage individuals who are labelled as at-risk by public health discourses, such as teens and males who have sex with males (MSM), to undertake preventative screening. THEORETICAL DESIGN: To undertake this task, we approached Health Canada's (2002) determinants of health utilizing Lupton's (1995) post-structuralist work on public health to suggest that for some members of these groups, health is not an imperative. CONCLUSIONS: As such, we propose that increasing anonymous testing and its advertisement would provide one means of providing population-sensitive care and could thus increase the screening rates of individuals within groups who reject the public health "healthy" disquisition.

Adolescent↗
PubMed1999

Prevalence of HIV infection among hospital patients in north west Tanzania.

In order to estimate hospital HIV prevalence, the economic impact of AIDS on health care and to assess the implications of HIV testing on clinical suspicion of AIDS this hospital based study was done at the government regional hospital of Kagera, Tanzania. Consecutive admissions were recruited into the study, and those consenting had a blood specimen taken, one portion of which was used to aid clinical diagnosis, while the other was tested anonymously for HIV antibodies using two ELISA systems. A short questionnaire was used to specify demographic characteristics, hospital ward of admission and diagnosis of each study subject. The overall age adjusted HIV-1 prevalence was 32.8% (N = 1422) and there was no significant difference in the age adjusted sex specific prevalence. The highest prevalence (53.3%) was found in the 25-34 years age group as well as in the gynaecological and medical wards (41.2% and 40.4%, respectively). The diagnostic category of clinical AIDS had a sensitivity of 11.3% and a specificity of 99.3%, indicating that only 11.3% of the HIV seropositives would have been HIV tested on clinical suspicion of AIDS. Similarly, the HIV-1 antibody sensitivity and specificity for tuberculosis were 5.9% and 97.9%, respectively. Patients who were HIV-1 infected were more likely to have a history of previous hospital admissions, RR = 1.34 (95% CI = 1.16-1.56), and were at an increased risk of developing tuberculosis, RR = 2.02 (95% CI = 1.50-2.70). The diagnostic categories with the highest HIV-1 infection prevalence were clinical AIDS (88.5%), herpes zoster and other HIV-1 skin manifestations combined (85.7%) and pulmonary tuberculosis (58.3%). In conclusion, the prevalence of HIV-1 infection was high among hospitalized patients in Bukoba hospital indicating that the major cause of illness leading to admission to the hospital may have been underlying HIV-1 infection. The findings also indicate that in a high HIV-1 prevalence area, testing for HIV infection on the basis of clinical suspicion of AIDS alone is not sufficient to provide rational care to the majority of HIV infected patients.

AIDS-Related Opportunistic Infections↗
PubMed2003

Evaluation of human serum albumin cobalt binding assay for the assessment of myocardial ischemia and myocardial infarction.

BACKGROUND: Clinical diagnoses were correlated with results of a Co(II)-albumin binding assay in 167 patients treated at an emergency department of a health maintenance organization. METHODS: Patients were evaluated as being nonischemic or potentially ischemic through standard coronary disease indicators [creatine kinase (CK), CK-MB, cardiac troponin I, and electrocardiographic findings] and were tested by a Co(II)-albumin binding assay. Samples were tested anonymously, and the study was double-blinded. The sensitivity and specificity of this assay for the detection of ischemia were evaluated by ROC curve analysis. Known Co(II) binding sites on albumin were analyzed by N-terminal amino acid sequencing. RESULTS: The mean absorbance units (ABSU) +/- 2 SD for non-myocardial ischemic and myocardial ischemic individuals measured at 470 nm were 0.43 +/- 0.10 and 0.63 +/- 0.25, respectively (P <0.0001). The area under the ROC curve was 0.95 [95% confidence interval (CI), 0.92-0.99], and at a cutoff value of 0.50 ABSU, sensitivity and specificity were 88% (78-94%) and 94% (86-98%), respectively, suggesting a high distinction between the two groups. When we compared non-acute myocardial infarction (AMI) and AMI ischemic individuals, the area under the ROC curve was 0.66 (95% CI, 0.53-0.79) and was considered a poor discriminator between these two groups. N-Terminal amino acid sequencing data for purified albumin showed normal amino acid residues for six of seven high-ABSU (> or =0.70) individuals and one nonischemic individual tested. However, only one individual with a high ABSU (0.80) had two missing amino acid residues (DA) from the N-terminal region. Clinical diagnosis for this patient did not reveal an ischemic event. CONCLUSIONS: The Co(II)-albumin binding test may serve as a useful diagnostic tool in emergency facilities for the assessment of myocardial ischemia. High and low ABSU were associated with myocardial ischemic individuals and non-myocardial ischemic individuals, respectively. However, the Co(II)-albumin binding was a poor discriminator between ischemic individuals with and without MI.

Adolescent↗
PubMed2004

Hepatitis C virus among childbearing women in Scotland: prevalence, deprivation, and diagnosis.

OBJECTIVES: (A) To examine the prevalence and demographic characteristics of hepatitis C virus (HCV) infection among childbearing women in Scotland; and (B) to determine the extent of maternal HCV infection diagnosed prior to birth. METHODS: (A) Residual dried blood spot samples from routine neonatal screening, collected throughout Scotland during March-October 2000, were unlinked from identifiers and tested anonymously for HCV antibodies; and (B) electronic record linkage of Scotland's databases of births and diagnosed HCV infections was performed. RESULTS: (A) Of 30,259 samples, 121 were enzyme linked immunosorbent assay repeat reactive and 88 of these were confirmed as anti-HCV positive in the recombinant immunoblot assay, representing a seroprevalence of 0.29-0.40%. HCV seroprevalence was high among 25-29 year olds (0.4-0.57%), in high deprivation areas (0.92-1.07%), and in Greater Glasgow (0.83-0.96%) and Grampian (0.38-0.62%). Adjusted relative risk for HCV infection was highest among residents in high deprivation areas of Glasgow (7.2 (95% confidence interval 2.0-25.5)). (B) Of 121 HCV infections found among women at delivery, 24% and 46% were estimated to have been diagnosed prior to pregnancy and birth, respectively. CONCLUSIONS: HCV prevalence among Scottish childbearing women is consistent with that expected from injecting drug use. Based on reported rates of mother to child transmission, 8-11 paediatric infections are expected per annum. Diagnosis in only 24% of infected women prior to pregnancy indicates the extent to which HCV goes unrecognised in the injecting community. The current HCV screening approach-to test only those with a history of injecting drug use (or other risk factors for infection)-identifies approximately a quarter of previously undetected infections among pregnant women.

Adult↗
PubMed2000

High HIV incidence and prevalence among young women in rural South Africa: developing a cohort for intervention trials.

OBJECTIVE: To measure prevalence and model incidence of HIV infection. SETTING: 2013 consecutive pregnant women attending public sector antenatal clinics in 1997 in Hlabisa health district, South Africa. Historical seroprevalence data, 1992-1995. METHODS: Serum remaining from syphilis testing was tested anonymously for antibodies to HIV to determine seroprevalence. Two models, allowing for differential mortality between HIV-positive and HIV-negative people, were used. The first used serial seroprevalence data to estimate trends in annual incidence. The second, a maximum likelihood model, took account of changing force of infection and age-dependent risk of infection, to estimate age-specific HIV incidence in 1997. Multiple logistic regression provided adjusted odds ratios (OR) for risk factors for prevalent HIV infection. RESULTS: Estimated annual HIV incidence increased from 4% in 1992/1993 to 10% in 1996/1997. In 1997, highest age-specific incidence was 16% among women aged between 20 and 24 years. In 1997, overall prevalence was 26% (95% confidence interval [CI], 24%-28%) and at 34% was highest among women aged between 20 and 24 years. Young age (<30 years; odds ratio [OR], 2.1; p = .001), unmarried status (OR 2.2; p = .001) and living in less remote parts of the district (OR 1.5; p = .002) were associated with HIV prevalence in univariate analysis. Associations were less strong in multivariate analysis. Partner's migration status was not associated with HIV infection. Substantial heterogeneity of HIV prevalence by clinic was observed (range 17%-31%; test for trend, p = .001). CONCLUSIONS: This community is experiencing an explosive HIV epidemic. Young, single women in the more developed parts of the district would form an appropriate cohort to test, and benefit from, interventions such as vaginal microbicides and HIV vaccines.

Adolescent↗
PubMed1992

Predictors of cocaine use in pregnancy.

Several hundred thousand infants are exposed to cocaine in utero every year in the United States. In an attempt to provide services for women abusing drugs, various programs have been proposed for prenatal drug testing. This study was conducted to assess the sensitivity, specificity, and predictive values of screening programs based on a variety of clinical and historical factors. Between October 1988 and March 1989, 1111 parturients who delivered at an inner-city hospital had urine samples and data collected. The urine, linked by code number to the data, which contained no identifiers, was tested anonymously for illicit drugs. We then assessed the associations of a variety of historical and clinical variables with positive toxicologies. An acknowledged history of drug use or a combination of no prenatal care and cigarette use provided the most valid prediction of cocaine use, with a 59.8% sensitivity, 97.5% specificity, 70% positive predictive value, and 94.9% negative predictive value for positive urine toxicologic examinations. The addition of clinical data such as low birth weight did not improve predictive values significantly. Although the use of easily available historical data allowed correct identification of 60% of parturients who used cocaine, no combination of factors could detect all users. If it is considered beneficial to identify all users at a given point, then urine toxicology screening would be more appropriate than sole reliance on patient history.

Cocaine↗
PubMed1994

Maternal-newborn human immunodeficiency virus infection in Harlem.

OBJECTIVE: To determine the prevalence of human immunodeficiency virus type 1 (HIV-1) infection and its association with illicit drug use for mothers being delivered of infants at an inner-city municipal hospital. METHODS: We anonymously tested the umbilical cord blood for HIV-1 antibody of 98.1% (2971/3028) of singleton infants with birth weight greater than 500 g born during 1989 and linked the results to a maternal-infant database from which all identifying information had been removed. RESULTS: Overall, HIV-1 seroprevalence was 3.3% (99/2971). Among HIV-1-seropositive mothers, 79% (78/99) gave no history of ever using injected drugs. Seropositivity for HIV-1 was independently associated with history of maternal cocaine use during pregnancy (odds ratio, 3.55; 95% confidence interval, 2.18, 5.78), history of ever using injected drugs (odds ratio, 6.02; 95% confidence interval, 3.14, 11.6), positive serologic test result for syphilis during pregnancy (odds ratio, 3.37; 95% confidence interval, 1.94, 5.88), and increasing maternal age per year (odds ratio, 1.04; 95% confidence interval, 1.00, 1.09). Voluntary testing programs failed to identify 71% (70/99) of all HIV-1-infected women. Infants placed into foster care were eight times more likely to be HIV-1 seropositive than those discharged to their mothers. CONCLUSIONS: Most HIV-1-infected mothers seem to have acquired the infection via heterosexual transmission rather than via injected drug use. Associations of maternal HIV-1 infection with cocaine use, syphilis, and increasing age probably operate through behaviors that increase maternal risk of exposure to an HIV-1-infected sexual partner or, in the case of syphilis, also through biologic factors that may predispose to HIV-1 transmission. The failure of voluntary testing to identify most HIV-1-infected mothers provides a strong rationale for routine HIV-1 testing during pregnancy and in the newborn period.

AIDS Serodiagnosis↗
PubMed2006

Anonymous pilot study of hepatitis C virus prevalence in liver transplant surgeons.

The risk of hepatitis C virus (HCV) transmission to surgeons is related to the HCV prevalence in the surgical patient population. As HCV-related cirrhosis is the commonest indication for liver transplantation in Europe and North America, liver transplant surgeons are at particular risk. The prevalence of HCV infection in liver transplant surgeons is unknown. The aim of this study was to estimate the prevalence of HCV infection in liver transplant surgeons attending the 9th Congress of the International Liver Transplantation Society using unlinked anonymous testing for HCV. Surgeons attending the conference were invited to complete an anonymised questionnaire regarding their surgical and transplant practice and provide an unlinked anonymised blood spot sample by finger prick. Samples were screened for antibodies to HCV (enzyme-linked immunosorbent assay III, Ortho Diagnostics, Raritan, NJ). Polymerase chain reaction testing for HCV RNA was performed on reactive samples.A total of 117 liver transplant surgeons (79 European, 16 North American, 10 Asian, 9 South American, 3 Australasian) provided a blood spot sample. Two (1.7%) surgeons had antibodies to HCV, 1 (0.8%) had detectable HCV RNA (genotype 1a). Assuming that both infections were acquired during surgery, the estimated maximum rate of HCV transmission is 1 per 743 to 1,045 years of surgical (0.96 to 1.35 HCV transmissions per 1,000 years of general surgical practice) and 449 to 683 years of liver transplant practice (1.46 to 2.23 HCV transmissions per 1,000 years of liver transplantation practice). In conclusion, risk of HCV transmission to liver transplant surgeons appears to be low despite the particular risks associated with frequently operating on HCV infected patients.

Hepacivirus↗
PubMed1992

Prevalence of antibodies to human immunodeficiency virus type 1 and condom use among outpatients at a sexually transmitted disease clinic in Rome.

To assess the prevalence of HIV-1 infection and study selected risk factors among patients attending a clinic for sexually transmitted diseases in Rome, 1442 outpatients seen consecutively between 20 February and 12 December 1989 were anonymously tested for anti-HIV-1. An evaluation of the trend of the HIV-1 infection was attempted by comparing the results of the present study with those obtained from a similar sample studied in 1986 in the same clinic. The overall estimated prevalence of anti-HIV-1 was 1.2% among heterosexual non-drug user subjects and 16.1% among homosexual or bisexual men. The anti-HIV-1 seropositivity was significantly higher in heterosexual subjects who reported sexual contact with intravenous drug users, as compared with those who did not report such exposure (12.5% vs 0.8%, p less than 0.005). Comparing the present data with those of a study conducted in 1986 in the same clinic, a lower prevalence of anti-HIV-1 was found among heterosexual subjects (1.2% in 1989 vs 6.0% in 1986, p less than 0.001). The availability after 1986 of several outpatient facilities attracting seropositive subjects and a change in the sexual behaviour of anti-HIV-1 positive subjects could explain this finding. Twenty percent of the heterosexual subjects and 62% of the homosexual or bisexual men reported consistent use of condoms.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

HIV infection at outcome of pregnancy in the Paris area, France.

The prevalence of HIV infection in women at end of pregnancy, irrespective of outcome, was determined in a comprehensive survey of both women and medical centres during successive 4-week periods in four areas of the Paris region, France. Blood samples were tested anonymously for antibodies to human immunodeficiency virus (HIV)-1 and HIV-2. Of the 11,593 blood samples 0.40% (95% confidence interval [CI] 0.28-0.51) were positive for HIV-1 and 0.02% (95% binomial interval [BI] 0.002-0.065) for HIV-2. Seroprevalence was higher among women with ectopic pregnancy (2%) (95% BI 0.24-7.04); the rate in women having an elective or therapeutic abortion was more than twice that in those delivering babies (0.70% vs 0.28%, p less than 0.05, relative risk 2.54, 95% CI 1.36-4.75). Studies with neonatal HIV seroprevalence as a surrogate for HIV prevalence in pregnant women would underestimate prevalence in these women.

Abortion, Therapeutic↗
PubMed1991

HIV seroprevalence and risk behaviors in psychiatric inpatients.

The seroprevalence of the human immunodeficiency virus (HIV) in 515 patients consecutively admitted to a state psychiatric hospital in New York City was 8.9%. There were 365 patients whose results were individually traceable; the remaining 150 patients were tested anonymously. Risk factors including parenteral drug abuse, male homosexual behaviors, and other sexual behaviors were studied in the traceable patients. Logistic regressions indicated that parenteral drug abuse was the main risk factor in both males and females. In females, two additional factors were significant: sex with parenteral drug users or with partners who have the acquired immunodeficiency syndrome (AIDS), and sex with bisexual men. Females with bipolar disorders were particularly likely to report sex with parenteral drug users or with partners who have AIDS.

Adult↗
PubMed1991

Surveillance for HIV antibody and antigen in trauma patients.

Studies in a Baltimore emergency room identified the patient with penetrating trauma as having the highest incidence of Human Immunodeficiency Virus Type I (HIV-1) infection. Anonymous testing over a 15-month period of 165 victims of penetrating trauma presenting to the Medical Center Hospital Emergency Center (San Antonio, Texas) revealed a 0% incidence of HIV-1. This data suggests that HIV-1 trauma patient incidence can be expected to vary between specific geographic areas and patient populations served, independent of community-wide AIDS incidence.

Adult↗
PubMed2005

A high prevalence of HIV-1 infection among pregnant women living in a rural district of north Uganda severely affected by civil strife.

This study aims at estimating the recent trends in HIV-1 prevalence and the factors associated with infection among pregnant women in the Gulu District of north Uganda, a rural area severely affected by civil strife. In 2000-2003, a total of 4459 antenatal clinic attendees of Lacor Hospital were anonymously tested for HIV-1 infection. The overall and age-specific prevalence did not show any significant trend over time. The age-standardized prevalence slightly declined, from 12.1% in 2000 to 11.3% in 2003. Increased age [20-24 years: adjusted odds ratio (AOR) 1.63; 95% CI 1.18-2.25; >or=25 years: AOR 2.56; 95% CI 1.91-3.44], residence in urban areas (AOR 1.76; 95% CI 1.41-2.18), being unmarried (AOR 1.60; 95% CI 1.27-2.01), increased age of partner (25-34 years: AOR 1.87; 95% CI 1.29-2.73; >or=35 years: AOR 2.68; 95% CI 1.72-4.16), modern occupation of partner (AOR 1.98; 95% CI 1.53-2.58), and short time of residence at the current address (AOR 1.36; 95% CI 1.05-1.76) were associated with infection. The HIV-1 prevalence in this rural district is high and similar to that observed in urban antenatal clinics, probably reflecting the effect of the last 18 years of civil strife.

Adult↗
PubMed1991

The biologic and social consequences of perinatal cocaine use in an inner-city population: results of an anonymous cross-sectional study.

Cocaine use among pregnant women and reports of its adverse perinatal consequences have increased substantially over the past 10 years. However, most researchers have studied patients registered at drug treatment centers or have relied on voluntary participation by patients, either of which introduces the possibility of selection bias. To determine the frequency and consequences of prenatal cocaine use among an unselected inner-city obstetric population, we collected urine samples from parturient women at a municipal hospital and anonymously tested these specimens for metabolites of cocaine, marijuana, opiates, and methadone. Urine specimens, with linked obstetric data sheets, were available from a study population of 1111 patients, and pediatric data sheets were available for 846 mother-infant pairs. Cocaine metabolites were found in 11.5% of the urine samples collected, whereas metabolites of marijuana, opiates, and methadone, respectively, were present in 1.1%, 1.2%, and 0.3% of the specimens. Cocaine users were more likely than nonusers to have had no prenatal care (51% vs 8.8%; p less than 0.0001), to be American-born rather than Caribbean-born (71% vs 33%; p less than 0.001), and to have a higher parity (1.83 vs 1.14; p less than 0.0001). Infants of cocaine users had a lower mean gestational age (-0.93 weeks; p less than 0.01), a lower mean birth weight (2560 +/- 788 vs 3151 +/- 699 gm; p less than 0.001), and an increased probability of having an Apgar score of less than 7 at 5 minutes (12.5% vs 3.2%; p less than 0.0001). Multiple linear regression analysis that isolated confounding variables such as the presence or absence of prenatal care, maternal age and parity, and the use of cigarettes and alcohol did not substantially affect the differences described above. The effect of cigarette smoking on reducing fetal size was cumulative. In conclusion, cocaine is the most commonly used illicit drug among parturients in this community and is strongly associated with underutilization of prenatal care services. Infants of cocaine users are more likely to be preterm and depressed at birth and to have a low birth weight. Cocaine use, through the above-noted effects, increases the need for prenatal care while simultaneously decreasing the likelihood that it will be obtained.

Adult↗
PubMed2000

[Trend of HIV seroprevalence among mothers of new-born infants from 1996 to 1999].

BACKGROUND: To analyze the evolution of HIV prevalence in mothers of Spanish new-borns. SUBJECTS AND METHOD: Unlinked anonymous testing of HIV in blood spots for detection of metabolic diseases of all new-borns in 1996-1999 in seven regions: Baleares, Canarias, Castilla-La Mancha, Castilla y León, Galicia, Melilla and Murcia. HIV antibody detection was done with ELISA and confirmation with a immunoblot. RESULTS: The prevalence of HIV antibodies was 0.99 per 1,000 in 1996, 1.29 in 1997, 1.42 in 1998 and 1.54 in 1999. There was an upward trend both in the global sample (p = 0.0015) and in those from Canarias (p < 0.0001) and Castilla y León (p = 0.0389). The prevalence of HIV-1 for the whole period was 1.31 per 1.000 and of 1.13 per 100.000 for HIV-2. CONCLUSIONS: There is a need to offer systematic counselling and HIV testing to all pregnant women.

HIV Antibodies↗
PubMed1997

Should patients with facial fractures be regarded as high risk for HIV?

OBJECTIVE: To determine the prevalence of HIV seropositivity in patients with facial fractures in Edinburgh, UK. DESIGN: A prospective study of 100 consecutive patients in 1994. SETTING: Department of Maxillofacial Surgery, City Hospital, Edinburgh, UK. SUBJECTS: 100 patients with facial fractures who were willing to participate in the study. MAIN OUTCOME MEASURES: Details of facial fractures. Assessment of risk factors for HIV. The seroprevalence of HIV based on unlinked anonymous testing of saliva. RESULTS: None of the participants were HIV positive on saliva testing. Nine patients were found to have one or more risk factors for HIV. Eight patients had been tested for HIV previously. CONCLUSION: Direct history taking appears to be effective in eliciting risk factors for HIV. A detailed risk factor history should be taken for all patients with facial fractures. Continuation of this study may establish whether or not there is a link between facial bone fractures and HIV seropositivity.

Adolescent↗