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Marjorie J. Robertson, PhD, Richard A. Clark, MPH, Edwin D. Charlebois, PhD, MPH, Jacqueline Tulsky, MD, Heather L. Long, MPH, David R. Bangsberg, MD, MPH and Andrew R. Moss, PhD

Marjorie J. Robertson, Richard A. Clark, Heather L. Long, and Andrew R. Moss are with the Department of Epidemiology, University of California, San Francisco. Marjorie J. Robertson is also with the Alcohol Research Group, Public Health Institute, Berkeley, Calif. Edwin D. Charlebois and David R. Bangsberg are with the Epidemiology and Prevention Interventions Center, San Francisco General Hospital, University of California, San Francisco. Jacqueline Tulsky is with the Department of Medicine, University of California, San Francisco.

Correspondence: Requests for reprints should be sent to Marjorie J. Robertson, PhD, Alcohol Research Group, 2000 Hearst Ave, Suite 300, Berkeley, CA 94706 (e-mail: mrobertson{at}arg.org).

Objectives. We report HIV seroprevalence and risk factors for urban indigent adults.

Methods. A total of 2508 adults from shelters, meal programs, and low-cost hotels received interviews, blood tests, and tuberculosis screening.

Results. Seroprevalence was 10.5% overall, 29.6% for men reporting sex with men (MSM), 7.7% for non-MSM injection drug users (IDUs), and 5.0% for residual non-MSM/non-IDUs. Risk factors were identified for MSM (sex trade among Whites, non-White race, recent receptive anal sex, syphilis), non-MSM IDUs (syphilis, lower education, prison, syringe sharing, transfusion), and residual subjects ( 5 recent sexual partners, female crack users who gave sex for drugs).

Conclusions. HIV seroprevalence was 5 times greater for indigent adults than in San Francisco generally. Sexual behavior predicted HIV infection better than drug use, even among IDUs.

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