Outline of the Human Retrovirus Registry: profile of a Puerto Rican HIV infected population

Abstract

Objective: To present the general socio-demographic profile, some risk related parameters and elements of the clinical spectrum of disease at presentation, of those HIV/AIDS patients enrolled in the Human Retrovirus Registry.

Methods: This is a prospective longitudinal cohort study, which has been identifying since May 1992, adults or adolescents 18 years or older with AIDS or HIV infection at the time they present to our health care facilities: University Hospital Ramon Ruiz Arnau and the Bayamon Immunology Clinic. The present analysis include patients enrolled between May 1992 and December 1996 (n = 1520). The measurement instrument is a modular questionnaire which actually includes 237 variables including socio-demographic data, risk variables, lifestyle and affective parameters, clinical and immunological variables and therapeutic data.

Results: The mean baseline age of the 1520 patients was 35.7 years of age. Most participants were male (77.7%) and Hispanic (98.8%). Forty-five percent (45.1%) of the population were single and only 21.9% were married; nevertheless, fifty-one percent (51.7%) indicated to have children. 70% reported to be unemployed. Injecting Drug Usage appears as the first exposure mode (54.3%), followed by heterosexual contact cases (25.71%) and by men having sex with men (12.9%). The study of other risk practices revealed a large proportion of patients smoking tobacco (65.6%) and using alcohol (49.5%). Based on the 1993 CDC definition, forty-seven percent (47%) of the subjects had a clinical or immunological criterion to be considered as an AIDS case at first presentation. Among all AIDS cases, 440 patients presented with clinical AIDS (61.7%%) and 274 persons were classified as AIDS due to low CD4 counts alone (38.3%%). The most common AIDS defining conditions were: Pneumocystis carinii pneumonia (n = 201, 28.1%), Candidiasis Esophageal (n = 123, 17.2%), Toxoplasmosis (n = 95, 13.3%), Wasting syndrome (n = 68, 9.5%), and Tuberculosis (n = 68, 10.3%).

Conclusions: The socio-demographic and risk profile of AIDS patients in the present study is representative of the Puerto Rican AIDS population with regards to gender, age distribution, and risk scenario groups. This study revealed that a wide spectrum of social and behavioral vulnerabilities are impacting this population. A large proportion of patients is arriving to the health care facilities at a late stage of disease. Further studies including data from follow-up interviews will help to assess changes in the expression and evolution of the disease.