The possibility of assessing HIV prevalence and pregnancy status by conducting HIV and pregnancy tests on anonymously collected urine specimens will be explored. A low-cost feasibility study is proposed using arrestees participating in an on-going needs assessment survey as part of the California Drug Use Forecasting (CAL-DUF) Program. While drug abusers, who constitute the majority of arrestees, are among the highest risk groups for HIV infection, the rates of HIV positivity are not well documented among key subgroups of drug abusers, especially non-injection users. Furthermore, female arrestees, most of whom are in their prime child-bearing years, are likely to engage in high-risk sex without effective use of contraception, and to have high pregnancy rates. This application addresses the following goals: 1) to assess the feasibility of applying urine-based techniques for determining HIV-1 antibody and pregnancy status within an ongoing field study of arrestees; 2) to document the prevalence of HIV and pregnancy among arrestees and to compare these rates to other at-risk populations; and 3) to assess relationships among demographic factors, risk behaviors, and HIV and pregnancy status. Seven counties from the 15-county CAL-DUF study, representing both southern and northern California and making up approximately 63% of the state's population, will participate. These counties represent urban areas where a constellation of related public health problems exist. Approximately 200 men and 100 women arrestees from each county will be interviewed with a final aggregate sample of approximately 2100 arrestees, comprised of 75% men and 25% women, with an ethnic distribution of 45% white, 35% Mexican-American, and 20% African- American. We will conduct HIV testing using a microplate ELISA (Calypte Biomedical) and a modified Western Blot as a confirmatory test. Urine pregnancy testing will be done with the Early Pregnancy Test (EPT) (Warner- Lambert Co.).
