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Logo of straninfSexually Transmitted InfectionsVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
Sex Transm Infect. Oct 1999; 75(5): 332–336.
PMCID: PMC1758234

Trends in undiagnosed HIV-1 infection among attenders at genitourinary medicine clinics, England, Wales, and Northern Ireland: 1990-6


OBJECTIVE: To describe trends in seroprevalence of undiagnosed HIV-1 infection among attenders at 15 genitourinary medicine clinics in England, Wales, and Northern Ireland between 1990 and 1996. METHOD: Prospective, cross sectional sentinel serosurvey. Unlinked anonymous testing of remnant serum drawn for routine syphilis screening. RESULTS: In 1996, the seroprevalence of undiagnosed HIV-1 infection was 5% in homosexual men, 0.48% in heterosexual men, and 0.33% in heterosexual women. Between 1990 and 1996, there was a significant linear decrease in the seroprevalence of undiagnosed HIV-1 infection among homosexual and bisexual men within and outside London (p < 0.0001; p = 0.0141), equivalent to yearly decreases of 7.65% and 10.73% respectively. However, seroprevalence among homosexual and bisexual men under 25 years of age did not decline either inside or outside London. Seroprevalence among heterosexual men declined outside London (p < 0.005), equivalent to an average annual decrease of 14.54%. There was a significant increase among male heterosexuals inside London (p < 0.05) equivalent to a 8.09% increase per annum. Seroprevalence over time was unchanging among female heterosexuals both inside and outside London. Seroprevalence was significantly higher among those who injected drugs than those who did not report injecting in the following groups: homosexual and bisexual males within London (p < 0.005), male heterosexuals both within and outside London (p < 0.05; p < 0.05) and female heterosexuals within London (p < 0.05). CONCLUSIONS: The study highlights a significant burden of undiagnosed HIV-1 infection more than 15 years since the HIV epidemic began. Methods of offering HIV testing need to be reassessed to extend the practice of routinely testing for HIV in GUM clinics. HIV transmission among young homosexual and bisexual men continues. The contrasting trends between homosexual and bisexual men, injecting drug users, and heterosexuals attending GUM clinics indicate these groups should be considered separately. The substantial HIV seroprevalence in each group indicates that they should be priorities for targeted HIV prevention.

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Selected References

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  • Parry JV, Mahoney A, Mortimer PP. Are seroepidemiological surveys for human immunodeficiency virus infection based on tests on pools of serum specimens accurate and cost-effective? Clin Diagn Virol. 1993 Aug;1(3):167–178. [PubMed]
  • Simms I, Hughes G, Swan AV, Rogers PA, Catchpole M. New cases seen at genitourinary medicine clinics: England 1996. Commun Dis Rep CDR Suppl. 1998 Feb;8(1):S2–11. [PubMed]
  • Gill ON, Adler MW, Day NE. Monitoring the prevalence of HIV. BMJ. 1989 Nov 25;299(6711):1295–1298. [PMC free article] [PubMed]
  • Catchpole MA, Mercey DE, Nicoll A, Rogers PA, Simms I, Newham J, Mahoney A, Parry JV, Joyce C, Gill ON. Continuing transmission of sexually transmitted diseases among patients infected with HIV-1 attending genitourinary medicine clinics in England and Wales. BMJ. 1996 Mar 2;312(7030):539–542. [PMC free article] [PubMed]
  • Ades AE. Serial HIV seroprevalence surveys: interpretation, design, and role in HIV/AIDS prediction. J Acquir Immune Defic Syndr Hum Retrovirol. 1995 Aug 15;9(5):490–499. [PubMed]
  • Duong T, Ades AE, Rogers P, Nicoll A. Non-participation bias in unlinked anonymous HIV-prevalence surveys in England and Wales. Epidemiol Infect. 1999 Apr;122(2):267–272. [PMC free article] [PubMed]
  • De Cock KM, Johnson AM. From exceptionalism to normalisation: a reappraisal of attitudes and practice around HIV testing. BMJ. 1998 Jan 24;316(7127):290–293. [PMC free article] [PubMed]
  • Hickson FC, Reid DS, Davies PM, Weatherburn P, Beardsell S, Keogh PG. No aggregate change in homosexual HIV risk behaviour among gay men attending the Gay Pride festivals, United Kingdom, 1993-1995. AIDS. 1996 Jun;10(7):771–774. [PubMed]
  • Torian LV, Weisfuse IB, Makki HA, Benson DA, DiCamillo LM, Patel PR, Toribio FE. Trends in HIV seroprevalence in men who have sex with men: New York City Department of Health sexually transmitted disease clinics, 1988-1993. AIDS. 1996 Feb;10(2):187–192. [PubMed]
  • Fennema JS, van Ameijden EJ, Coutinho RA, van Doornum GJ, Cairo I, van den Hoek A. HIV surveillance among sexually transmitted disease clinic attenders in Amsterdam, 1991-1996. AIDS. 1998 May 28;12(8):931–938. [PubMed]
  • Osmond DH, Page K, Wiley J, Garrett K, Sheppard HW, Moss AR, Schrager L, Winkelstein W. HIV infection in homosexual and bisexual men 18 to 29 years of age: the San Francisco Young Men's Health Study. Am J Public Health. 1994 Dec;84(12):1933–1937. [PMC free article] [PubMed]
  • Miller E, Waight PA, Tedder RS, Sutherland S, Mortimer PP, Shafi MS. Incidence of HIV infection in homosexual men in London, 1988-94. BMJ. 1995 Aug 26;311(7004):545–545. [PMC free article] [PubMed]
  • Ridge DT, Plummer DC, Minichiello V. Young gay men and HIV: running the risk? AIDS Care. 1994;6(4):371–378. [PubMed]
  • McGarrigle CA, Nicoll A. Prevalence of HIV-1 among attenders at sexually transmitted disease clinics: analyses according to country of birth. Sex Transm Infect. 1998 Dec;74(6):415–420. [PMC free article] [PubMed]
  • Nicoll A, McGarrigle C, Brady AR, Ades AE, Tookey P, Duong T, Mortimer J, Cliffe S, Goldberg D, Tappin D, et al. Epidemiology and detection of HIV-1 among pregnant women in the United Kingdom: results from national surveillance 1988-96. BMJ. 1998 Jan 24;316(7127):253–258. [PMC free article] [PubMed]

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