Literature DB >> 15054181

Trends in, and determinants of, HIV testing at genitourinary medicine clinics and general practice in England, 1990-2000.

T R Chadborn1, C A McGarrigle, P A Waight, K A Fenton.   

Abstract

OBJECTIVES: To describe the trends in and determinants of HIV testing and positivity at genitourinary medicine (GUM) clinics and in general practice (GP) in England between 1990 and 2000.
METHODS: Data on all first HIV specimens from GUM and GP clinics and tested at seven sentinel laboratories were related to key demographic, clinical, and behavioural variables.
RESULTS: During the observation period, 202 892 eligible first HIV tests were reported. 90% (182 746) of specimens were from GUM clinics, of which 55% were from heterosexuals, 12% from men who have sex with men (MSM), and 3% from injecting drug users (IDU). In contrast, only 3% of GP specimens were from MSM and 13% from IDUs. The total number of first HIV tests increased threefold between 1990 and 2000. Overall, 1.6% of GUM and 0.9% of GP first testers were diagnosed HIV positive. In GUM clinics, HIV positivity was highest among heterosexuals who have lived in Africa (11.7%), MSM (6.9%), and IDUs (2.8%) and lowest among heterosexuals with no other specified risk (0.3%). Consistently lower prevalences were observed in GP settings. HIV positivity among GUM first testers declined in MSM, from 13.6% in 1990 to 5.2% in 2000 (p<0.01), and in IDUs, from 7.5% in 1990 to 2.0% in 2000 (p = 0.03). Prevalence remained constant in the groups heterosexually exposed to HIV infection.
CONCLUSIONS: HIV testing in GUM settings increased over the decade, with a concomitant reduction in HIV positivity among MSM and IDUs. Increased testing among heterosexual first testers overall was not associated with declining positivity.

Entities:  

Mesh:

Year:  2004        PMID: 15054181      PMCID: PMC1744790          DOI: 10.1136/sti.2003.006288

Source DB:  PubMed          Journal:  Sex Transm Infect        ISSN: 1368-4973            Impact factor:   3.519


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