Abstract

The objectives were to determine the sociodemographic profile, risk category, and prevalence of HIV infection amongst people attending a confidential clinic providing counselling, medical advice and results of HIV antibody testing on the same day of consultation. Data were collected on all 1749 individuals attending the same-day HIV testing clinic at the Royal Free Hospital, London and proceeding to HIV testing between June 2000 and May 2001. One thousand, one hundred and forty-eight men and 601 women (mean age 33.3 years) were tested for HIV antibodies. The primary risk for HIV infection was heterosexual contact (69.9%; 1224/1749) and homosexual contact (27.7%; 485/1749). Fifty individuals tested HIV-positive (42 men and eight women). HIV seroprevalence was 2.8% (50/1749) and was highest among men who reported risk through homosexual contact (6.2%; 30/485). The rates for heterosexual men and women were 1.8% (12/648) and 1.4% (8/576), respectively, though they were highest among Black Caribbean (12%; 3/25) and Black African attendees from sub-Saharan African countries (11.2%; 18/160). Of the total number attending the clinic, more than half (56%; 981/1749) had previously been tested and received a negative test result. Of the fifty HIV antibody-positive individuals, 26%, (13) had previously received a negative result and had all reported risk through homosexual contact. Thirty of the HIV antibody-positive individuals were asymptomatic, 14 were symptomatic and three were diagnosed with an AIDS-defining condition. Half of all HIV-positive attendees (51.2%; 22/43) presented at the time of testing with CD4 cell counts below the normal range (>400x10(6)/l). The high HIV seroprevalence among homosexual men, some of whom had previously tested negative, suggests that HIV prevention strategies used within this group may need to be reassessed. The continuing high HIV seroprevalence among individuals from African countries suggests that this population require specific targeting for HIV risk reduction and information on the advantages of early diagnosis and treatment.

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