Loveday C, Pomeroy L, Weller I V, Quirk J, Hawkins A, Williams H, Smith A, Williams P, Tedder R S, Adler M W
Academic Department of Genitourinary Medicine, University College and Middlesex School of Medicine, London.
BMJ. 1989 Feb 18;298(6671):419-22. doi: 10.1136/bmj.298.6671.419.
To determine the prevalence of infection with the human immunodeficiency virus (HIV) in all patients attending a London sexually transmitted disease clinic over four weeks at the end of 1987 and to see how it varied from that in similar samples studied between 1982 and 1986.
Anonymous testing of serum samples from consecutive heterosexual and homosexual patients having routine serological investigations for syphilis. Testing was for anti-HIV-I, anti-HIV-II, and hepatitis B core antibody (anti-HBc) and P24 antigen. Age, nationality, sexual orientation, and past sexually transmitted diseases were recorded for each patient. Gonorrhoea rates by quarters were analysed among homosexual and bisexual men and heterosexual men and women from 1981 to 1987.
Outpatient department of genitourinary medicine.
A total of 1074 patients attending consecutively for syphilis serology. Thirty five homosexual and bisexual men were excluded (these were regular attenders as part of a prospective study of the natural course of HIV infection).
The prevalence of anti-HIV-I in homosexual and bisexual men in 1987 was 25.6% (64/250). Results in the same clinic population between 1982 and 1984 had shown a rise in prevalence, which flattened out in 1985-6 and continued at that level. Among heterosexual attenders in 1987 the prevalence of anti-HIV-I was 1% (women 4/412; men 4/377), which contrasted with a prevalence of 0.5% (women 2/395; men 3/757) in January 1986. One homosexual man was seropositive for anti-HIV-II and seronegative for anti-HIV-I. Among homosexual and bisexual men the rate of gonorrhoea had declined by an average of 2.7% a year since 1981, such that by 1987--and for the first time in the clinic--there was no significant difference in the rates between these men and heterosexual men and women.
The appearance of HIV-I infection among heterosexuals indicates a need for more aggressive education programmes and intervention strategies along the lines adopted for homosexual men. Surveillance for HIV-II infection is needed to provide information for future policy in national screening programmes.
确定1987年末在伦敦一家性传播疾病诊所就诊的所有患者中人类免疫缺陷病毒（HIV）感染的患病率，并观察其与1982年至1986年研究的类似样本中的患病率相比有何变化。
对连续进行梅毒常规血清学检查的异性恋和同性恋患者的血清样本进行匿名检测。检测项目包括抗HIV-I、抗HIV-II、乙肝核心抗体（抗-HBc）和P24抗原。记录每位患者的年龄、国籍、性取向和既往性传播疾病史。分析了1981年至1987年期间同性恋和双性恋男性、异性恋男性和女性按季度划分的淋病发病率。
泌尿生殖医学门诊部。
共有1074名连续前来进行梅毒血清学检查的患者。35名同性恋和双性恋男性被排除在外（这些人是作为HIV感染自然病程前瞻性研究的一部分的定期就诊者）。
1987年同性恋和双性恋男性中抗HIV-I的患病率为25.6%（64/250）。1982年至1984年同一诊所人群的结果显示患病率上升，在1985 - 1986年趋于平稳并维持在该水平。1987年异性恋就诊者中抗HIV-I的患病率为1%（女性4/412；男性4/377），这与1986年1月0.5%（女性2/395；男性3/757）的患病率形成对比。一名同性恋男性抗HIV-II血清学阳性，抗HIV-I血清学阴性。自1981年以来，同性恋和双性恋男性中的淋病发病率平均每年下降2.7%，到1987年，在该诊所这些男性与异性恋男性和女性之间的发病率首次没有显著差异。
异性恋者中出现HIV-I感染表明需要按照针对同性恋男性所采用的方式开展更积极的教育项目和干预策略。需要对HIV-II感染进行监测，为国家筛查项目的未来政策提供信息。
