Fennema J S, van Ameijden E J, Coutinho R A, van Doornum G J, Henquet C J, van den Hoek J A
Department of Public Health and Environment, Municipal Health Service, Amsterdam, The Netherlands.
Genitourin Med. 1993 Feb;69(1):23-8. doi: 10.1136/sti.69.1.23.
Patients attending a clinic for sexually transmitted diseases (STD) in general have engaged in at risk sexual behaviour. Therefore they are at increased risk of acquiring HIV through sexual contact.
To determine the HIV prevalence among patients attending a STD clinic in Amsterdam.
An anonymous cross sectional study was conducted in two 5-week periods in Spring and Autumn 1991.
Of the 2362 patients attending the clinic during the study period, 2292 (97%) consented to participate; of these, 2138 (93%) were interviewed and anonymously tested, while 154 (7%) consented to be interviewed but refused HIV antibody testing. The HIV prevalence was 4.2% (90/2138); 93% of seropositive participants reported homosexual contacts and/or intravenous use of drugs (IVDU). HIV prevalence among heterosexual non-IVDU men was 0.5% and among non-IVDU women 0.1%. Among all heterosexually active participants, including IVDU and bisexual men, the HIV prevalence was 1.5%. The 28 of 90 HIV infected participants that were heterosexually active reported together approximately 135 heterosexual partners in the six months preceding the study; 13 of these 28 heterosexually active participants had a STD diagnosed at their present clinic visit, while four (30%) of them already knew they were HIV infected.
From these data we conclude that there is a substantial risk of further transmission of HIV through heterosexual contact. In order to try to reduce this potential for further sexual transmission of HIV, services offered by the STD clinic should not only include voluntary confidential counselling and HIV testing, but also notification of partners of HIV infected clinic-attendants. Finally, we conclude that anonymous HIV prevalence studies that link HIV test results to risk behaviour for HIV infection can be performed with a high rate of participation. Repeating such prevalence studies in time can help in monitoring the HIV incidence in the heterosexually active population.
一般来说，前往性传播疾病（STD）诊所就诊的患者都有过危险性行为。因此，他们通过性接触感染艾滋病毒的风险增加。
确定阿姆斯特丹一家性病诊所患者中的艾滋病毒感染率。
在1991年春季和秋季的两个为期5周的时间段内进行了一项匿名横断面研究。
在研究期间前往该诊所就诊的2362名患者中，2292名（97%）同意参与；其中，2138名（93%）接受了访谈并进行了匿名检测，而154名（7%）同意接受访谈但拒绝进行艾滋病毒抗体检测。艾滋病毒感染率为4.2%（90/2138）；93%的血清阳性参与者报告有同性恋接触和/或静脉注射毒品（IVDU）。异性恋非IVDU男性中的艾滋病毒感染率为0.5%，非IVDU女性中的感染率为0.1%。在所有有异性性行为的参与者中，包括IVDU和双性恋男性，艾滋病毒感染率为1.5%。90名艾滋病毒感染参与者中有28名有异性性行为，在研究前的六个月里，他们总共报告了约135个异性性伴侣；这28名有异性性行为的参与者中有13名在此次诊所就诊时被诊断患有性病，其中有4名（30%）已经知道自己感染了艾滋病毒。
从这些数据中我们得出结论，通过异性接触进一步传播艾滋病毒的风险很大。为了试图降低艾滋病毒进一步性传播的可能性，性病诊所提供的服务不仅应包括自愿保密咨询和艾滋病毒检测，还应通知感染艾滋病毒的诊所就诊者的性伴侣。最后，我们得出结论，将艾滋病毒检测结果与艾滋病毒感染风险行为相关联的匿名艾滋病毒感染率研究可以获得很高的参与率。及时重复进行此类感染率研究有助于监测有异性性行为人群中的艾滋病毒发病率。
