Fennema J S, van Ameijden E J, Coutinho R A, van Doornum G J, Cairo I, van den Hoek A
Municipal Health Service, Division of Public Health and Environment, Amsterdam, The Netherlands.
AIDS. 1998 May 28;12(8):931-8. doi: 10.1097/00002030-199808000-00016.
To determine trends in HIV prevalence among attenders of a clinic for sexually transmitted diseases (STD), with emphasis on heterosexuals who did not have a history of injecting drug use.
Anonymous unlinked HIV surveys with individual consent, conducted each half year from 1991 to 1996 (except 1993) among STD clinic attenders who came for evaluation of a possible new STD episode.
Of 10,940 eligible attenders 10,046 (92%) accepted HIV testing. Of all tested attenders, 312 (3.1%) were HIV-infected. Overall HIV prevalence decreased significantly from 4.6% in 1991 to 2.8% in 1996. HIV prevalence among heterosexual men and women who were not injecting drug users was less than 1% in all but one survey period. Except for one woman, none of the 48 HIV-infected heterosexuals was aware of their current serostatus. Among HIV-infected heterosexuals, 21 out of 28 males (75%) and 18 out of 20 females (90%) were of non-Dutch origin. HIV prevalence was 16% among all homosexual men, and 12% among young homosexual men aged < 30 years. HIV prevalence among young homosexual men decreased significantly over time. Among HIV-infected homosexual men, 58% of older men and 59% of younger men were not aware of their current HIV infection. Rates of current STD were generally significantly higher among HIV-infected participants compared with non-HIV-infected participants.
Although HIV prevalence among heterosexual clinic attenders is low, there is a clear potential for ongoing sexual HIV transmission. Most heterosexually acquired HIV infections are found in non-Dutch persons. This observation suggests migration of HIV-infected heterosexuals or the separation of Dutch and non-Dutch heterosexual networks. Awareness of serostatus is almost non-existent among HIV-infected heterosexuals, and is low among male homosexual clinic attenders. To increase awareness of current HIV serostatus and possibly decrease risk behaviour, HIV counselling and testing should be offered actively to all clinic attenders.
确定性病门诊就诊者中艾滋病毒感染率的趋势，重点关注无注射吸毒史的异性恋者。
1991年至1996年（1993年除外）每半年对前来评估可能新发性病病例的性病门诊就诊者进行一次匿名非关联艾滋病毒调查，并获得个人同意。
在10940名符合条件的就诊者中，10046人（92%）接受了艾滋病毒检测。在所有接受检测的就诊者中，312人（3.1%）感染了艾滋病毒。艾滋病毒总体感染率从1991年的4.6%显著下降至1996年的2.8%。在除一个调查期外的所有时期，无注射吸毒史的异性恋男性和女性中的艾滋病毒感染率均低于1%。除一名女性外，48名感染艾滋病毒的异性恋者中无人知晓自己目前的血清学状态。在感染艾滋病毒的异性恋者中，28名男性中有21名（75%）、20名女性中有18名（90%）非荷兰籍。所有男同性恋者中的艾滋病毒感染率为16%，年龄<30岁的年轻男同性恋者中的感染率为12%。年轻男同性恋者中的艾滋病毒感染率随时间显著下降。在感染艾滋病毒的男同性恋者中，58%的年长男性和59%的年轻男性不知晓自己目前感染了艾滋病毒。与未感染艾滋病毒的参与者相比，感染艾滋病毒的参与者中当前性病发病率总体上显著更高。
尽管性病门诊异性恋就诊者中的艾滋病毒感染率较低，但存在明显的艾滋病毒通过性传播的可能性。大多数异性传播的艾滋病毒感染病例见于非荷兰籍人士。这一观察结果提示感染艾滋病毒的异性恋者存在迁移情况，或荷兰和非荷兰异性恋者社交网络相互隔离。感染艾滋病毒的异性恋者几乎无人知晓自己的血清学状态，性病门诊男同性恋就诊者中知晓率也较低。为提高对当前艾滋病毒血清学状态的知晓率并可能降低危险行为，应积极为所有门诊就诊者提供艾滋病毒咨询和检测服务。
