Abstract

A multicentre investigation was made into the prevalence of sexually transmitted diseases and HIV infection amongst homosexual/bisexual (HS/BS) men attending genitourinary medicine clinics in the UK during the final quarters of 1986, 1987, and 1988. The results from individual clinics have been collated into regional groupings in order to assess geographical and temporal trends. A statistical analysis has also been performed on the data from 19 large teaching hospital clinics which contributed to both the 1986 and 1988 studies. There was a marked decline in the numbers of HS/BS men attending clinics and a statistically significant decrease in the prevalence of infectious syphilis and gonorrhoea. Although there was a concomitant fall in HIV testing rates, the prevalence of newly detected HIV antibody positive patients remained virtually constant. In 1988, 12.2% of 544 HS/BS men attending clinics in the Thames regions compared with 5.9% of 895 attending clinics elsewhere in the UK were found to be seropositive. No less than 30% of the 122 newly diagnosed individuals had been seronegative at a previous test during 1987/88. In addition to these new diagnoses, there were 953 attenders who had been previously diagnosed as being HIV seropositive. Total HIV seropositivity rates amongst HS/BS attenders ranged from 15-29% in different regions. These overall figures may underestimate the true size of the seropositive HS/BS clinic population because of the large number of untested individuals which constituted 33-51% of clinic attenders. The proportion of seropositives with clinical manifestations of chronic HIV infection was 54% nationally and was highest in the Thames regions and lowest in North England. Despite changes in the sexual behaviour of HS/BS men in the UK during the mid-eighties, a large proportion have been infected with HIV which has become the most widespread and prevalent sexually transmitted disease in patients attending genitourinary medicine clinics.