Trends in the incidence of HIV in Scotland, 1988–2009
- Scott A McDonald1,2,
- Sharon J Hutchinson1,2,
- Lesley A Wallace1,
- Sheila O Cameron3,
- Kate Templeton4,
- Paul McIntyre5,
- Pamela Molyneaux6,
- Amanda Weir1,
- Glenn Codere1,
- David J Goldberg1
- 1Health Protection Scotland, Glasgow, UK
- 2Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK
- 3West of Scotland Specialist Virology Centre, Gartnavel General Hospital, Glasgow, UK
- 4East of Scotland Specialist Virology Centre, Royal Infirmary of Edinburgh, Edinburgh, UK
- 5Department of Medical Microbiology, Ninewells Hospital and Medical School, Dundee, UK
- 6Department of Medical Microbiology, University Medical School, Aberdeen, UK
- Correspondence to Dr Scott A McDonald, Health Protection Scotland, Meridian Court, 5 Cadogan Street, Glasgow G2 6QE, UK;
Contributors SAM performed the statistical analyses and drafted the manuscript. SAM and SJH were involved in the study design and chose the main directions for analysis. GC and AW assisted in preparation and record-linkage of the data source. SJH, DJG, SC, LAW, KT, PM and PMc interpreted the results and revised the manuscript before submission. All authors have approved the final version of this manuscript.
- Accepted 9 November 2011
- Published Online First 8 December 2011
Objectives To estimate temporal trends in HIV incidence and prevalence in Scotland, according to three main risk groups for infection: men who have sex with men (MSM), injecting drug users (IDUs) and heterosexuals.
Methods The authors extracted data for all single- and multiple-tested individuals from the national HIV test database covering the period 1980–2009 and calculated the incidence of HIV infection in each risk group and estimated RRs by fitting Poisson regression models.
Results 620 of 59 807 individuals tested positive following an initial negative HIV test, generating an overall incidence rate of 3.7/1000 person-years (95% CI 3.4 to 4.0); 60%, 20% and 37% of the 620 were associated with the risk behaviour categories MSM, IDU and heterosexual, respectively. The incidence rate among MSM in Scotland remained relatively stable between the periods <1995 and 2005–2009 (overall: 15.3/1000 person-years, 95% CI 13.8 to 17.0), whereas the incidence among IDUs decreased between the periods <1995 and 2005–2009, from 5.1/1000 to 1.7/1000 person-years, and also decreased among heterosexuals, from 2.9/1000 to 1.4/1000 person-years.
Conclusions The reduction in the incidence rate among IDUs suggests that harm reduction measures initiated from the late 1980s were effective in reducing HIV transmission in this risk group; however, the absence of a reduction in HIV incidence rates among MSM is disappointing and highlights the need for renewed efforts in the prevention of HIV in this major risk group.
- men who have sex with men
- injecting drug users
- epidemiology (general)
- hepatitis C
- virology clinical
Competing interests None.
Ethics approval It is a database study, involving anonymised records.
Provenance and peer review Not commissioned; externally peer reviewed.