A national study of the prevalence of HIV antibody in homosexual and heterosexual patients attending sexually transmitted disease clinics in the years 1985-7 was continued in 1988. Among homosexual men in two clinics in south east England HIV antibody was less prevalent in 1988 (30 (7.1%) of 420) than in 1987 (81 (14.6%) of 556) but was more prevalent in 1988 in other regions where the corresponding findings were 48 (4.9%) of 975 and 36 (2.8%) of 1291. HIV antibody prevalence continued to be higher in homosexual men aged 25 or more years or with one or more specified minor complaints. The trend was similar in heterosexual patients: among men in the south east in 1988 HIV antibody was found in 1 (0.1%) of 948 but in 10 (1.0%) of 962 in 1987 and among women in 1 (0.1%) of 1043 in 1988 but in 7 (0.7%) of 949 in 1987. In other regions the corresponding findings for men were 2 (0.1%) of 5620 in 1988 and 3 (0.1%) of 5312 in 1987 and for women were 7 (0.2%) of 4483 in 1988 and 1 (0.1%) of 4778 in 1987. The two most notable differences between findings in 1987 and 1988 were that in the south east the number of heterosexual intravenous drug abusers with HIV antibody decreased from five to one among men and from five to none among women and for the first time in the study HIV antibody positive women without known risk factors were identified--1 (0.1%) of 1043 in the south east and 2 (0.04%) of 4483 in other regions. Refusals to participate continued to increase but, as before, comparison of patients who agreed and refused in terms of age, the presence of symptoms suggesting HIV infection, travel abroad, and number of sexual partners in the past twelve months showed little evidence of selective bias that might have artificially reduced the prevalence.
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