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Trends in, and determinants of, HIV testing at genitourinary medicine clinics and general practice in England, 1990–2000
  1. T R Chadborn1,
  2. C A McGarrigle1,
  3. P A Waight1,
  4. K A Fenton1,2,
  5. on behalf of the HIV Testing Surveillance Collaborative Group
  1. 1HIV/STI Division, Communicable Disease Surveillance Centre, Health Protection Agency, 61 Colindale Avenue, London NW9 5EQ, UK
  2. 2Department of STDs, Royal Free and University College London Medical School, off Capper Street, London WC1E 6AU, UK
  1. Correspondence to:
 Tim Chadborn
 HIV/STI Department, Communicable Disease Surveillance Centre, 61 Colindale Avenue, London NW9 5EQ, UK;


Objectives: To describe the trends in and determinants of HIV testing and positivity at genitourinary medicine (GUM) clinics and in general practice (GP) in England between 1990 and 2000.

Methods: Data on all first HIV specimens from GUM and GP clinics and tested at seven sentinel laboratories were related to key demographic, clinical, and behavioural variables.

Results: During the observation period, 202 892 eligible first HIV tests were reported. 90% (182 746) of specimens were from GUM clinics, of which 55% were from heterosexuals, 12% from men who have sex with men (MSM), and 3% from injecting drug users (IDU). In contrast, only 3% of GP specimens were from MSM and 13% from IDUs. The total number of first HIV tests increased threefold between 1990 and 2000. Overall, 1.6% of GUM and 0.9% of GP first testers were diagnosed HIV positive. In GUM clinics, HIV positivity was highest among heterosexuals who have lived in Africa (11.7%), MSM (6.9%), and IDUs (2.8%) and lowest among heterosexuals with no other specified risk (0.3%). Consistently lower prevalences were observed in GP settings. HIV positivity among GUM first testers declined in MSM, from 13.6% in 1990 to 5.2% in 2000 (p<0.01), and in IDUs, from 7.5% in 1990 to 2.0% in 2000 (p = 0.03). Prevalence remained constant in the groups heterosexually exposed to HIV infection.

Conclusions: HIV testing in GUM settings increased over the decade, with a concomitant reduction in HIV positivity among MSM and IDUs. Increased testing among heterosexual first testers overall was not associated with declining positivity.

  • HIV infections
  • HIV testing
  • STD clinics
  • general practice

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  • Conflict of interest: None