Epidemiology and outcome of HIV infection in North-East Scotland (1985-1997)

Objective: to assess the epidemiology of HIV infection in North-East Scotla nd. Methods: retrospective casenote review of all HIV-infected patients who hav e had contact with the Infection Unit in Aberdeen. Results: one hundred and forty-two HIV-infected patients were treated betwe en April 1985 and December 1997. The risk behaviour related to the acquisit ion of the HIV infection was: 56 (39%) homosexually infected, 45 (32%) hete rosexually-infected, 34 (24%) injecting drug users (IDUs), and seven (5%) b lood products or not known. Sixteen of the 45 (36%) heterosexually-infected patients were native to Africa and 16 of the 34 (31%) IDUs were prisoners in Peterhead prison at the time of referral. Fifty-two (37%) of the cohort continue to attend the Infection Unit, 41 (29%) have relocated, 40 (28%) ha ve died and nine (6%) have been lost to follow-up. The ratio of heterosexua l:homosexual men:IDUs changed significantly between the first 7 years (12:2 1:25) and the second 6 years (33:35:9) of the review, with significantly mo re patients being infected through heterosexual contact and fewer infected by IDU in the second period-P<0.001. The median AIDS survival was 17 months. Survival was significantly longer i n those patients who took anti-retroviral therapy (median = 20 months) than in the patients who opted not to take anti-retroviral therapy (median = 11 months)-P<0.01. Conclusions: Although homosexual contact represents the commonest risk grou p for HIV infection in this region, the number of heterosexually-infected p atients has increased significantly in the last 5 years. Temporary resident s account for one-third of the HIV-infected population cared for in NE Scot land, Almost half of those lost to follow-up have returned to Africa or bee n released from prison. The introduction of anti-retroviral therapy has res ulted in a dramatic improvement in AIDS survival in our cohort as it has do ne elsewhere.