Unlinked anonymous HIV study of hospital patients and general practice attenders in Glasgow, 1991-1997

Aim-To determine whether HIV is spreading from injecting drug users and hom osexual/bisexual males into lower risk heterosexual populations in Glasgow, Scotland, and to pilot a method of monitoring HIV prevalence which involve s testing routine biochemistry specimens. Methods-An unlinked anonymous HIV testing study of hospital patients and ge neral practice attenders was conducted during January 1992 to December 1997 . Testing was performed on routine biochemistry specimens from patients age d 16-49 years attending two hospitals with catchment areas covering the nor th and the east of the city. Results-78 260 specimens were tested in the study period and no patient obj ected to their samples being tested anonymously HIV prevalence rates among male and female subjects were 0.63% and 0.01%, respectively; the large diff erence in prevalence resulted, in part, from the inclusion of HIV infected haemophiliac patients who attended one of the hospitals. Prevalence among m ale general practice patients ranged between 0.1% and 0.2%, while that for male patients attending surgical or surgically related specialties was 0.1% . Conclusions-The prevalence data indicate that HIV has not seeded from the h igh risk groups into the wilder heterosexual population, and that the risk of a surgeon acquiring HIV occupationally is extremely low in a city which has an HIV prevalence similar to or greater than that seen in most other pa rts of the United Kingdom. Large numbers of residual specimens from busy bi ochemistry laboratories can be processed for unlinked anonymous testing wit hout interfering with the laboratories' routine functions. This survey appr oach might be best suited to monitoring HIV trends in developing countries with relatively high prevalence rates and where transmission is principally heterosexual.