Trends in HIV seroprevalence among patients with sexually transmitted diseases in 17 European sentinel networks, 1990-1996

Objective: To monitor trends in HIV seroprevalence among sentinel populatio ns of patients with new sexually transmitted disease episodes in 17 network s of 15 European countries. Methods: Time trends were estimated by logistic regression for homo-/bisexu al men, injecting drug users (IDU) and non-IDU heterosexuals. The networks were included as independent variables to account for different prevalence levels across Europe. Sociodemographic and behavioural data were also inclu ded in the model. The interactions of time and each factor in the model wer e evaluated to determine whether trends differed across networks or populat ion subgroups. Results: Overall, more than 150 000 sexually transmitted disease episodes w ere registered in this study. In the European network as a whole, the preva lence decreased significantly among IDU [n = 2619; odds ratio (OR) for annu al change, 0.86; 95% confidence interval (CI), 0.80-0.93]. It also decrease d among homo-/bisexual men (n = 11 809; OR, 0.92; 95% CI, 0.89-0.94). In bo th groups, trends did not differ statistically between networks. Among non- IDU heterosexuals (n = 114 024) the prevalence increased significantly (OR 1.08; 95% CI, 1.04-1.13), especially among women (OR, 1.13) and the time tr ends differed statistically across networks. A significant increase was obs erved in four networks, whereas no specific change was detected in the othe rs. Conclusions: By applying a standardized protocol, trends in HIV prevalence could be compared across networks and estimated at a more global level. For the validity of HIV trends in such surveys, it is essential to minimize th e number of patients not being tested in networks where voluntary testing i s required. (C) 2000 Lippincott Williams & Wilkins.