title: Sexually transmitted diseases and HIV-1 infection among homosexual men in England and Wales.
abstract: OBJECTIVE
  To examine surveillance data for evidence of changing sexual behaviour and continuing transmission of HIV-1 among men who have sex with men.
  
  
  METHODS
  Analytic study of surveillance data on sexually transmitted diseases.
  
  
  METHODS
  England and Wales.
  
  
  METHODS
  Number of cases of rectal gonorrhoea and newly diagnosed HIV infection in homosexual men.
  
  
  RESULTS
  New cases of gonorrhoea among men attending genitourinary medicine clinics increased by 7.7% in 1989 and by 4.2% in 1990. Reports of rectal isolates of Neisseria gonorrhoeae also rose and the male to female ratio for patients with rectal gonorrhoea changed from 0.3:1 during 1988-9 to 2.6:1 in 1990-1. Although the overall number of cases of acute hepatitis B fell during 1988-91, 81 and 82 homosexual men were infected in 1990 and 1991 respectively compared with 50 and 42 in 1988 and 1989. 1526 men had HIV-1 infection diagnosed in 1991, the largest number since 1987. Twenty eight of the 97 (29%) men who seroconverted between January 1989 and December 1991 were aged less than 25. The proportion of men aged 15-19 who were found to be infected with HIV-1 at their first test increased from an average of 2.4% up to 1990 to 4.7% in the first nine months of 1991. The prevalence of HIV infection in men under 25 attending genitourinary medicine clinics in London was 17% compared with 7.8% outside London.
  
  
  CONCLUSIONS
  Unsafe sexual behaviour and HIV transmissions have increased among homosexual men after a period of decline. Recent HIV transmissions may disproportionately affect younger men.
authors: Public Health Laboratory Service AIDS Centre, Communicable Disease Surveillance Centre, London.
authors: B G
authors: BG
authors: Evans
authors: M A
authors: MA
authors: Catchpole
authors: J
authors: J
authors: Heptonstall
authors: J Y
authors: JY
authors: Mortimer
authors: C A
authors: CA
authors: McCarrigle
authors: A G
authors: AG
authors: Nicoll
authors: P
authors: P
authors: Waight
authors: O N
authors: ON
authors: Gill
authors: A V
authors: AV
authors: Swan
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000635:transmission*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D004739:England / Q000453:epidemiology; D006069:Gonorrhea / Q000453:epidemiology / Q000635:transmission*; D015497:HIV-1; D006716:Homosexuality; D006801:Humans; D015994:Incidence; D008297:Male; D015995:Prevalence; D012002:Rectal Diseases / Q000453:epidemiology / Q000209:etiology*; D012307:Risk Factors; D014852:Wales / Q000453:epidemiology