title: Trends in HIV infection among sexually transmitted disease patients in Paris.
abstract: OBJECTIVE
  To assess trends in HIV infection among sexually transmitted disease (STD) patients.
  
  
  METHODS
  Repeated unlinked anonymous survey, 1991-1993.
  
  
  METHODS
  STD clinics in Paris, France.
  
  
  METHODS
  Patients (n = 4354) with a new suspected STD.
  
  
  METHODS
  HIV antibody testing, using blood from syphilis samples.
  
  
  RESULTS
  HIV prevalences were stable over time in all transmission groups. One-third of homo-/bisexual men were HIV-positive. Prevalence was 2.5 times higher among heterosexual patients from Africa or the Caribbean than among those from other countries. Among patients under 25 years of age prevalence significantly decreased from 4.3% in 1991 to 0.8% in 1993 (P = 0.01). Among homo-/bisexual men, despite a 50% reduction in the incidence of STD, the absolute number of those newly HIV-infected remained stable; median age increased from 28 years in 1991 to 32 years in 1993 (P = 0.02). Among heterosexuals, trends in HIV incidence were difficult to assess: recently infected patients were more likely to be identified in 1993 than in 1991, since the proportion of patients who reported a recent HIV-negative test increased over time.
  
  
  CONCLUSIONS
  Prevalence studies contribute to define specific subgroups which should be targeted for prevention (HIV-positive or older homosexuals, heterosexuals from Africa and the Caribbean). Despite a decrease in both overall STD incidence and HIV prevalence among patients aged under 25 years, overall HIV incidence has not decreased, at least among homo-/bisexual men in whom recent HIV infections occurred at a high rate overall, and increased in those aged 35 years or more. Sentinel site-based HIV seroprevalence studies are best interpreted in the light of results obtained from different populations and through routine surveillance of STD.
authors.affiliation: Department of Epidemiology, INSERM U292, Bicêtre Hospital, Le Kremlin-Bicêtre, France.
authors.forename: L
authors.initials: L
authors.lastname: Meyer
authors.forename: E
authors.initials: E
authors.lastname: Couturier
authors.forename: Y
authors.initials: Y
authors.lastname: Brossard
authors.forename: M
authors.initials: M
authors.lastname: Janier
authors.forename: Y
authors.initials: Y
authors.lastname: Taquin
authors.forename: J P
authors.initials: JP
authors.lastname: Mertz
authors.forename: H
authors.initials: H
authors.lastname: Helal
authors.forename: J M
authors.initials: JM
authors.lastname: Bohot
authors.forename: J E
authors.initials: JE
authors.lastname: Malkin
authors.forename: P
authors.initials: P
authors.lastname: Franceschini
authors.forename: J B
authors.initials: JB
authors.lastname: Brunet
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities; D005260:Female; D015483:HIV Antibodies / Q000097:blood; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D010297:Paris / Q000453:epidemiology; D015995:Prevalence; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000453:epidemiology
chemical_list: D015483:HIV Antibodies