title: Regional differences in HIV testing among European patients with sexually transmitted diseases: trends in the history of HIV testing and knowledge of current serostatus.
abstract: OBJECTIVE
  To determine trends in (1) HIV testing and knowledge of current serostatus and (2) clinic-visits of aware HIV-infected patients and (3) to determine associates of incident HIV infection among patients with sexually transmitted disease (STD) in 15 countries participating in a European Community anonymous HIV seroprevalence survey.
  
  
  METHODS
  Demographics, STD diagnosis, self-reported history of HIV tests and current HIV test results were collected for patients diagnosed with one of 12 pre-selected STDs. Incident HIV infections were determined among patients who reported prior HIV-negative test results.
  
  
  RESULTS
  Between June 1990 and December 1996, 66560 STD patients were tested for HIV. Of these, 1581 (2.4%) reported a prior HIV-positive test. Of 41727 (62%) patients who reported no previous HIV test, 611 (1.4%) were HIV infected. Of 20785 (31%) patients who reported a prior HIV-negative test, 213 (1.0%) were HIV infected. Of 2467 (4%) patients without prior HIV test data available 123 (4.9%) were HIV infected. Overall, 63% of HIV-seropositive patients was aware of their HIV infection. Over time, the proportion of aware HIV-seropositive patients increased in some exposure categories in south and central Europe. Among the 11684 patients who reported dates of prior HIV-negative tests, 108 HIV infections were found. Compared with the north, HIV incidence was higher in the central region [odds ratio (OR), 1.23; 95% confidence interval (CI), 0.71-2.12] and in the south (OR, 4,39; 95% CI, 2.80-6.88) in all exposure categories except homosexual men.
  
  
  CONCLUSIONS
  Two-thirds of patients with an STD had never been tested for HIV. Of all HIV infections found, 32% were undiagnosed, indicating missed opportunities for counselling, safe sex education and referral for treatment. HIV testing should be routinely offered to all STD patients.
authors.affiliation: Municipal Health Service, Division of Public Health and Environment, Amsterdam, The Netherlands. hfennema@soagggd.amsterdam.nl
authors.forename: H
authors.initials: H
authors.lastname: Fennema
authors.forename: A
authors.initials: A
authors.lastname: van den Hoek
authors.forename: J
authors.initials: J
authors.lastname: van der Heijden
authors.forename: V
authors.initials: V
authors.lastname: Batter
authors.forename: A
authors.initials: A
authors.lastname: Stroobant
mesh_terms: D015492:AIDS Serodiagnosis; D000328:Adult; D005060:Europe / Q000453:epidemiology; D005260:Female; D015483:HIV Antibodies / Q000097:blood*; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology* / Q000821:virology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016036:Seroepidemiologic Studies; D012749:Sexually Transmitted Diseases
chemical_list: D015483:HIV Antibodies