title: Black Caribbean adults with HIV in England, Wales, and Northern Ireland: an emerging epidemic?
abstract: BACKGROUND
  HIV is now well established in the Caribbean, with prevalence in several countries being surpassed only by those of sub-Saharan Africa. Continuing inward migration from the Caribbean and a high incidence of some bacterial STIs among Britain's black Caribbean communities, suggests a considerable potential for HIV spread.
  
  
  METHODS
  Data from three national HIV/AIDS surveillance systems were reviewed, providing information on new HIV diagnoses, numbers accessing treatment and care services, and HIV prevalence.
  
  
  RESULTS
  Between 1997 and 2001, 528 black Caribbean adults were newly diagnosed with HIV; 62 new diagnoses in 1997, rising to 176 in 2001. Probable heterosexual acquisition accounted for 335 (63%) infections (161 (48%) males, 174 females), and sex between men 171 (32%). Infection was acquired both in the Caribbean and in the United Kingdom. Numbers of black Caribbeans accessing treatment and care services more than doubled between 1997 (294) and 2001 (691). In 2001, 528 (76%) black Caribbeans accessing services were London residents. Among the Caribbean born previously undiagnosed heterosexuals, HIV prevalence was 0.7%; among men who have sex with men (MSM) it was 10.4%. Of those born in the Caribbean, 73% of male heterosexuals, 50% of female heterosexuals, and 65% of MSM who were previously undiagnosed left the clinic unaware of their HIV infection.
  
  
  CONCLUSIONS
  Numbers of black Caribbean adults newly diagnosed and accessing treatment and care services in England, Wales, and Northern Ireland increased between 1997 and 2001. Despite a high prevalence of diagnosed bacterial STIs, prevalence among Caribbean born heterosexuals remains low, but it is high among MSM. Surveillance data highlight the need for targeted HIV prevention among black Caribbeans.
authors.affiliation: Health Protection Agency, Communicable Disease Surveillance Centre, 61 Colindale Avenue, London NW9 5EQ, UK. sarah.dougan@hpa.org.uk
authors.forename: S
authors.initials: S
authors.lastname: Dougan
authors.forename: L J C
authors.initials: LJ
authors.lastname: Payne
authors.forename: A E
authors.initials: AE
authors.lastname: Brown
authors.forename: K A
authors.initials: KA
authors.lastname: Fenton
authors.forename: L
authors.initials: L
authors.lastname: Logan
authors.forename: B G
authors.initials: BG
authors.lastname: Evans
authors.forename: O N
authors.initials: ON
authors.lastname: Gill
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D044383:Black People / Q000208:ethnology; D004196:Disease Outbreaks; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000208:ethnology*; D020010:Heterosexuality / Q000208:ethnology; D018451:Homosexuality, Male / Q000208:ethnology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology; D015995:Prevalence; D012111:Residence Characteristics; D006113:United Kingdom / Q000453:epidemiology; D014900:West Indies / Q000208:ethnology