1 Monitor sexual spread of HIV infection by following HIV seroprevalence levels over time: repeated cross-sectional estimates of prevalence could provide indirect estimates of the rates and changes in the acquisition of new infections in the population over time.
2 Serve as an early warning of spread of HIV infection outside the recognized risk groups: STD patients represent a group at increasing risk situated between the high-risk groups and the general population. The spread of HIV infection into other populations than the high-risk groups may be apparent first among STD patients.
3 Detect possible changes in the proportion and characteristics of infected STD patients, with a detailed registration of their risk behaviour.
A protocol for monitoring human immunodeficiency virus (HIV) among sexually transmitted disease (STD) patients has been developed. A total of 41 652 STD episodes have been registered, with an overall refusal rate for HIV testing of 5.2%, and the HIV-1 test result being known for 88.5% of the patients.
Genital warts was by far the most frequent diagnosis made, accounting for 29.3% of the STD episodes, followed by male urethritis.
The HIV seropositivity rates were usually much higher for males than females. They were highest in the age group 25-34 years. HIV infection was observed among patients aged less than 20 years in 5 of the 18 networks studied. The highest HIV seropositivity rates were observed among homosexuals or bisexuals and/or intravenous drug users.
Seropositive cases were however seen among noninjecting heterosexuals in the majority of the networks.
Seropositive cases among patients born or residing in HIV highly endemic countries were seen in 8 networks.
No significant increase over time was observed in the HIV seropositivity rates calculated for all STD patients. An increasing trend was observed over time among the heterosexual STD patients in the Italian and Portuguese networks.
The intent of this protocol is to provide a standardized set of procedures to be used in the conduct of this survey in the different participating countries. This standard approach should allow to aggregate the data collected at national level and provide figures on the European situation.