14th Annual Conference of the British HIV Association 23–25 April 2008, Belfast

SHOULD WE TARGET COMMUNITY AND PRIMARY CARE HIV TESTING EFFORTS IN CERTAIN AREAS? ESTIMATES OF HIV PREVALENCE FOR KEY PREVENTION GROUPS BY REGION AND LOCAL AUTHORITY (LA) IN ENGLAND

HIV Med 2008; 9(Suppl. 1):1 (abstract no. O1)

T Chadborn, K Hutton, V Delpech and B Rice
Health Protection Agency, London, UK

BACKGROUND: CDC recommends routine HIV screening in all 13–64 year olds in health-care settings with a diagnosis rate of at least 0.1%. UK and Europe are considering how to expand HIV testing to reduce late diagnoses and incidence. Overall UK HIV prevalence is about 0.12% with one in three undiagnosed.

METHODS: Diagnosed HIV prevalence for each LA was calculated using 2006 SOPHID data (survey of persons diagnosed with HIV) in combination with ONS population estimates (ages 16–64 for men, 16–59 for women) for 2005 by ethnic group and LA and NATSAL estimates of the proportion of the population of men who have had sex with men in the last 5 years (MSM).

RESULTS: Diagnosed HIV prevalence was >1% among MSM and black African heterosexuals in all SHA. Of the 354 LAs: diagnosed HIV prevalence was >0.1% in all white men in 76 (21%) LAs and >0.02% in almost all other LAs. If 2.6% of all men outside London were MSM, the lowest HIV prevalence in MSM would be 0.25%. Diagnosed HIV prevalence was >0.1% in all white women in Lambeth and >0.05% in 15 LAs (mostly London). For black African women, almost all LAs with populations >299 had >2.0% prevalence.

CONCLUSIONS: Discussions continue about how to enhance HIV testing but the epidemiology suggests a localized approach of targeting offers of HIV testing based on a simple risk assessment. This would also allow for local patient acceptability and setting appropriateness to be considered. Partner notification (including of the long-term diagnosed) is likely to be key to the earlier diagnosis of people in low prevalence areas.

2007-04-23
O1

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