A system for surveillance of voluntary HIV testing: results of the first 2 years, 1989-1990

In 1988, in order to improve the already established surveillance of AIDS and HIV-infected cases in Scotland, UK, the Communicable Diseases (Scotland) Unit [CD(S)U], in collaboration with microbiologists responsible for HIV testing, instituted a routine system for the epidemiological surveillance of all voluntary HIV tests.

To facilitate information capture, a standardized HIV request form was introduced for use throughout the country by clinicians requesting an HIV test. In addition, a network of laboratory computers, operated by clerical personnel, was established for the collection and collation of data.

In 1989, of 9483 individuals tested for HIV, 129 (1.4%) were HIV-antibody-positive compared with 130 (1.2%) of 11,111 tested in 1990. A comparison of 1989 with 1990 rates of HIV among specific population groups, including injecting drug users (4.1%, 1989; 2.7%, 1990), homosexual men (5.2%, 1989; 4.5%, 1990), heterosexual men and women with high-risk partners (1.6%, 1989; 1.8%, 1990) and heterosexual men and women with lesser risk (0.3%, 1989; 0.5%, 1990), revealed no statistically significance differences at a 95% level of confidence.

We believe that this surveillance system is the first of its kind to be implemented on a nationwide basis. The first 2 years' findings suggest a degree of stability in new transmissions of HIV occurring in Scotland. However, the increasing numbers of those known to be HIV-infected continue to cause considerable concern: 1943 individuals were reported to CD(S)U as HIV-antibody-positive by December 1991.