OPEN ACCESS CLINIC PROVIDING HIV-I ANTIBODY RESULTS ON DAY OF TESTING - THE 1ST 12 MONTHS

Objectives - To determine the sociodemographic profile, risk category, and prevalence of HIV-1 infection among people attending a clinic providing counselling, medical advice, and results of HIV-1 antibody testing on the day of consultation; to determine the stage of infection and peripheral blood CD4 cell count among attenders with detectable HIV-1 antibodies. Design - Analysis of prospectively collected data for the 12 months from March 1989. Setting - Same day testing clinic run by the HIV/AIDS team at an urban teaching hospital. Patients - 561 consecutive people choosing to attend and proceeding to HIV-1 testing. Results - The demand for the service caused it to run to capacity within six months. The median age of those attending was 28 years and 65% (364 patients) were male. The overall prevalence of HIV-1 infection was 3.9% (22 patients). The greatest prevalence was in men reporting their primary risk as homosexual contact (11.9%, 13/109. The median CD4 cell count in the 22 patients who had detectable HIV-1 antibodies was 0.31 X 10(9) cells/l (normal range 0.5 X l0(9)/l to 1.2 X l0(9)/l). Twenty of these patients were asymptomatic (Centers for Disease Control stages 11 or 111), 14 had CD4 cell counts below 0.5 X l0(9)/l. Conclusions - There is a recognisable demand for a service providing rapid results of HIV-1 antibody testing in this setting. The overall seroprevalence of 3.9% is comparable with the 5.8% reported from freestanding clinics in the United States. Most patients with HIV-I antibodies detected in this way are asymptomatic but could benefit from early medical intervention because of low CD4 cell counts.