HIV RISK-FACTORS AND SEROPREVALENCE IN SURGICAL PATIENTS

Objective: To determine the prevalence of risk factors for human immunodeficiency virus (HIV) infection, and HIV-1 seroprevalence, in surgical patients. Design: Prospective study in which consenting patients completed a questionnaire on from potentially related to a higher risk of HIV infection, and underwent an HIV-1 antibody test. Patients and setting: Both elective and emergency surgical admissions between July and November 1990 at St Vincent's Hospital, Sydney. Results: Of 1292 patients who were approached to participate, 27 had been previously diagnosed with HIV-1 infection and, of the remaining 1265, eight (0.63%) refused to answer the questionnaire and undergo a blood test, and 12 (0.95%) refused the blood test only. HIV-1 antibody testing was completed for 1171 study subjects. Twenty-six of the 807 men who answered the questionnaire had been previously diagnosed with HIV-1 infection. Of the remaining 781 male patients, 133 (17%) reported a history of homosexual contact, injecting drug use or blood transfusion, 132 (17%) had had a prior HIV-1 antibody test and three were newly diagnosed with HIV-1 infection as a result of the survey. Of 476 women who completed the questionnaire, one had been previously diagnosed with HIV-1 infection, and of the remaining 475, 59 (12.4%) reported injecting drug use or a blood transfusion and 72 (15%) had had a prior HIV-1 antibody test. No women were newly diagnosed with HIV-1 infection. Of patients reporting specific factors, the proportion who had had a prior HIV-1 antibody test varied from 62% for men reporting homosexual contact to 34% for recipients of a blood transfusion between 1980 and 1985. Conclusion: Although an appreciable proportion of surgical patients admitted to St Vincent's Hospital reported factors associated with a higher risk of HIV infection, the prevalence of undiagnosed HIV-1 infection is very low, particularly among patients reporting no such factors.