A prospective STD surveillance system was developed in Italy in 1990. Newly diagnosed cases of sexually transmitted disease (STD) are reported by a network of 45 sentinel STD clinics throughout the country. A total of 10,253 patients were reported between September 1990 and December 1991. The most frequent diagnoses were genital warts (30.8%), non-specific genital infection (male) (12.8%), and non-specific genital infection (female) (11.5%). All patients were asked to undergo an HIV test; 68.4% accepted, of whom 9.3% were seropositive. During the 16-month study period HIV prevalence decreased among IDUs and homo-bisexuals, but increased among non-IDU heterosexuals. These data suggest that STD patients may represent a useful early warning system to detect changes in the epidemic and in the spread of the virus among low-risk heterosexuals. A better counselling programme is needed to improve the acceptance rate of HIV testing among STD patients, and to draw more attention to at-risk sexual behaviours.
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Suligoi et al. (1994) studied this question.