Table 1 Hierarchical behavioural categories* and undiagnosed HIV prevalence definitions of the population of undiagnosed HIV infected individuals in the UK in 2003.
| Behavioural categories | ρg definition | πUirg source | πUirg definition | Adjustment made to UAPMP undiagnosed prevalence | Source of adjustments | |
|---|---|---|---|---|---|---|
| g1 | Current MSM, STD clinic attendees | Men reporting a male sexual partner in the past five years who have been to an STD clinic in the past five years | UAPMP STD clinic survey | HIV prevalence among MSM attending STD clinic not clinically diagnosed | ||
| Inner London | 1.0 | |||||
| Outer London | 0.29 | SOPHID,7 ratio of inner: outer London population rate of diagnosed HIV cases | ||||
| Rest of Britain | 0.78 | ONS,14 ratio of urban: rural population rate | ||||
| g2 | Current MSM not STD clinic attendees | Men reporting a male sexual partner in the past five years who have not been to an STD clinic in the last five years | UAPMP STD clinic survey | HIV prevalence among MSM attending STD clinic not clinically diagnosed adjusted for differential risk for HIV of non‐STD attendees (derived from the ratio of prevalence in STD attendees compared to non‐attendees; Dodds et al11 and the ratio of the proportion of STD attendees who have ever had an STI to non‐STD attendees, Johnson et al12) | ||
| Inner London | 0.79 | Dodds et al 200411 ratio of undiagnosed prevalence in STD attenders in last year compared to non‐STD attenders | ||||
| Outer London | 0.79*0.29 | Dodds et al 2004, (as above) + SOPHID, ratio of inner: outer population rate of diagnosed HIV cases | ||||
| Rest of Britain | 0.40*0.78 | Johnson et al,12 ratio of proportion who have ever had an STI of non‐STD attenders in the past 5 years to men who have attended in the past 5 years + ONS, ratio urban: rural population rate | ||||
| g3a | Current male IDU | Men reporting injecting drugs in the last five years where not a current MSM | UAPMP IDU survey | HIV prevalence among men attending specialist centres for IDU, not clinically diagnosed | 0.32 | UA IDU survey,15 proportion of HIV infections undiagnosed |
| g3b | Current female IDU | Women reporting injecting drugs in the last five years | UAPMP IDU survey | HIV prevalence among women attending specialist centres for IDU not clinically diagnosed | 0.32 | UA IDU survey, proportion of HIV infections undiagnosed |
| g4 | Past MSM | Men reporting a male anal sexual partner more than five years ago, no male sexual partner in the past five years and not a current IDU | UAPMP STD clinic survey | HIV prevalence among men not clinically diagnosed adjusted for differential risk for HIV of men not had sex with a man for more than 5 years (derived from the number of lifetime sexual partners of current MSM compared to past MSM, and the odds of having a previous STI by numbers of partners; Fenton et al16) | 0.1 | Fenton et al 2005,16 Natsal 2000, odds of previous STI with 10+ lifetime partners compared to one sexual partner |
| g5a | Past male IDU | Men reporting injecting drugs but who last injected more than five years ago where not a current MSM and not a past MSM | UAPMP IDU survey | HIV prevalence among men attending specialist centres for IDU who last injected more than five years ago, not clinically diagnosed | 0.03 | UA IDU survey, proportion of HIV infections undiagnosed |
| g5b | Past female IDU | Women reporting injecting drugs but who last injected more than five years ago | UAPMP IDU survey | HIV prevalence among women attending specialist centres for IDU who last injected more than five years ago not clinically diagnosed. | 0.03 | UA IDU survey, proportion of HIV infections undiagnosed |
| g6a | Current heterosexual males, STD clinic attendees, black African | Men, non‐virgin, reporting STD clinic attendance in past five years and never IDU and never had a same sex partner, of black‐African ethnicity | UAPMP STD clinic survey of men born in sub‐Saharan Africa | HIV prevalence among men born in sub‐Saharan Africa attending STD clinics, not clinically diagnosed | ||
| Inner London | 1.0 | |||||
| Outer London | 0.51 | SOPHID, ratio of inner:outer London population rate of diagnosed HIV cases | ||||
| Rest of Britain | 0.78 | ONS, ratio urban:rural population rate | ||||
| g7a | Current heterosexual males, STD clinic attendees, not black African | Men, non‐virgin, reporting STD clinic attendance in past five years, never IDU, who have never had a same sex partner and not of black‐African ethnicity | UAPMP STD clinic survey of men not born in sub‐Saharan Africa | HIV prevalence among men not born in sub‐Saharan Africa attending STD clinics, not clinically diagnosed. | ||
| Inner London | 1.0 | |||||
| Outer London | 0.51 | SOPHID, ratio of inner:outer London population rate of diagnosed HIV cases | ||||
| Rest of Britain | 0.78 | ONS, ratio urban:rural population rate | ||||
| g6b | Current heterosexual females, STD clinic attendees, black African | Women, non‐virgin, reporting STD clinic attendance in past five years but never IDU, of black‐African ethnicity | UAPMP STD clinic survey of women born in sub‐Saharan Africa | HIV prevalence among women born in sub‐Saharan Africa attending STD clinics and not clinically diagnosed | ||
| Inner London | 1.0 | |||||
| Outer London | 0.51 | SOPHID, ratio of inner:outer London population rate of diagnosed HIV cases | ||||
| Rest of Britain | 0.78 | ONS, ratio urban:rural population rate | ||||
| g7b | Current heterosexual females, STD clinic attendees, not black African | Women, non‐virgin, reporting STD clinic attendance in past five years but never IDU, not of black‐African ethnicity | UAPMP STD clinic survey of women not born in sub‐Saharan Africa | HIV prevalence among women not born in sub‐Saharan Africa attending STD clinics and not clinically diagnosed | ||
| Inner London | 1.0 | |||||
| Outer London | 0.51 | SOPHID, ratio of inner:outer London population rate of diagnosed HIV cases | ||||
| Rest of Britain | 0.78 | ONS, ratio urban:rural population rate | ||||
| g8a | Lower risk heterosexual males, black African | All men, non‐virgins, and are not in any of the above categories, of black‐African ethnicity | UAPMP DBS survey of women born in sub‐Saharan Africa | HIV prevalence of pregnant women born in sub‐Saharan Africa (adjusted for fertility (Nicoll et al17 & Cliffe et al18), known positives, and overlap with STD attendance and IDU (Johnson et al12)) | ||
| Inner London | 0.68*0.8/1.03 | UA DBS survey,15 undiagnosed proportion prenatal | ||||
| Outer London | 0.68*0.8/1.03 | + Natsal 2000, overlap of IDUs and STD attendance | ||||
| Rest of Britain | 0.65*0.8/0.8 | + Nicoll et al 1998,17 relative inclusion ratio (fertility adjustment) | ||||
| g9a | Medium risk heterosexual males, not black African | All men, non‐virgins, attended an STD clinic more than 5 years ago and are not in any of the above categories and not of black‐African ethnicity | UAPMP DBS survey of women not born in sub‐Saharan Africa | HIV prevalence of pregnant women not born in sub‐Saharan Africa (adjusted for fertility17,18 known positives, and overlap with STD attendance and IDU12 and proportion of STD clinic attendance more than 5 years ago (Gilbart et al19)) | ||
| Inner London | 0.68*0.8/1.03*0.33 | UA DBS survey,15 undiagnosed proportion prenatal | ||||
| Outer London | 0.68*0.8/1.03*0.33 | + Natsal 2000, overlap of IDUs and STD attendance | ||||
| Rest of Britain | 0.65*0.8/0.8*0.33 | + Nicoll et al 1998,17 relative inclusion ratio (fertility adjustment) | ||||
| + Gilbart et al 2006,19 proportion attended an STD clinic more than 5 years ago | ||||||
| g10a | Lower risk heterosexual males, not black African | All men non‐virgins and are not in any of the above categories and not of black‐African ethnicity | UAPMP DBS survey of women not born in sub‐Saharan Africa | HIV prevalence of pregnant women not born in sub‐Saharan Africa (adjusted for fertility17,18 known positives, and overlap with STD attendance and IDU12 and proportion never attended an STD clinic19) | ||
| Inner London | 0.64*0.8/1.03*0.67 | UA DBS survey,15 undiagnosed proportion prenatal | ||||
| Outer London | 0.64*0.8/1.03*0.67 | + Natsal 2000, overlap of IDUs and STD attendance | ||||
| Rest of Britain | 1.00*0.8/0.8*0.67 | + Nicoll et al 1998,17 relative inclusion ratio (fertility adjustment) | ||||
| + Gilbart et al 2006,19 proportion never attended an STD clinic | ||||||
| g8b | Lower risk heterosexual females, black African | All women, non‐virgins, and are not in any of the above behavioural categories, of black‐African ethnicity | UAPMP DBS survey of women born in sub‐Saharan Africa | HIV prevalence of pregnant women born in sub‐Saharan Africa (adjusted for fertility, known positives, and overlap with STD attendance and IDU) | ||
| Inner London | 0.61*0.8/1.03 | UA DBS survey, undiagnosed proportion pre‐natal | ||||
| Outer London | 0.61*0.8/1.03 | + Natsal 2000, overlap of IDU and STD attendance | ||||
| Rest of Britain | 1.00*0.8/0.8 | + Nicoll et al 1998, relative inclusion ratio (fertility adjustment) | ||||
| g9b | Medium risk heterosexual females, not black African | All women, non‐virgins, who attended an STD clinic more than 5 years ago and are not in any of the above behavioural categories and not of black‐African ethnicity | UAPMP DBS survey of women not born in sub‐Saharan Africa | HIV prevalence of pregnant women not born in sub‐Saharan Africa (adjusted for fertility, known positives, and overlap with STD attendance and IDU and proportion of STD clinic attendance more than 5 years ago) | ||
| Inner London | 0.64*0.8/1.03*0.33 | UA DBS survey, undiagnosed proportion prenatal | ||||
| Outer London | 0.64*0.8/1.03*0.33 | + Natsal 2000, overlap of IDU and STD attendance | ||||
| Rest of Britain | 1.00*0.8/0.8*0.33 | + Nicoll et al 1998, relative inclusion ratio (fertility adjustment) | ||||
| + Gilbart et al 2006, proportion attended an STD clinic more than 5 years ago | ||||||
| g10b | Lower risk heterosexual females, not black African | All women, non‐virgins, and are not in any of the above behavioural categories, not of black‐African ethnicity | UAPMP DBS survey of women not born in sub‐Saharan Africa | HIV prevalence of pregnant women not born in sub‐Saharan Africa (adjusted for fertility, known positives, and overlap with STD attendance and IDU and proportion who never attended an STD clinic) | UA DBS survey, undiagnosed proportion prenatal | |
| Inner London | 0.64*0.8/1.03*0.67 | + Natsal 2000, overlap of IDU and STD attendance | ||||
| Outer London | 0.64*0.8/1.03*0.67 | + Nicoll et al 1998, relative inclusion ratio (fertility adjustment) | ||||
| Rest of Britain | 1.00*0.8/0.8*0.67 | + Gilbart et al 2006, proportion never attended an STD clinic |
*All groups are mutually exclusive.