Two Methods for Assessing the Risk-factor Composition of the HIV-1 Epidemic in Heterosexual Women: Southeast England, 1988-1991

Objective: The prevalence of HIV-1 in the heterosexual population in southeast England between 1988 and 1991 was examined using two methods.

Design And Methods: First, district neonatal seroprevalence was compared on a geographical basis to social and demographic variables reflecting risk-factor prevalence. Second, over the same period eight children who developed AIDS within the first 12 months of life were born.

Results: The differences in seroprevalence between districts could be explained by the proportion of livebirths to women born in parts of Africa. An estimated 92% of neonatal seropositives could be associated with this demographic variable. The proportions of livebirths to women born in other countries, the prevalence of notified injecting drug use, and area measures of social deprivation, were only poorly related to HIV seroprevalence, and had no additional explanatory value. Seven of the eight (87.5%) children who developed AIDS in the first year were born to black women from Africa.

Conclusions: Both methods suggest that a high proportion of heterosexually transmitted HIV in southeast England has been imported.