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We reviewed the use of HIV prevalence data from blood donors for surveillance purposes and for the estimation of HIV prevalence. Fifty countries with generalized epidemics were considered. Data on HIV prevalence in blood donors were compared with published estimates of adult HIV prevalence. In most of the 19 countries with similar estimates, blood donations came primarily from replacement donors. Our analysis suggests that blood donors are usually not a good proxy for the general population.

Objectives: To evaluate rates and predictors of testing and HIV positivity among the sexual partners of Italian HIV-positive haemophiliacs., Methods: Our index cases were 602 sexually active HIV-positive haemophiliacs (aged 18 years or more) enrolled in the Italian Registry of Haemophilia. Data on the demographic and clinical status of the haemophiliacs, whether their partners had undergone HIV testing, and the results of these tests were collected., Results: To date, 205 (34.1%) partners of HIV-positive haemophiliacs have been tested for HIV, of whom 27 (13.2%) were seropositive. On univariate analysis, haemophiliacs who were unmarried, younger, and asymptomatic were less likely to have partners who had been tested for HIV (P << 0.001). On multivariate analysis, unmarried status [odds ratio (OR), 8.4; 95% confidence interval (CI), 5.4-13.1; P << 0.001] and younger age (OR, 1.9; 95% CI, 1.1-3.2) again predicted a higher rate of non-tested partners. There was no association between the demographic and medical characteristics of HIV-seropositive haemophiliacs and the risk of HIV positivity among their sexual partners., Conclusion: This study demonstrates that a high proportion of sexual partners of HIV-positive haemophiliacs have not yet been tested for HIV. The single most important predictor of not being tested was the marital status of the index case. These results emphasize the need to strengthen prevention programmes aimed at minimizing the risk of heterosexual HIV transmission, particularly among younger unmarried haemophiliacs.

To investigate the interval between HIV-1 infection and the development of clinical AIDS among Italian patients with congenital coagulation disorders, a national cohort study was undertaken in 1988. Information was collected both retrospectively and prospectively on 499 HIV-1-positive patients enrolled in an ongoing national registry of patients with congenital coagulation disorders. Two methods were used to estimate each patient's seroconversion date: the mid-point between the last negative (either known or estimated) and the first positive test, and the median under a Weibull distribution, which was assumed to fit seroconversion data. The two methods of estimating the seroconversion time yielded similar results. The actuarial incidence of AIDS was estimated using the Kaplan-Meier survival analysis at 12.8% (95% confidence interval = 9.7-15.9) over 7 years for Italian haemophiliacs. Progression appears to be slow in the first 5 years after the infection, and to rise steadily thereafter. A strong association between faster progression and older age at seroconversion was found. Zidovudine-treated individuals seem to have a slower progression than untreated individuals, after controlling for CD4, but there was no association between progression and type and severity of the congenital disorder.