Unlinked Anonymous Prevalence Monitoring Programme

The Unlinked Anonymous Prevalence Monitoring Programme which began in 1990 aims to measure the distribution of infection, in particular HIV, in accessible groups of the adult population.

The programme has a number of objectives, including assessing the effectiveness of voluntary confidential testing for clinical diagnosis of HIV infection. The data obtained are used to target and evaluate health promotion, to inform estimates of the numbers requiring treatment and care in the future, and to plan services for those affected by HIV and AIDS. Summaries of the data are published in Annual Reports.

The programme provides estimates of the prevalence of infection among groups in whom a substantial proportion of infections are undiagnosed and therefore not ascertained by other surveillance systems. Essential public health information on the prevalence of HIV infection in these groups cannot be obtained in any other way.

The programme monitors HIV infection levels in two population sub-groups:

• The first includes those whose behaviour puts them at increased risk of HIV infection, e.g. homosexual and bisexual men and heterosexual men and women attending genitourinary medicine clinics, and injecting drug users in contact with specialist treatment and support agencies or genitourinary medicine clinics.
• The second includes those at lower or general risk of infection, e.g. pregnant women or women having a termination of pregnancy.

1. To monitor the prevalence of, and associated risks for, HIV infection in accessible groups of those adults whose risk behaviour makes them vulnerable to infection, such as attenders at genitourinary medicine clinics and injecting drug users.

2. To measure, through serosurveillance of accessible groups, the impact of HIV infection on those who are less vulnerable behaviourally and are more broadly representative of the adult population.

3. To monitor closely the prevalence of HIV infection in London and to recognise emerging problems elsewhere.

4. To measure the effectiveness of voluntary confidential testing strategies for clinical diagnosis of HIV infections.

5. In combination with other data, to provide estimates of the total numbers of HIV-infected persons and to assist in projecting future numbers of persons with severe HIV disease who will require care.

6. To use specimens gathered by the programme to measure the prevalence of, and associated risk factors for, other important infections.

7. To make available programme data in a timely and accessible form so as to inform the targeting of health promotion, the assessment of the effectiveness of preventive measures, and the planning of medical and social services for those affected by HIV.

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