More than one in five patients diagnosed with an Aids-related illness were not aware that they were HIV-positive, according to doctors from St Mary's Hospital in Paddington, one of London's main treatment centres.
Dr Mark Poznansky, lecturer in the Department of Genitourinary Medicine at St Mary's Hospital medical school, said yesterday that latest figures give no sign that the situation is improving. "There are real risks from a population of people who do not know they are HIV. We may be entering an iceberg phenomenon in which more people are unaware than the number who have been diagnosed."
The findings highlight the scale of the problem still to be faced, he said.
The patients in the study, reported in the latest edition of the British Medical Journal, were predominantly non-white and aged between 15 and 24. They all had similar lifestyles or risk factors for HIV. The homosexual: heterosexual ratio was about 65:25. There were more heterosexual women than men.
The analysis of the details of 436 HIV-positive men and women found that 97, or 22 per cent, did not realise their HIV status at the time of seeing a doctor for a first Aids illness. The remainder in the study had been diagnosed with HIV within the previous eight years and had been attending clinics. They were also being seen for their first Aids illness.
The diagnoses all took place between January 1991 and December 1993. But unpublished 1994 data show similar levels of unawareness.
Comparing the two groups Dr Poznansky and his colleagues found that the majority, who knew about their HIV, were more likely to have diseases associated with deficient immune systems, while the minority, who did not know, were more likely to have pneumonia and tuberculosis.
The knowledgeable group developed Aids diseases later than the ignorant group. But, as with other studies, overall survival did not seem to be affected by earlier medical help.
"I think we are talking about giving people a better quality of life for longer rather than increasing survival," Dr Poznansky said.Reuse content