Objective: To determine prevalence of hepatitis B virus (HBV) serological markers in Chinese residents in the United Kingdom. Method: Retrospective case-controlled study between January 1997 and June 2000 in two genitourinary medicine (GUM) clinics. Results: 117 Chinese and 234 non-Chinese controls were studied. Baseline characteristics except marital status showed no difference. Overall prevalence of HBV serological markers was 35.8% in Chinese, controls 5.5% (p<0.001). Hepatitis B surface antigen (HBsAg) positive carrier rate was 12.8% in Chinese, controls 0.4% (p<0.001); 1.7% of Chinese patients were also hepatitis B e antigen (HBeAg) positive, none in controls. Natural immunity was acquired in 23.0% of Chinese, controls 5.1% (p<0.001). Prevalence of HBV serological markers in UK born Chinese was 6.7%, non-UK born Chinese 40.1% (p<0.011). Only 7.6% of Chinese had a history of previous HBV vaccination. Conclusions: Prevalence of HBV serological markers among Chinese patients attending two GUM clinics in London was high and only a minority of Chinese had immunisation against HBV. Although the prevalence of HBV markers in UK born Chinese was lower than non-UK born Chinese, they may be at continuous risk of HBV infection. Non-UK born Chinese patients attending GUM services in the United Kingdom should be targeted for screening and vaccination to reduce HBV transmission.

Compared with other published studies the completion rate of HIV-PEP in our study was high. The uptake and adverse events of HAART in this scenario were similar to previously published studies. A multidisciplinary approach to the management of this patient group will improve adherence to PEP.

Objectives: To determine the prevalence of sexually transmitted infections (STIs) and the mental health needs of female child and adolescent survivors of rape and sexual assault who were referred to a specialist genitourinary medicine (GUM) clinic. Method: Retrospective case notes review of 98 females aged 16 or less, who attended over a 5 year period (1996)(1997)(1998)(1999)(2000). Results: The overall prevalence of STIs was 26%. Among the girls who were aged 0-12 years (n = 16), one had gonorrhoea and another had Trichomonas vaginalis infection. Prevalence of STIs in those aged 13-16 years, who were not sexually active before the index assault, was 24% and in those who gave a history of previous consensual sexual activity it was 39% (p = 0.17). Chlamydial infection was more common among the girls who disclosed previous consensual sexual activity than in those did not disclose previous sexual activity (p = 0.012). The overall prevalence of vaginal candidiasis was 17% and bacterial vaginosis 13%. More than one third of the study population gave a history of previous sexual, physical, or other abuse. 81% reported having current psychological difficulties. Mood changes and sleep disturbances were reported more frequently than other psychological symptoms; 15% attempted self harm. All types of psychological difficulties, except mood changes, were not affected by the time interval between index assault and first presentation to the clinic and the type of assailant. 29% had no involvement with social and mental health services before their attendance at the clinic Conclusions: The prevalence of STIs among female child and adolescent survivors of rape and sexual assault attending a specialist clinic was high. The range of mental health and social difficulties was wide and multiple. The importance of an early assessment for the presence of STIs and mental health difficulties was demonstrated. S exual abuse of children and adolescents is widespread.

Objectives To determine whether HIV‐infected mothers knew the HIV status of their children, enabling the offer of targeted testing of children at risk. Methods All HIV‐positive women attending the genitourinary medicine clinic at a district general hospital in the United Kingdom were asked whether they had children and the age, HIV status and residence of their children using a standardized proforma. Results A total of 297 HIV‐positive women were included in a prospective audit. Two hundred and fifty‐four women had 551 offspring; 143 had a total of 217 children aged <16 years. Of those children, 118 lived in the United Kingdom. Of the 99 children living abroad, 71% were living in Zimbabwe, 21% in other African countries (Zambia, Kenya, Burundi, Malawi and South Africa) and 5% in Jamaica and other Caribbean countries. Of the 118 children living in the UK, mothers knew the HIV status in 49 (42%), of whom nine (18%) were HIV positive. A further two older offspring were also HIV positive. Mothers were aware of the HIV status in significantly fewer children staying in the country of origin: nine (9%; P<0.05), of whom four were known to be HIV positive. All HIV‐positive children living in the United Kingdom were under the care of paediatricians with special expertise in paediatric HIV infection. Conclusions The HIV status of the majority of children of HIV‐positive immigrant mothers is unknown, particularly those children who remain in their country of origin.