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Title: Human immunodeficiency virus : the Edinburgh epidemic
Author: Brettle, Raymond Patrick
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 1995
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For a variety of socio-economic reasons an epidemic of injection drug use (IDU) involving heroin occurred during the early 1980's in Edinburgh: one third were female, most were young, unemployed and living on large council estates. At the peak of this IDU epidemic, HIV arrived and rapidly spread through this community. By July 1989 over 1000 individuals or 0.1% of the population of Lothian (750,000) had been recognised to have been infected with HIV, the majority via IDU. This is of the same order as the worst affected region in England (North West Thames). The majority of these individuals however live in the City of Edinburgh with a population of only around 300,000 (1981 census). Consequently a realistic prevalence for this population is actually 0.3% or 3 times the worst affected English region. Thus this new area of medicine has considerable relevance for future medicine in Edinburgh and Scotland. The thesis describes the disease, the epidemiology of Injection Drug Use and IDU related HIV and the early epidemic in Edinburgh. It also describes the clinical services that were developed at the City Hospital in Edinburgh and the problems that this new service encountered. The provision of health care for this difficult patient population facilitated a variety of research projects. The thesis describes some of the results of these projects particularly those concerned with natural history, clinical presentation and use of antiretroviral therapy in IDU related HIV. Lastly the factors found to affect the transmission of HIV to the heterosexual partners of the patients are presented together with their relevance for other populations.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available