Number of named partners and number of partners newly diagnosed with HIV infection identified by persons with acute versus established HIV infection.
ABSTRACT Acute infections with HIV account for a disproportionate share of forward transmission in certain populations. We hypothesized that persons with acute HIV infection (AHI) would identify more named partners than those with established HIV infection (EHI).
We reviewed North Carolina surveillance databases to identify all persons aged > or =18 years in whom HIV was diagnosed during November 1, 2002 to October 31, 2007. We compared the number of named partners identified by persons with AHI versus EHI (based on nucleic acid amplification plus serologic testing) using a multivariable model and also compared information regarding HIV testing among partners identified by these groups.
EHI was diagnosed in 9044 persons and AHI in 120 persons during the study period. Persons with AHI named 2.5 times more partners per index patient [95% confidence interval: 2.1 to 3.0] and 1.9 times more partners newly diagnosed with HIV infection per index patient (95% confidence interval: 1.1 to 3.5) as did persons with EHI.
In North Carolina, persons with AHI identified proportionately more named partners and more partners newly diagnosed with HIV infections than persons with EHI. Improved detection of AHI offers critical opportunities to intervene and potentially reduce transmission of HIV.
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ABSTRACT: The U.S. HIV staging system is being revised to more comprehensively track early and acute HIV infection (AHI). We evaluated our ability to identify known cases of AHI using King County (KC) HIV surveillance data.The Open AIDS Journal 09/2014; 8:45-9.
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ABSTRACT: Sexually transmitted infection (STI) diagnosis after diagnosis of acute HIV infection (AHI) indicates ongoing high-risk sexual behavior and possible risk of HIV transmission. We assessed predictors of STI acquisition and the effect of time since care entry on STI incidence in patients with AHI in care and receiving consistent risk-reduction messaging.Sex Transm Dis 07/2014; 41(7):447-452. · 2.75 Impact Factor
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ABSTRACT: Objectives. We estimated the seroprevalence of both acute and chronic HIV infection by using a random sample of emergency department (ED) patients from region of the United States with low-to-moderate HIV prevalence. Methods. This cross-sectional seroprevalence study consecutively enrolled patients aged 18 to 64 years within randomly selected sampling blocks in a Midwestern urban ED in a region of lower HIV prevalence in 2008 to 2009. Participants were compensated for providing a blood sample and health information. After de-identification, we assayed samples for HIV antibody and nucleic acid. Results. There were 926 participants who consented and enrolled. Overall, prevalence of undiagnosed HIV was 0.76% (95% confidence interval [CI] = 0.30%, 1.56%). Three participants (0.32%; 95% CI = 0.09%, 0.86%) were nucleic acid-positive but antibody-negative and 4 (0.43%; 95% CI = 0.15%, 1.02%) were antibody-positive. Conclusions. Even when the absolute prevalence is low, a considerable proportion of undetected HIV cases in an ED population are acute. Identification of acute HIV in ED settings should receive increased priority. (Am J Public Health. Published online ahead of print July 17, 2014: e1-e5. doi:10.2105/AJPH.2014.301953).American Journal of Public Health 07/2014; · 4.23 Impact Factor