The findings and conclusions in these presentations have not been formally disseminated by the Centers for Disease Control and Prevention and should not be construed to represent any agency determination or policy.

Wednesday, May 10, 2006

Syphilis Interviewing: Opportunity for Identification of Undiagnosed HIV Infection

Dawne DiOrio Rekas1, Laurie L. Anderson2, Dawn Broussard2, and Carol Ciesielski3. (1) Chicago Department of Public Health, STD/HIV Programs, CDC, NCHSTP, DSTDP, 530 E. 31st St, Chicago, IL, USA, (2) STD/HIV Prevention and Care Program, CDC/Chicago Department of Public Health, 530 E. 31st Street, Chicago, IL, USA, (3) Division of STD Prevention, Centers for Disease Control and Prevention, Chicago Department of Health, 530 E 31st Street 2nd floor, Chicago, IL, USA

The epidemiologic synergy between HIV and syphilis is well described, with both often appearing in the same social/sexual networks. Many STD Programs conduct cluster interviews, which elicits names of those at risk for syphilis or HIV by interviewing close associates or sex partners of an infected patient.

To describe newly identified HIV cases in Chicago Department of Public Health (CDPH) STD Clinics diagnosed solely as a result of syphilis interviewing and case management.

HIV cases newly identified in 2005 from CDPH STD clinics were analyzed using the “Method of Case Detection” field from the interview record CDC Form 73.54.

Between 1/1/05 and -6/30/05, 84 newly diagnosed cases of HIV were identified and interviewed at CDPH STD Clinics. Of these, 63 (75%) were diagnosed as a result of patient initiative; 14 (17%) from patient or provider referral to HIV; 4 (5%) from patient or provider referral for syphilis; 2 (2%) from syphilis cluster interviews, and 1 (1%) from HIV cluster interviews. The six new cases of HIV identified during syphilis case management accounted for 7% of the new HIV cases diagnosed and interviewed in CDPH STD clinics during the study period and, presumably, would not have been identified if cluster interviews had not been conducted.

Social network associates named during syphilis case management resulted in identification of newly-diagnosed HIV cases. Obtaining social network connections through syphilis interviewing to identify high risk persons, whether directly exposed to syphilis or not, can be an important source of identifying undiagnosed HIV infection.

STD Programs should continue to ensure quality syphilis case management and aggressive testing of not only sex partners but also of social network associates of syphilis patients.