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.

Tuesday, March 11, 2008 - 4:00 PM
B6e

Acceptability of Acute HIV Infection Screening at STD Clinics that Utilize Rapid HIV Screening Tests, New York City, 2007

Kathleen D. Gallagher1, Pragna Patel2, Alexis Kowalski1, Ellen Klingler1, Kathy Gombel3, Tim Sullivan3, Monica Parker3, and Susan Blank4. (1) Bureau of STD Control, New York City Department of Health and Mental Hygiene, 125 Worth St, Rm 207 CN-73, New York, NY, USA, (2) Division of HIV/AIDS Prevention, Centers for Disease Control & Prevention, Atlanta, GA, USA, (3) Wadsworth Center, New York State Department of Health, Albany, NY, USA, (4) Bureau of Sexually Transmitted Disease Control, NYC DOHMH / Division of STD Prevention, CDC, 125 Worth St., Room 207, CN-73, New York, NY, USA


Background:
Beginning in 2006, the NYC Department of Health and Mental Hygiene (DOHMH) partnered with the Centers for Disease Control and Prevention (CDC), in a multi-site research study examining the impact and acceptability of pooled HIV-1 RNA nucleic acid amplification testing (HIV-NAAT) for detection of acute HIV infection (AHI).

Objective:
To measure the acceptability of HIV-NAAT.

Method:
Individuals ≥18-years seeking a confidential HIV test at 3 participating NYCDOHMH clinics were offered HIV-NAAT. Acceptability was determined by whether or not an eligible person provided written consent and had blood tested. Bivariate analyses examined acceptability among groups defined by sex, race/ethnicity, age and sexual behavior (based on sex of partner in 3 months prior to testing).

Result:
From June-August 2007 among eligible persons (N=3898), testing was accepted by 59% (2305/3898). A larger proportion of women accepted testing 63% (963/1531) than men 57% (1341/2364), African Americans 64% (1232/1915) than Caucasians 41% (307/750), Hispanics 69% (611/898) than non-Hispanics 57% (1677/2966), lesbians 63% (69/102) than MSM 51% (227/444), and persons 41-50 years-old (62%; 243/390) compared to other ages. Those tested (N=2305) were mostly male (58%; 1341/2305), African American (53%; 1232/2305), 21-30 years-old (52%; 1189/2305) and heterosexual (88%; 2036/2305). Men-who-have-sex-with-men (MSM) accounted for 10% of all participants. Two cases of AHI were diagnosed; both were white, MSM and 21-30 years-old.

Conclusion:
Acceptability of HIV-NAAT is lower than expected. Possible explanations for this include 1) testing is offered as part of a research study and involves signing a separate consent 2) anxiety of waiting 5-7 days for test result, 3) longer pre/post test counseling sessions to cover AHI information.

Implications:
Diagnosing AHI can curtail transmission of HIV, as AHI-infected persons are usually unaware of infection and highly infectious. Strategies should be devised to surmount barriers to acceptance of HIV-NAAT, especially among persons at increased risk for HIV.

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