Role of Partner Counseling and Referral Service (PCRS) in Identifying New HIV Infections among Partners of HIV Co-Infected Syphilis Cases

Background:
Knowledge of HIV co-infection in patients with syphilis is an important factor for clinical management and partner follow-up. Early syphilis in California has been increasing since 1999, primarily among men who have sex with men (MSM). HIV positivity among these cases remains high. HIV Partner Counseling and Referral Services (PCRS) assists HIV-infected individuals with notifying partners of HIV exposure and providing linkages to care.

Objective:
Evaluate the number of new HIV infections identified among partners of early syphilis/HIV co-infected cases through health department assisted third party notification.

Method:
Interviews of early syphilis cases reported by the California Project Area from January 1, 2007 through June 30, 2007 were assessed for self-reported HIV status. If a case reported being HIV-infected, unique identification numbers were used to match PCRS data with syphilis partner services data. Proportions of locatable partners of HIV co-infected syphilis patients who requested third party partner notification, proportions of partners found and number of newly identified HIV infections were assessed.

Result:
Preliminary CPA data show that 285 interviewed early syphilis/HIV co-infected cases were reported from January 1, 2007 through June 30, 2007; 93 percent were among MSM. Of these 285 cases, 49 (17 percent) had a matching PCRS offer form; 17 of these led to 29 partners initiated for PCRS notification. Partner outcomes were: 27 notified, 19 previous positives, 7 tested, and 3 new HIV infections. Six of seven tested partners were first-time testers.

Conclusion:
Preliminary data suggest that many locatable partners of syphilis/HIV-co-infected patients are previously known positives. PCRS may be less efficient in finding new HIV infections among partners of reported early syphilis/HIV co-infected cases than other patient populations. However, of partners tested, the majority were first-time testers.

Implications:
PCRS for syphilis/HIV co-infected cases needs further evaluation to better understand the role of serosorting among patients and their locatable partners.