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Background: Core group (CGp) members contribute disproportionately to transmission of HIV and other STD; identification of CGp members may facilitate the implementation of interventions to interrupt transmission.
Objectives: To identify CGp members in New York City (NYC) using population-based STD and HIV surveillance registries.
Methods: The NYC DOHMH conducted a retrospective cross-match of STD and HIV surveillance registries (2001- 2005). Data included diagnoses of Chlamydia (Ct), gonorrhea (GC), early syphilis, and HIV among NYC residents. Identification of CGp members were based on gender-specific rates of incident HIV diagnosis and subsequent STD among twelve diagnosis groups constructed from patterns of STD and HIV infection (e.g, single and repeat infections of Ct/GC/early syphilis, and/or HIV).
Results: Data included 275,764 individuals; 178,688 were reported with Ct/GC/early syphilis and 101,977 were Persons Living With HIV/AIDS (PLWHA) during the study period. Overall incidence rates of new HIV diagnoses were highest among individuals with at least one secondary syphilis diagnosis. The overall incidence rates of subsequent STD were highest among individuals diagnosed with repeat STD infections and PLWHA diagnosed with incident STD (range 10.6 – 18.1 per 100 person-years). Consequently, we defined CGps in NYC as individuals diagnosed with syphilis or repeat STD, including PLWHA diagnosed with incident STD. Of 178,688 persons reported with Ct/GC/early syphilis during the study period, 25% (n=45,387) were identified as CGp members and were diagnosed with 43% of the observed Ct/GC/early syphilis events; 16% (n=28,975) met the CGp definition after excluding repeat Chlamydial infections.
Conclusions: Incidence of HIV and subsequent STD estimated from population-based surveillance data can be used to identify CGp members.
Implications for Programs, Policy, and/or Research: Providers diagnosing STD should use STD history to advise patients of marked elevation of HIV risk. In NYC, individuals diagnosed with syphilis, repeat STD and PLWHA with subsequent STD should be targeted for prevention services.