HIV Positivity Rates of Partners of Coinfected STD/HIV Positive Cases

Background:The District of Columbia has integrated HIV partner services into its STD surveillance and testing program by prioritizing those with a history of an STD and HIV diagnosis.  An evaluation of this strategy and benefits will allow for better penetration into high risk populations.

Objectives: To characterize the risk behavior of coinfected individuals and determine if partners have significantly higher HIV positivity compared to general DC population.

Methods: The STDMIS database was matched with the eHARS database to identify coinfected individuals during 2006-2010. The partners who tested positive were compared to all possible partners to find the proportion of positive tests. This was then compared to the prevalence in DC using a binomial test (p=.05).

Results:  The match between eHARS and STDMIS yielded 1329 coinfected cases. Among coinfected cases 50.49% were reported only having one STD infection, while the remaining 49.51% had 2 or more infections.  49.36% of cases reported a STD infection after HIV infection. An evaluation of all STD cases from 2006-2010 yielded 902 partner referred HIV tests. Of these 136 cases, or 15.1% were positive for HIV. The binomial model reported the test rate among partner referrals was significantly higher (p<.001,α=.05) with a confidence interval of 12.8% to 17.5%. 

Conclusions: The proportion of positive tests among referred individuals is significantly higher than in the general population.. Integrated partner services are an effective way to reach high risk populations.

Implications for Programs, Policy, and Research:  Measure and quantify high-risk populations within programmatic reach of state health departments. Create evidence-based rationale for adopting an integrated partner services program.