Gonorrhea Infections Diagnosed Among Persons Living with HIV/Aids; Cross Matching Surveillance Registries to Identify Potential Opportunities for Integrated Partner Services, New York City, Miami/Dade County, and Arizona

Taylor, Melanie

Wednesday, March 14, 2012: 4:30 PM

Regency

Melanie Taylor, MD, MPH, DIVISION OF STD PREVENTION, CENTERS FOR DISEASE CONTROL, Phoenix, AZ, Julia Schillinger, MD, MSc, US Centers for Disease Control and Prevention, CDC Division of STD Prevention;, NYC DOHMH Bureau of STD,The New York City Department of Health and Mental Hygiene;, New York, NY, Preeti Pathela, PhD, Bureau of STD Control and Prevention, The New York City Department of Health and Mental Hygiene, Long Island City, NY, Julia Skinner, MS, HIV Surveillance Division, Arizona Department of Health Services, Phoenix, AZ, Daniel R. Newman, MA, Epidemiology and Surveillance, Centers for Disease Control and Prevention, Atlanta, GA, Sarah Braunstein, PhD, HIV/STD Program, New York City Department of Health and Mental Hygiene, New York City, NY, Colin Shepard, MD, Bureau of HIV/AIDS Prevention and Control, New York City Department of Health and Mental Hygiene, New York City, NY and Toye Brewer, MD, Centers for Disease Control and Prevention, Division of STD Prevention, Field Epidemiology Unit, Florida Bureau of STD Prevention and Control, Miami, FL

Background: Persons living with HIV/AIDS (PLWHA) who acquire new STDs pose a risk for enhanced transmission of both HIV and STDs. Some state and local STD and HIV programs prohibit data sharing that would identify these individuals due to concerns with data security and confidentiality. Significant resources are dedicated to partner services (PS) for syphilis cases however, due to resource limitations, few if any gonorrhea (GC) cases in high morbidity areas receive this intervention.

Objectives: To describe the frequency of HIV co-infection among gonorrhea cases in 3 cities/regions in the US with varied GC and HIV epidemiology.

Methods: A probabilistic method was used to match the HIV and STD surveillance databases at the New York City Department of Health (NYC), Miami/Dade County Health Department (MDC), and Arizona Department of Health Services (AZ). Person and diagnosis events from the matched HIV-STD datasets included GC cases diagnosed during 2000-2008.

Results: During 2000-2008, 4% (8,159/187,779) of reported GC cases occurred among persons with previously diagnosed (eg. preexisting) HIV: NYC (5.5%, 5,930/107,786), MDC (4%, 1,504/40,214), and AZ (2%, 725/39,779). Overall, white male GC cases had the highest HIV co-infection in each jurisdiction: NYC (22%, 592/2,680), MDC (11%, 339/3,080), and AZ (7%, 397/5,501). The overall HIV-GC coinfection rate increased over the study period: from 3% (367/12,314) to 7% (752/10,553) in NYC, 2% (91/3,917) to 4% (165/4,265) in MDC, and 0.7% (31/4,400) to 3% (91/3,486) in AZ.

Conclusions: Retrospective data integration identified many co-infected HIV/GC cases, and indicated HIV co-infection rates are increasing.

Implications for Programs, Policy, and Research: Real time access to integrated HIV and STD surveillance would allow better targeting of public health interventions to subgroups of the population posing highest risk for transmitting HIV in their jurisdictions, and specifically rapid identification of persons who could be reached for more intensive counseling and PS.

LB.4 Gonorrhea Infections Diagnosed Among Persons Living with HIV/Aids; Cross Matching Surveillance Registries to Identify Potential Opportunities for Integrated Partner Services, New York City, Miami/Dade County, and Arizona