5C 5 High Yield of New HIV Diagnoses and Patients with High Viral Loads from HIV Partner Services, Philadelphia Department of Public Health STD Control Program (STDCP) and AIDS Activities Coordinating Office (AACO), 2012

Thursday, June 12, 2014: 8:40 AM
Grand Ballroom A/B/C/D1
Felicia Lewis, MD1, Michael Eberhart, MPH2, Greta Anschuetz, MPH3, Melinda Salmon, BA3, Coleman Terrell, BA2 and Kathleen Brady, MD2, 1Division of STD Prevention, Centers for Disease Control and Prevention and Philadelphia Department of Public Health, Philadelphia, PA, 2AIDS Activities Coordinating Office, Philadelphia Department of Public Health, Philadelphia, PA, 3STD Control Program, Philadelphia Department of Public Health, Philadelphia, PA

Background: Traditionally, partner services (PS) is evaluated by the number of new infections found; however, for HIV, risk of transmission is highest when viral load (VL) is high, and impact depends upon successfully linking persons to care. Successful HIV PS may be better defined as finding and linking to care persons with high VL; however, this can be difficult if VL values are not available to PS. Currently, AACO and STDCP maintain separate databases and HIV surveillance data is not used to initiate PS.

Methods: PS interviews and records from Jan. 1-Dec. 31, 2012 in the STDCP database were reviewed; cases and contacts were matched with eHARS to confirm HIV status and VL.

Results: In 2012, 750 persons were entered into eHARS as newly-diagnosed HIV. PS was initiated for 509 HIV-infected persons (30.7% of whom were diagnosed in 2012):  447 (87.8%) were interviewed; 226 (50.6%) named 529 partners.  109 (20.6%) partners refused PS or were not locatable. Of 420 (79.4%) partners interviewed, 116 (36.3%) reported never being HIV tested and 236 (44.6%) were previously HIV+. Of 178 partners testing after provision of PS, STDCP records categorized 23 (12.9%) as newly HIV+; however, matching with eHARS showed 3 were previously diagnosed, and 1 was false positive. VL was available for 16/19 new positives: 11 had VL ≥10,000 and 7 had VL ≥100,000 at diagnosis. 10/16 were linked to care within 1 month, 2 within 8 months and 4 have not linked to care to date.

Conclusions: A substantial number of persons found during HIV PS had high VL and were highly infectious. However, many persons with newly diagnosed HIV were not offered PS due to parallel data systems. Consideration should be given to using local HIV surveillance data to initiate PS and using DIS to assure HIV+ persons are in care.