Sexually Transmitted Disease Partner Services Increases HIV Testing Among Partners of Men Who Have Sex with Men

Katz, David

Thursday, September 22, 2016

Galleria Exhibit Hall

David Katz, PhD, MPH¹, Teal Bell, MPH², Julia Dombrowski, MD, MPH³, Roxanne Kerani, PhD⁴, Mark Aubin, BA⁵, Zandt Bryan, BS⁶, David Kern, BA⁷, David Heal, MSW⁶ and Matthew R. Golden, MD, MPH⁸, 1Department of Medicine, University of Washington, Seattle, WA, 2Infectious Disease Assessment Unit, Washington State Department of Health, Olympia, WA, 3Div Infectious Diseases, Medicine, University of Washington, Seattle, WA, 4HIV/STD Control Program, Public Health - Seattle and King County, Seattle, WA, 5STD Services Section, Washington State Department of Health, Olympia, WA, 6Washington State Department of Health, Olympia, WA, 7Chicago Department of Public Health, Chicago, IL, 8Department of Medicine, Division of Allergy and Infectious Disease, and Public Health - Seattle & King County HIV/STD Program, University of Washington, Seattle, WA

Background: Men who have sex with men (MSM) with bacterial sexually transmitted diseases (STDs) are at elevated risk for HIV infection. We instituted and evaluated a program promoting HIV testing through public health STD partner services (PS).

Methods: In May 2012, health departments in Washington State revised PS programs to provide PS to all MSM with early syphilis, gonorrhea, or chlamydial infection and promote HIV testing among MSM and their partners as an explicit, measured PS objective. We compared the number of partners tested for and newly diagnosed with HIV following notification of exposure to the index STD case before (January 2010-April 2012) and during the revised program (May 2012-December 2015) using Poisson regression. Analyses adjusted for index STD, county of residence, and HIV status and, for case-finding, statewide HIV incidence among MSM.

Results: In the intervention period, 8695 (71%) of 12,204 MSM STD cases received PS and provided information for a total of 13,600 partners, compared with 2994 (63%) of 4740 cases and 5974 partners pre-intervention (p<0.001 for both). The number of partners tested for HIV per interviewed index case increased from 0.254 (760/2994) pre-intervention to 0.426 (3703/8695) during the intervention [adjusted incidence rate ratio (aIRR)=1.63, 95%CI=1.50-1.76]. The number of partners newly diagnosed with HIV per interviewed index was stable (0.0094 pre-intervention vs. 0.0060 during; aIRR=1.04, 95%CI=0.64-1.70). In multivariable analysis, index diagnosis with urethral gonorrhea, pharyngeal gonorrhea, and early syphilis and residence outside King County were associated with new HIV diagnosis in partners (p<0.01 for all). Of 52 new partner HIV diagnoses during the intervention, 44 (85%) occurred following initial PS interview with the index.

Conclusions: Promoting HIV testing among partners of MSM diagnosed with STDs through PS was feasible and increased HIV testing but not case-finding. Fewer than one new HIV case was identified for every 100 index cases receiving PS.

THP 55 Sexually Transmitted Disease Partner Services Increases HIV Testing Among Partners of Men Who Have Sex with Men