Abstract
Objective:
Human immunodeficiency virus (HIV) partner services are an integral part of comprehensive HIV prevention programs. We examined the patterns of HIV testing and positivity among partners of HIV-diagnosed people who participated in partner services programs in CDC-funded state and local health departments.
Methods:
We analyzed data on 21 484 partners submitted in 2013-2014 by 55 health departments. We conducted descriptive and multivariate analyses to examine patterns of HIV testing and positivity by demographic characteristics and geographic region.
Results:
Of 21 484 partners, 16 275 (75.8%) were tested for HIV; 4503 of 12 886 (34.9%) partners with test results were identified as newly HIV-positive. Compared with partners aged 13-24, partners aged 35-44 were less likely to be tested for HIV (adjusted odds ratio [aOR] = 0.86; 95% confidence interval [CI], 0.78-0.95) and more likely to be HIV-positive (aOR = 1.35; 95% CI, 1.20-1.52). Partners who were male (aOR = 0.89; 95% CI, 0.81-0.97) and non-Hispanic black (aOR = 0.68; 95% CI, 0.63-0.74) were less likely to be tested but more likely to be HIV-positive (male aOR = 1.81; 95% CI, 1.64-2.01; non-Hispanic black aOR = 1.52; 95% CI, 1.38-1.66) than partners who were female and non-Hispanic white, respectively. Partners in the South were more likely than partners in the Midwest to be tested for HIV (aOR = 1.56; 95% CI, 1.35-1.80) and to be HIV-positive (aOR = 2.18; 95% CI, 1.81-2.65).
Conclusions:
Partner services programs implemented by CDC-funded health departments are successful in providing HIV testing services and identifying previously undiagnosed HIV infections among partners of HIV-diagnosed people. Demographic and regional differences suggest the need to tailor these programs to address unique needs of the target populations.
References
| 1. |
Centers for Disease Control and Prevention . Monitoring selected national HIV prevention and care objectives by using HIV surveillance data: United States and 6 dependent areas—2013. HIV Surveill Suppl Rep. 2015;20(2):1–70. Google Scholar |
| 2. |
Centers for Disease Control and Prevention . Monitoring selected national HIV prevention and care objectives by using HIV surveillance data: United States and 6 dependent areas—2014. HIV Surveill Suppl Rep. 2016;21(4):1–87. Google Scholar |
| 3. |
Centers for Disease Control and Prevention . Diagnoses of HIV infection in the United States and dependent areas, 2014. HIV Surveill Rep. 2015;26:1–123. Google Scholar |
| 4. |
White House (US), Office of National AIDS Policy . National HIV/AIDS strategy for the United States. 2010. https://www.aids.gov/federal-resources/national-hiv-aids-strategy/nhas-fact-sheet.pdf. Accessed February 19, 2016. Google Scholar |
| 5. |
White House (US), Office of National AIDS Policy . National HIV/AIDS strategy for the United States: updated to 2020. 2015. https://www.aids.gov/federal-resources/national-hiv-aids-strategy/nhas-update.pdf. Accessed February 19, 2016. Google Scholar |
| 6. |
Centers for Disease Control and Prevention . High-impact HIV Prevention: CDC’s approach to reducing HIV infections in the United States. https://www.cdc.gov/hiv/pdf/policies_nhpc_booklet.pdf. 2011. Accessed December 10, 2015. Google Scholar |
| 7. |
Centers for Disease Control and Prevention . HIV partner counseling and referral services: guidance. 1998. https://stacks.cdc.gov/view/cdc/5150/cdc_5150_DS1.pdf. Accessed December 10, 2015. Google Scholar |
| 8. |
Centers for Disease Control and Prevention . Program operations guidelines for STD prevention. 2001. http://www.cdc.gov/std/program/progevaluation.pdf. Accessed December 10, 2015. Google Scholar |
| 9. |
Centers for Disease Control and Prevention . Recommendations for partner services programs for HIV infection, syphilis, gonorrhea, and chlamydial infection. MMWR Recomm Rep. 2008;57(RR-9):1–63. Google Scholar |
| 10. |
Ahrens, K, Kent, CK, Kohn, RP. HIV partner notification outcomes for HIV-infected patients by duration of infection, San Francisco, 2004 to 2006. J Acquir Immune Defic Syndr. 2007;46(4):479–484. Google Scholar | Crossref | Medline |
| 11. |
Hogben, M, McNally, T, McPheeters, M; Task Force on Community Preventive Services. The effectiveness of HIV partner counseling and referral services in increasing identification of HIV-positive individuals: a systematic review. Am J Prev Med. 2007;33(suppl 2):S89–S100. Google Scholar | Crossref | Medline |
| 12. |
Lin, F, Farnham, PG, Shrestha, RK. Cost effectiveness of HIV prevention interventions in the U.S. Am J Prev Med. 2016;50(6):699–708. Google Scholar | Crossref | Medline |
| 13. |
Bernstein, KT, Stephens, SC, Moss, N. Partner services as targeted HIV screening: changing the paradigm. Public Health Rep. 2014;129(suppl 1):50–55. Google Scholar | SAGE Journals |
| 14. |
Udeagu, CC, Shah, D, Shepard, CW. Impact of a New York City Health Department initiative to expand HIV partner services outside STD clinics. Public Health Rep. 2012;127(1):107–114. Google Scholar | SAGE Journals |
| 15. |
Varghese, B, Peterman, TA, Holtgrave, DR. Cost-effectiveness of counseling and testing and partner notification: a decision analysis. AIDS. 1999;13(13):1745–1751. Google Scholar | Crossref | Medline |
| 16. |
Shrestha, RK, Begley, EB, Hutchinson, AB. Costs and effectiveness of partner counseling and referral services with rapid testing for HIV in Colorado and Louisiana, United States. Sex Transm Dis. 2009;36(10):637–641. Google Scholar | Crossref | Medline |
| 17. |
Jones, JL, Wykoff, RF, Hollis, SL. Partner acceptance of health department notification of HIV exposure, South Carolina. JAMA. 1990;264(10):1284–1286. Google Scholar | Crossref | Medline |
| 18. |
Passin, WF, Kim, AS, Hutchinson, AB; HIV/AIDS Prevention Research Synthesis Project Team. A systematic review of HIV partner counseling and referral services: client and provider attitudes, preferences, practices, and experiences. Sex Transm Dis. 2006;33(5):320–328. Google Scholar | Crossref | Medline |
| 19. |
Henley, C, Forgwei, G, Welty, T. Scale-up and case-finding effectiveness of an HIV partner services program in Cameroon: an innovative HIV prevention intervention for developing countries. Sex Transm Dis. 2013;40(12):909–914. Google Scholar | Crossref | Medline |
| 20. |
Malave, MC, Shah, D, Sackoff, JE. Human immunodeficiency virus partner elicitation and notification in New York City: public health does it better. Sex Transm Dis. 2008;35(10):869–876. Google Scholar | Crossref | Medline |
| 21. |
Wilson, TE, Hogben, M, Malka, ES. A randomized controlled trial for reducing risks for sexually transmitted infections through enhanced patient-based partner notification. Am J Public Health. 2009;99(suppl 1):S104–S110. Google Scholar | Crossref | Medline |
| 22. |
Bocour, A, Renaud, TC, Udeagu, CC. HIV partner services are associated with timely linkage to HIV medical care. AIDS. 2013;27(18):2961–2963. Google Scholar | Crossref | Medline |
| 23. |
Weller, SC, Davis-Beaty, K. Condom Effectiveness in Reducing Heterosexual HIV Transmission (Review): The Cochrane Collaboration. Hoboken, NJ: John Wiley and Sons; 2007;4:1–22. Google Scholar |
| 24. |
Patel, P, Borkowf, CB, Brooks, JT. Estimating per-act HIV transmission risk: a systematic review. AIDS. 2014;28(10):1509–1519. Google Scholar | Crossref | Medline |
| 25. |
Tripathi, A, Gardner, L, Ogbuanu, I. Predictors of time to enter medical care after a new HIV diagnosis: a statewide population-based study. AIDS Care. 2011;23(11):1366–1373. Google Scholar | Crossref | Medline |
| 26. |
Page-Shafer, K, Veugelers, PJ, Moss, AR. Sexual risk behavior and risk factors for HIV-1 seroconversion in homosexual men participating in the Tricontinental Seroconverter Study, 1982-1994 [published erratum appears in Am J Epidemiol. 1997;146(12):1076]. Am J Epidemiol. 1997;146(7):531–542. Google Scholar | Crossref | Medline |
| 27. |
Ostrow, DG, DiFranceisco, WJ, Chmiel, JS. A case-control study of human immunodeficiency virus type 1 seroconversion and risk-related behaviors in the Chicago MACS/CCS cohort, 1984-1992 [published erratum appears in Am J Epidemiol. 1996;143(1):104]. Am J Epidemiol. 1995;142(8):875–883. Google Scholar | Crossref | Medline |
| 28. |
Quinn, TC, Wawer, MJ, Sewankambo, N. Viral load and heterosexual transmission of human immunodeficiency virus type 1. Rakai Project Study Group. N Engl J Med. 2000;342(13):921–929. Google Scholar | Crossref | Medline | ISI |
| 29. |
Gray, RH, Wawer, MJ, Brookmeyer, R. Probability of HIV-1 transmission per coital act in monogamous, heterosexual, HIV-1-discordant couples in Rakai, Uganda. Lancet. 2001;357(9263):1149–1153. Google Scholar | Crossref | Medline | ISI |
| 30. |
Wawer, MJ, Gray, RH, Sewankambo, NK. Rates of HIV-1 transmission per coital act, by stage of HIV-1 infection, in Rakai, Uganda. J Infect Dis. 2005;191(1):1403–1409. Google Scholar | Crossref | Medline |
| 31. |
Freeman, EE, Weiss, HA, Glynn, JR. Herpes simplex virus 2 infection increases HIV acquisition in men and women: systematic review and meta-analysis of longitudinal studies. AIDS. 2006;20(1):73–83. Google Scholar | Crossref | Medline | ISI |
| 32. |
Macdonald, N, Elam, G, Hickson, F. Factors associated with HIV seroconversion in gay men in England at the start of the 21st century. Sex Transm Infect. 2008;84(1):8–13. Google Scholar | Crossref | Medline |
| 33. |
US Census Bureau . Census regions and divisions of the United States. 2013. https://www2.census.gov/geo/pdfs/maps-data/maps/reference/us_regdiv.pdf. Accessed October 25, 2015. Google Scholar |
| 34. |
SAS Institute Inc . SAS Version 9.3. Cary, NC: SAS Institute Inc; 2011. Google Scholar |
| 35. |
Centers for Disease Control and Prevention . CDC-funded HIV testing: United States, Puerto Rico, and the U.S. Virgin Islands, 2013. https://www.cdc.gov/hiv/pdf/library/reports/cdc-hiv-CDCFunded_HIV_Testing_UnitedStates_Puerto_Rico_USVI_2013.pdf. Accessed April 14, 2017. Google Scholar |
| 36. |
Green, N, Hoenigl, M, Chaillon, A. Partner services in adults with acute and early HIV infection. AIDS. 2017;31(2):287–293. Google Scholar | Crossref | Medline |
| 37. |
Katz, DA, Hogben, M, Dooley, SW. Increasing public health partner services for human immunodeficiency virus: results of a second national survey. Sex Transm Dis. 2010;37(8):469–475. Google Scholar | Crossref | Medline |
| 38. |
Centers for Disease Control and Prevention . CDC-funded HIV testing: United States, Puerto Rico, and the U.S. Virgin Islands, 2014. https://www.cdc.gov/hiv/pdf/library/reports/cdc-hiv-funded-testing-us-puerto-rico-2014.pdf. Accessed April 14, 2017. Google Scholar |
| 39. |
Centers for Disease Control and Prevention . PS12-1201: comprehensive HIV prevention programs for health departments: monitoring and evaluation report, 2012–2013. https://www.cdc.gov/hiv/pdf/funding/announcements/ps12-1201/cdc-hiv-ps12-1201_monitoring_and_evaluation_report.pdf. Accessed April 14, 2017. Google Scholar |
| 40. |
US Census Bureau . United States population growth by region. 2015. https://www.census.gov/popclock/data_tables.php?component=growth. Accessed October 20, 2015. Google Scholar |
| 41. |
Reynolds, SJ, Makumbi, F, Nakigozi, G. HIV-1 transmission among HIV-1 discordant couples before and after the introduction of antiretroviral therapy. AIDS. 2011;25(4):473–477. Google Scholar | Crossref | Medline |
| 42. |
Cohen, MS, Gay, CL. Treatment to prevent transmission of HIV-1. Clin Infect Dis. 2010;50(suppl 3):S85–S95. Google Scholar | Crossref | Medline |
| 43. |
Cohen, MS, Chen, YQ, McCauley, M. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365(6):493–505. Google Scholar | Crossref | Medline | ISI |
| 44. |
McMahon, JM, Myers, JE, Kurth, AE. Oral pre-exposure prophylaxis (PrEP) for prevention of HIV in serodiscordant heterosexual couples in the United States: opportunities and challenges. AIDS Patient Care STDS. 2014;28(9):462–474. Google Scholar | Crossref | Medline |
