Partner services in adults with acute and early HIV infection

Abstract

Background To examine the yield of HIV partner services provided to persons newly diagnosed with acute and early HIV infection (AEH) in San Diego, United States. Design Observational cohort study. Methods The study investigated the yield (i.e. number of new HIV and AEH diagnoses, genetically linked partnerships, and high risk uninfected partners) of partner services (confidential contact tracing) for individuals with AEH enrolled in the San Diego Primary Infection Resource Consortium 1996 - 2014. Results A total of 107 of 574 persons with AEH (19%; i.e. index cases) provided sufficient information to recruit 119 sex partners. Fifty seven percent of the 119 recruited partners were HIV infected, and 33% of the 119 were newly HIV diagnosed. Among those newly HIV diagnosed, 36% were diagnosed during AEH. There were no significant demographic or behavioral risk differences between HIV infected and uninfected recruited partners. Genetic sequences were available for both index cases and partners in 62 partnerships, of which 61% were genetically linked. Partnerships in which both index case and partner enrolled within 30 days were more likely to yield a new HIV diagnosis (p=0.01) and to be genetically linked (p<0.01). Conclusion PS for persons with AEH within 30 days of diagnosis represents an effective tool to find HIV unaware persons, including those with AEH who are at greatest risk of HIV transmission.

Clinical, Diagnostic, and Treatment Disparities between HIV-Infected and Non-HIV-Infected Immunocompromised Patients with <b><i>Pneumocystis jirovecii</i></b> Pneumonia

“…Community-based screening methods, partner services, and simple risk scores can be effective tools to find HIV-unaware individuals [70, 71]. PCP prophylaxis is of outmost importance and should be initiated in HIV-infected patients with CD4+ T lymphocyte counts < 200/µL.…”

Community‐led HIV testing services including HIV self‐testing and assisted partner notification services in Vietnam: lessons from a pilot study in a concentrated epidemic setting

“…According to an observational study by Green et al. 36% of partners tested for the first time through aPN had acute or early HIV infection . We did not attempt to detect acute infection or use recency testing.…”

“…Nearly half (44.4%) of all those reached for HIV testing were young between 16 and 25 years of age (Table ), and 66.7% of all those reached were first‐time testers (Table ). Previous studies have suggested that social media and dating apps are appealing to young people and may increase the uptake of testing services – and also provide innovative ways of implementing aPN . Offering aPN via lay provider and self‐testing may also have increased access to and uptake of testing services among key populations, men and young people .…”

Social network approaches to locating people recently infected with HIV in Odessa, Ukraine

“… and research by Green et al. in San Diego showed that partner services that traced the sexual contacts of the recently infected are effective at finding other PwRI. Taken together with this paper, this pattern of results suggests that risk network (although perhaps not venue tracing) methods starting with either recently‐ or longer‐term HIV‐infected people are effective ways to locate PwRI.…”

“…A final limitation is that TRIP was designed to recruit PwRI for intervention purposes, whereas IBBS had an epidemiologic focus, which might have influenced their relative yields of PwRI. Past research on injectors' networks in Athens by Nikolopoulos et al [13] and research by Green et al in San Diego [32] showed that partner services that traced the sexual contacts of the recently infected are effective at finding other PwRI. Taken together with this paper, this pattern of results suggests that risk network (although perhaps not venue tracing) methods starting with either recently-or longer-term HIV-infected people are effective ways to locate PwRI.…”