The 130th Annual Meeting of APHA

Abstract #34161

John F. Beltrami, MD, MPH&TM, HIV/STD Epidemiology Section, Georgia Department of Human Resources, 2 Peachtree St., NW; 14th floor # 450, Atlanta, GA 30303-3142, 404-657-2601, jfbeltrami@dhr.state.ga.us, Travis H. Sanchez, DVM, MPH, Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Atlanta, GA 30333, Susan E. Lance-Parker, DVM, PhD, MPH, Notifiable Disease Section, Georgia Department of Human Resources, 2 Peachtree St., NW, Atlanta, GA 30303-3142, Paul A. Blake, MD, MPH, Epidemiology Branch, Georgia Department of Human Resources, 2 Peachtree St., NW, Atlanta, GA 30303-3142, and Kathleen E. Toomey, MD, MPH, Division of Public Health, Georgia Department of Human Resources, 2 Peachtree Street, NW, Atlanta, GA 30303-3142.

Background: Men who have sex with men (MSM) are increasingly engaging in high-risk behaviors and acquiring HIV/STDs; however, analyzing both HIV/STD and non-HIV/STD databases may more comprehensively describe diseases and behaviors among MSM.

Methods: MSM variables from the Georgia STD surveillance system, Gonococcal Isolate Surveillance Project (GISP), and anonymous HIV surveys are used to describe disease trends in metropolitan Atlanta. Surveillance data for syphilis, gonorrhea, hepatitis A and B, and shigellosis are used to track postulated changes among MSM in metropolitan Atlanta by comparing reported infections over time with the male to female (M:F) ratio for persons aged 10 to 49 years.

Results: Of reported male syphilis cases in metropolitan Atlanta, the proportion among MSM increased from 7% in 1998 to 16% in 2000. At a DeKalb County STD clinic, the HIV seroprevalence among MSM increased from 32% in 1997 to 43% in 1999. In Fulton County, the HIV seroprevalence among MSM fluctuated between 14% to 32% from 1995-1998 at a drug treatment clinic, and the proportion of MSM with gonorrhea in GISP fluctuated between 1.5% to 5.3% from 1996-1999. From 1998-2001, the M:F ratio increased in metropolitan Atlanta for hepatitis A (2:1 to 12:1), shigellosis (1:1 to 15:1), and syphilis (1.5:1 to 3:1), but there was little change in trends for hepatitis B and gonorrhea.

Conclusions: Syphilis, HIV, hepatitis A, and shigellosis may be increasing among MSM in metropolitan Atlanta. In the absence of standardized MSM variables, surrogate markers may be helpful in describing infections and behaviors among MSM.

Learning Objectives:

• By the end of this session, participants will be able to a) articulate the advantages and disadvantages of using both HIV/STD and non-HIV/STD databases to describe infectious diseases and behaviors among MSM, b) discuss the potential for using surrogate markers in the absence of standardized MSM variables, c) discuss the potential for creating standardized MSM variables in notifiable disease surveillance systems that lack such variables, and d) articulate the importance of disease prevention strategies to account for modes of transmission that vary for different diseases.

Keywords: Infectious Diseases, Gay Men

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.