Recorded presentation

Charu P. Sharma, MS¹, Kristen Shaw, MS¹, Mariama D. Janneh, MPH¹, Douglas Shehan, BA¹, Anne C. Freeman, MSPH¹, and Sharon K. Melville, MD, MPH². (1) Internal Medicine/Community Prevention and Intervention Unit, University of Texas Southwestern Medical Center at Dallas, 400 South Zang Blvd., Suite 520, Dallas, TX 75208, 214-645-7343, charu.sharma@utsouthwestern.edu, (2) HIV/STD Epidemiology and Surveillance Branch, Texas Department of State Health Services, 1100 W. 49th Street, Austin, TX 78756

BACKGROUND: Information on HIV incidence, the number of individuals recently infected with HIV, has previously been difficult to obtain. The Serologic Testing Algorithm for Recent HIV Seroconversion (STARHS) provides a new mechanism for calculating more accurate HIV incidence estimates providing insight into the leading edge of HIV infection. METHODS: The Texas Counseling and Testing System database from 1999-2001 contains 344,603 unduplicated tests with 4946 positives. 2,631 stored positive specimens were blinded and tested with STARHS, of which 551 were recently infected at time of visit. Bivariate analyses (for STARHS tested data only) and weighted incidence estimates (adjusted by site type) were used to explore patterns in recent infections. RESULTS: HIV incidence was 650 per-100,000 per-year (0.65%); 2.87% among MSM/MSM-IDU, 0.51% among IDU, and 0.34% among heterosexuals. Incidence was higher for males (0.92% per-year) than females (0.34%). However, heterosexual positive females were more likely to test when recently infected than males [OR: 1.73 (1.25, 2.39)]. Incidence was higher for blacks (0.75% per-year) than whites (0.66%) or Hispanics (0.53%). Yet, white positives were more likely than other race groups to test when recently infected [OR: 1.603 (1.316, 1.952)]; black positives were less likely to test when recently infected [OR: .637 (.523, .777)]. Incidence was higher among anonymous testers (1.17% per-year) than confidential (0.58%). CONCLUSIONS: Populations with the highest incidence were less likely to test when recently infected, highlighting the need to better direct prevention efforts. Incidence can be used to monitor access to high-risk populations and conduct time sensitive program evaluations.

Learning Objectives: At the conclusion of the session, the participant (learner) will be able to

• Understand the use of the Serologic Testing Algorithm for Recent HIV Seroconversion (STARHS) in estimating the number of recently HIV infected individuals in a population.
• Describe incidence estimates for demographic and risk groups.
• Identify groups that have high incidence but are less likely to test when recently infected, and discuss implications in monitoring access to high-risk populations.

Keywords: HIV/AIDS, Epidemiology

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.

Recorded presentation