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APHA Scientific Session and Event Listing

JoAnn D. Kuruc, RN, MSN¹, Lisa B. Hightow, MD, MPH², Sandra I. McCoy, MPH³, Donna V. Pittard, RN², Kara S. McGee, PA-C, MSPH⁴, Rhonda M. Ashby⁵, Charles B. Hicks, MD⁴, Peter A. Leone, MD⁶, Joseph J. Eron, MD², and Christopher D. Pilcher, MD². (1) School of Medicine/Division of Infectious Diseases, The University of North Carolina at Chapel Hill, 130 Mason Farm Road, CB 7030, Chapel Hill, NC 27514, (2) School of Medicine/ Division of Infectious Diseases, The University of North Carolina at Chapel HIll, 130 Mason Farm Road, CB 7030, Chapel Hill, NC 27514, (3) School of Public Health, University of North Carolina at Chapel Hill, 2105f McGavran-Greenberg, CB # 7435, Chapel Hill, NC 27599-7435, (4) Division of Infectious Diseases, Duke Unversity, DUMC, Box 3360, Durham, NC 27710, (5) Field Services Unit, North Carolina Department of Health and Human Services, 2045 C. Eastgate Drive, Greenville, NC 27858, (6) School of Medicine/Division of Infectious Diseases, University of North Carolina at Chapel HIll, 130 Mason Farm Road, CB 7030, Chapel Hill, NC 27514, 919-843-0724, pal007@med.unc.edu

BACKGROUND. Since 2002, North Carolina's Screening & Tracing Active Transmission (STAT) program has utilized both RNA testing of HIV antibody (-) public testing specimens and rapid reporting procedures to identify acute HIV infections. Disease intervention specialists (DIS) provide urgent notification, confirmatory testing, contact tracing, and immediate referral to specialty medical care. We evaluated this program's impact on entry to care. METHODS. We analyzed data from DIS STAT interventions and the Duke-UNC Acute HIV Consortium collected over one year (Jan. – Dec. 12/31/05) for individuals reported to have acute HIV infection. RESULTS. There were 35 cases identified with acute HIV, 86% were male and 49% were black. Black males were significantly younger (70.6% age <30) than white males (18.8%, p<0.01.) and were more likely to be diagnosed through public testing (88% versus 44%, p<0.01). 28 (80%) of the reported acute cases were evaluated by an HIV specialist, 65% within 30 days of their first positive test. 61% initiated therapy within the same 30 day period. Median time entry into care was 26.5 days; for blacks 27 days and for whites 17 days. Median time to enter care was longer for publicly diagnosed persons (29 versus 8 days). CONCLUSION. A coordinated approach to rapid public health intervention can be highly effective in diagnosing and accelerating access to care for persons with acute HIV infection; disparities still exist. While public programs facilitate testing of underserved populations, maximal benefit from access to care may significantly be influenced by how one enters the healthcare system.

Learning Objectives:

• Learn about North Carolina's acute HIV program
• Describe health disparities among HIV infected persons entering care.
• Describe the demographics, risk behaviors and testing sites of acute HIV infected persons in North Carolina

Keywords: Access to Health Care, HIV Interventions

Presenting author's disclosure statement:

Not Answered