Clinics Contact Tracing Recent HIV Works

posted: 08/07/2009

Contact tracing people with acute (very recent) HIV infection leads to diagnosing others with HIV, such as newly infected partners, say investigators from North Carolina, USA, in the online edition of the Journal of Acquired Immune Deficiency Syndrome.

Contact tracing of people with acute, or new, HIV finds more people with HIV who are undiagnosed than tracing the contacts of people who have had HIV for a while - what medics call chronic HIV infection.

1 in 4 partners of newly infected people were also newly infected

A quarter of the partners of people with acute HIV infection contacted were also found to have acute infection.

“Identifying persons with acute HIV infection is vital to controlling the spread of HIV. Phylogenetic and epidemiological analyses among other populations have demonstrated the crucial role this group plays in forward transmission,” comment the investigators.

How they did the study

In 2002, the North Carolina Department of Public Health began using nucleic acid amplification testing (NAT) to identify individuals with acute HIV infection. The theory they wanted to test was that people with new (acute) HIV infection would be able to identify more of their sex / drug using partners than people infected longer ago.

To test this idea, they compared the number of partners found by contact-tracing services for both people with new and older HIV infections. The period of the study was 2002 to 2007.

Contact details collected next day

People with acute HIV infection were interviewed by trained counsellors within a day of their diagnosis, whereas those with established HIV infection were seen within an average of a week of diagnosis. People with new infection were asked to name their sexual partners for the past six months, and those with established HIV were asked to name partners for the whole year before.

They compared the results from 120 people with a new HIV infection and 9044 people who had HIV for some time.

What they found

People with new HIV reported a median of two partners in the six months before interview, whereas those with established infection reported a median of one partner. About half of the named partners who were contacted had previously taken a HIV test. A quarter of the contacted partners already knew they were HIV-positive.

They found that the partners of people with new HIV infection were more likely to be tested than the partners of patients with established infection. There wasn't much difference in the proportions of partners becoming newly diagnosed after contact tracing, between men with new HIV themselves and men with longer term HIV infection (twelve of 264 [5%] vs 468 of 7899 [6%]).

However, of these newly-diagnosed partners with acute infection, 25% were also found to have acute infection, compared to below 1% of partners of individuals with established infection. If you want to find people with acute HIV infection, testing the partners of the newly infected makes sense. People with new (acute) HIV infection are far, far more infectious than people infected a few months or years before.

Twice the names remembered with acute HIV

Statistical analysis showed that people with acute HIV named over twice as many total named partners as did those with chronic HIV infection.

Moreover, 9% of the partners of individuals recently infected with HIV were themselves HIV-positive compared to 5% of the partners of patients who had HIV infection for a year of more. This difference was significant (p = 0.03).

The investigators calculated that acutely infected individuals identified 1.93 times as many newly diagnosed partners than did individuals with established HIV infection.

“This is the first population-based study to demonstrate that persons with acute HIV infection identify higher numbers of named partners per index case than persons with established infections,” write the investigators. They add, “persons with acute HIV infection also have a higher proportion of partners who get tested for HIV.”

Urgent contact tracing of people with new HIV works well

“The results of this analysis”, conclude the authors, “lend additional support for routine identification of acute HIV infections as a means to increase the number of partners reached by [contact tracing] and the number of new infections identified.”

Reference
Moore ZS et al. Number of named partners and number of partners newly diagnosed with HIV infection identified by persons with acute versus established HIV infection. J Acquire Immune Defic Syndr (online edition), 2009.

Source

RAW Jam at Contact Theatre

posted: 28/11/2008

Free Lunchtime World AIDS Day RAW Jam, Monday 1 December 1pm

Gerry Potter (the force behind the indomitable Chloe Poems and the recent smash-hit play Miracle) joins Jackie Hagan for a special lunchtime spoken word tribute to people living with HIV, as part of Manchester's World AIDS Day celebrations.

Presented by Contact Theatre in association with George House Trust

Contact Theatre, Devas Street, off Oxford Road, Manchester M15 6JA

The Contact Theatre is almost opposite the Manchester Royal Infirmary

map and directions.