Is there an epidemic of HIV/AIDS among heterosexuals in the USA?

Haverkos, Harry W.; Chung, Rakkoo; Perez, L C Norville

doi:10.1136/pmj.79.934.444

Cited by 7 publications

(7 citation statements)

References 2 publications

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“…The results of this study indicate that using the current classification of HIV risk factors in an intensive investigation can improve risk factor ascertainment. Haverkos et al (2003) suggested that more risk factor information (e.g. regarding sex and drug-use behaviours) should be collected in order to properly classify those without an identified risk factor.…”

Section: Discussionmentioning

confidence: 99%

Results of the Expanded HIV Risk Factor Assessment Project (EHRAP)

et al. 2006

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An objective of EHRAP was to evaluate the HIV risk factor information reported to CDC through routine surveillance. HIV/AIDS surveillance programmes used medical and ancillary records to determine if information on HIV risk factors can be found for surveillance. Surveillance staff from Mississippi, South Carolina, and Virginia collected data on risk factors for HIV infection on a sample of cases diagnosed during 1998 and 1999. Overall percent agreement and Cohen kappa statistics were calculated for initially reported compared to EHRAP-identified risk factors. Of 160 cases reported without an identified risk factor, 86% were reclassified with a known risk factor. A risk factor was identified for 96% of all cases of HIV infection. Overall, agreement was good (kappa = 0.89) between initially reported and verified HIV risk factor. All three states met the national goal of at least 85% of reported cases with a risk factor for HIV infection. The completeness of collection and reporting of HIV risk factors for national HIV/AIDS surveillance can be improved. The current method of risk factor redistribution at the national level should be evaluated.

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Section: Discussionmentioning

confidence: 99%

Results of the Expanded HIV Risk Factor Assessment Project (EHRAP)

et al. 2006

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“…The extent to which transmission occurs between people who are similar or different with respect to race/ethnicity and risk characteristics is unclear, and network data can aid in understanding transmission dynamics (reviewed in [1]). For example, understanding the links between different populations can be particularly useful in elucidating transmission routes for heterosexual women, who are often unaware of the HIV risk behaviors of their partners [8, 9]. Moreover, persons whose HIV sequences are similar to (i.e., are linked to) many other sequences are of particular interest for prevention, as these persons may be part of a dense section of a transmission network, and, therefore, most likely to transmit HIV.…”

Section: Introductionmentioning

confidence: 99%

Using Molecular HIV Surveillance Data to Understand Transmission Between Subpopulations in the United States

et al. 2015

JAIDS Journal of Acquired Immune Deficiency Syndromes

135

130

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Background Studying HIV transmission networks provides insight into the spread of HIV and opportunities for intervention. We identified transmission dynamics among risk groups and racial/ethnic groups in the United States. Methods For HIV-1 pol sequences reported to the U.S. National HIV Surveillance System during 2001–2012, we calculated pairwise genetic distance, identified linked pairs of sequences (those with distance ≤1.5%), and examined transmission category and race/ethnicity of these potential transmission partners. Results Of 40,950 sequences, 12,910 (32%) linked to ≥1 other sequence. Of men who have sex with men (MSM) who linked to ≥1 sequence, 88% were linked to other MSM and only 4% were linked to heterosexual women. Of heterosexual women for whom we identified potential transmission partners, 29% linked to MSM, 21% to heterosexual men, and 12% to persons who inject drugs. Older and black MSM were more likely to be linked to heterosexual women. Assortative mixing was present for all racial/ethnic groups; 81% of blacks/African Americans linked to other blacks. Conclusions This analysis is the first use of U.S. surveillance data to infer an HIV transmission network. Our data suggest that HIV infections among heterosexual women predominantly originate from MSM, followed by heterosexual men. Although few MSM were linked to women, suggesting that a minority of MSM are involved in transmission with heterosexual women, these transmissions represent a substantial proportion of HIV acquisitions by heterosexual women. Interventions that reduce transmissions involving MSM are likely to also reduce HIV acquisition among other risk groups.

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“…Thirty-five percent of the new cases of HIV infection that were diagnosed in 1999-2002 were acquired heterosexually, and these cases account for the majority of new cases of HIV infection among women [4]. Since the early 1980s, the proportion of individuals who have become infected with HIV through heterosexual transmission has continued to increase relative to the proportions noted for other groups of individuals at risk for HIV infection [5]. From 1989 to 1999, the percentage of AIDS cases that were attributable to heterosexual transmission increased 265% [6].…”

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confidence: 99%

It Is Time to Implement Routine, Not Risk‐Based, HIV Testing

et al. 2005

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Approximately one-quarter of a million persons in the United States who are infected with human immunodeficiency virus (HIV) do not know it. To decrease the number of such persons, primary care providers should make HIV testing a routine component of health care. HIV testing should also be offered routinely in other settings, such as emergency departments, jails, and substance abuse treatment centers. Currently, the Centers for Disease Control and Prevention and the Infectious Diseases Society of America recommend routine HIV testing only in settings where the prevalence of HIV infection is> or =1%; in settings where the prevalence of HIV infection is <1%, testing should be based on risk assessment. Because of the impracticality of strategies for testing that are based on estimates of prevalence, and because of the inaccuracy of risk assessment, we propose that HIV testing be routinely offered to any person who is sexually active. As an adjunct to the implementation of routine testing programs, counseling practices need to be streamlined, and rapid HIV testing needs to be implemented in the appropriate settings.

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Is there an epidemic of HIV/AIDS among heterosexuals in the USA?

Cited by 7 publications

References 2 publications

Results of the Expanded HIV Risk Factor Assessment Project (EHRAP)

Results of the Expanded HIV Risk Factor Assessment Project (EHRAP)

Using Molecular HIV Surveillance Data to Understand Transmission Between Subpopulations in the United States

It Is Time to Implement Routine, Not Risk‐Based, HIV Testing

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