Use of the Serologic Testing Algorithm for Recent HIV Seroconversion (STARHS) to Identify Recently Acquired HIV Infections in Men With Early Syphilis in Los Angeles County

Abstract

Syphilis epidemics in MSM may be contributing to HIV incidence in this population. The STARHS can be applied as a surveillance tool to assess HIV incidence in various at-risk populations, but further studies are necessary for validation.

Running in Place: Implications of HIV Incidence Estimates among Urban Men Who Have Sex with Men in the United States and Other Industrialized Countries

“…Publications resulting from studies that were designed to examine the effect of an important co-factor for incident HIV infections such as a concurrent STI infection were excluded from the literature (e.g. CDC 2004; Taylor et al 2005). Also excluded were studies that used HIV incidence measures to determine the effects of HIV prevention interventions (e.g.…”

Recent infection testing algorithm (RITA) applied to new HIV diagnoses in England, Wales and Northern Ireland, 2009 to 2011

“…These estimates were much higher than those reported among individuals attending publically funded testing sites in New York City where the annual HIV incidence rate among white persons was 0.38%, compared with 0.43% among Blacks, 0.22% among Hispanics, and 0.11% in Asian Pacific Islanders and Native Americans [15]. Among men with early syphilis in Los Angeles, recent HIV infections accounted for 17% of new diagnoses among African Americans, 33% among Whites, 42% among Hispanics, and 8.3% among other ethnic groups [26].…”

“…RITA testing among men with early syphilis using remnant samples from STI clinics in Atlanta, San Francisco and Los Angeles, resulted in annual estimates of HIV incidence of 9.5% (CI 3.9-15.1) among all men, increasing to 12.0% (CI 4.5-19.4) among MSM alone [35]. In a separate study among men with early syphilis in Los Angeles County between 1999 and 2002, the annualised HIV incidence was estimated to be 17% (CI 12-22%/yr), increasing to 26% (CI 19-33%/yr) among MSM [26].…”

“…In a Los Angeles study of STI clinic attendees, over half of newly diagnosed young men aged 20-29 were likely to have recently acquired their infection, with higher rates among those presenting with early syphilis [26].…”

Nomenclature and Definitions for Emergency Department Human Immunodeficiency Virus (HIV) Testing: Report from the 2007 Conference of the National Emergency Department HIV Testing Consortium

“…The term “patient” is general and can refer to each registered visit by individuals to the ED or to a single person for whom there can be multiple ED visits. However, by consensus, the subset of outcomes and key summary measures (Tables 4 and 5 26,27 ) involving confirmed positive patients defines “patient” only in terms of unique persons and not ED visits.…”