Use of Sentinel Surveillance and Geographic Information Systems to Monitor Trends in HIV Prevalence, Incidence, and Related Risk Behavior among Women Undergoing Syphilis Screening in a Jail Setting
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Innovative methods are needed to systematically track the HIV epidemic and appropriately target prevention and care programs in vulnerable populations of women. We conducted sentinel surveillance among women entering the jail system of San Francisco from 1999 to 2001 to track trends in HIV incidence, HIV prevalence, and related risk behavior. Using geographic information software (GIS), we triangulated findings to examine the spatial distribution of risk and disease. A total of 1,577 female arrestees voluntarily screened for sexually transmitted diseases at intake were included. HIV incidence, estimated using the serologic testing algorithm for recent HIV seroconversion (STARHS), was 0.4% per year (95% confidence interval [95%CI] = 0.1–2.1). HIV prevalence was 1.8% (95%CI = 1.1–2.4). HIV infection was independently associated with age 30 to 39 years compared to all other ages, African-American race/ethnicity vs. non-African-American, and recent injection drug use. Maps showed that the communities in which arrested women reside are also those with the highest concentrations of newly detected female HIV cases, AIDS cases, and clients of substance use programs. The combined strategy of using sentinel surveillance in the jail setting and GIS to map the spatial distribution of disease provides a useful tool to identify patterns of risk in hard-to-reach, vulnerable populations of women.
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- Use of Sentinel Surveillance and Geographic Information Systems to Monitor Trends in HIV Prevalence, Incidence, and Related Risk Behavior among Women Undergoing Syphilis Screening in a Jail Setting
Journal of Urban Health
Volume 86, Issue 1 , pp 79-92
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- Sentinel surveillance
- Sexually transmitted diseases
- Author Affiliations
- 1. San Francisco Department of Public Health, San Francisco, CA, USA
- 2. Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA, USA
- 3. Department of Sociology, San Francisco State University, San Francisco, CA, USA
- 4. San Francisco State University, 1600 Holloway Ave., San Francisco, CA, 94132, USA