Identifying People with Acute HIV Infection: Demographic Features, Risk Factors, and Use of Health Care among Individuals with AHI in North Carolina
- 163 Downloads
Identifying and counseling individuals with Acute HIV Infection (AHI) offers a critical opportunity to avert preventable HIV transmission, however, opportunities to recognize these individuals may be missed. We surveyed 32 adults diagnosed with AHI during voluntary HIV testing from 1/1/03 to 2/28/05 in publicly funded testing sites in NC to describe their clinical, social, and behavioral characteristics. Eighty-one percent of participants were men; 59% were African American. Seventy-five percent experienced symptoms consistent with acute retroviral syndrome; although 83% sought medical care for these symptoms, only 15% were appropriately diagnosed at that initial medical visit, suggesting opportunities to diagnose these individuals earlier were missed. Eighty-five percent of the men engaged in sex with men. More than 50% of the participants thought they were infected with HIV by a steady partner. This study yields important information to assist in identifying populations at risk for or infected with AHI and designing both primary and secondary prevention interventions.
KeywordsAcute HIV infection (AHI) North Carolina (NC) HIV/AHI screening AHI epidemiology HIV risk factors
This study was supported by a Developmental Grant from the University of North Carolina Center for AIDS Research (CFAR).
- Bollinger, R. C., Brookmeyer, R. S., Mehendale, S. M., Paranjape, R. S., Shepherd, M. E., Gadkari, D. A., et al. (1997). Risk factors and clinical presentation of acute primary HIV infection in India. Journal of the American Medical Association, 278, 2085–2089. doi: 10.1001/jama.278.23.2085.CrossRefPubMedGoogle Scholar
- CDC. (2003). HIV/STD risks in young men who have sex with men who do not disclose their sexual orientation: Six US Cities, 1994–2000. Atlanta: Centers for Disease Control and Prevention, 2003.Google Scholar
- CDC. (2007). Cases of HIV infection and AIDS in the United States and dependent areas, 2005. HIV/AIDS Surveillance Report, 17.Google Scholar
- Celum, C. L., Buchbinder, S. P., Donnell, D., Douglas, J. M., Jr, Mayer, K., Koblin, B., et al. (2001). Early human immunodeficiency virus (HIV) infection in the HIV network for prevention trials vaccine preparedness Cohort: Risk behaviors, symptoms, and early plasma and genital tract virus load. The Journal of Infectious Diseases, 183, 23–35. doi: 10.1086/317658.CrossRefPubMedGoogle Scholar
- Colfax, G. N., Buchbinder, S. P., Cornelisse, P. G. A., Vittinghoff, E., Mayer, K., & Celum, C. (2002). Sexual risk behaviors and implications for secondary HIV transmission during and after HIV seroconversion. AIDS (London, England), 16, 1529–1535. doi: 10.1097/00002030-200207260-00010.Google Scholar
- CDC. (2004). HIV transmission among black college student and non-student men who have sex with men–North Carolina, 2003. Morbidity and Mortality Weekly Report, 53, 731–734.Google Scholar
- Fiebig, E. W., Wright, D. J., Rawal, B. D., Garrett, P. E., Schumacher, R. T., Peddada, L., et al. (2003). Dynamics of HIV viremia and antibody seroconversion in plasma donors: Implications for diagnosis and staging of primary HIV infection. AIDS (London, England), 17, 1871–1879. doi: 10.1097/00002030-200309050-00005.Google Scholar
- Goldbaum, G., Perdue, T., Wolitski, R., Rietmeijer, C., Hedrich, A., Wood, R., et al. (1998). Differences in risk behavior and sources of AIDS information among gay, bisexual, and straight-identified men who have sex with men. AIDS and Behavior, 2, 13–21. doi: 10.1023/A:1022399021926.CrossRefGoogle Scholar
- Kingsley, L., Kaslow, R., Rinaldo, C., Detre, K., Odaka, N., Vanraden, M., et al. (1987). Risk factors for seroconversion to human immunodeficiency virus among male homosexuals: Results from the multicenter AIDS Cohort study. Lancet, 329, 345–349. doi: 10.1016/S0140-6736(87)91725-9.CrossRefGoogle Scholar
- North Carolina HIV/STD surveillance report. (2007). Available at: http://www.epi.state.nc.us/epi/hiv/stats.html.
- Pilcher, C. D., Shugars, D. C., Fiscus, S. A., Miller, W. C., Menezes, P., Giner, J., et al. (2001b). HIV in body fluids during primary HIV infection: Implications for pathogenesis, treatment and public health. AIDS (London, England), 15, 837–845. doi: 10.1097/00002030-200105040-00004.Google Scholar
- Ross, M. W., Essien, E. J., Williams, M. L., & Fernandez-Esquer, M. E. (2003). Concordance between sexual behavior and sexual identity in street outreach samples of four racial/ethnic groups. Sexually Transmitted Diseases, 30, 110–113. doi: 10.1097/00007435-200302000-00003.CrossRefPubMedGoogle Scholar
- Sabundayo, B. P., McArthur, J. H., Langan, S. J., Gallant, J. E., & Margolick, J. B. (2006). High frequency of highly active antiretroviral therapy modifications in patients with acute or early human immunodeficiency virus infection. Pharmacotherapy, 26, 674–681. doi: 10.1592/phco.26.5.674.CrossRefPubMedGoogle Scholar
- Schwarcz, S. K., Kellogg, T. A., Kohn, R. P., Katz, M. H., Lemp, G. F., & Bolan, G. A. (1995). Temporal trends in human immunodeficiency virus seroprevalence and sexual behavior at the San Francisco Municipal sexually transmitted disease Clinic, 1989–1992. American Journal of Epidemiology, 142, 314–322.PubMedGoogle Scholar