498. The Association between Race/Ethnicity, HIV Care Engagement, and New STD Acquisition in HIV-positive Individuals
Session: Poster Abstract Session: HIV Testing and Prevention
Friday, October 21, 2011
Room: Poster Hall B1
Handouts
  • 498_AvnishTRIPATHI.pdf (387.2 kB)
  • Background: Risk reduction following an HIV diagnosis is important for controlling the epidemic. The objective of this research study was to determine if race/ethnicity and level of HIV care engagement since 2004 were associated with new STD acquisition in HIV-infected individuals

    Methods: A retrospective cohort study involving 9,548 individuals ≥ 13 years of age diagnosed with HIV-infection from January 1, 1997-December 31, 2009. State-wide health department datasets were linked with the hospital discharge dataset of all outpatient, inpatient, and emergency department medical encounters to determine the number of reportable STDs (gonorrhea, Chlamydia, Syphilis) occurring after HIV diagnosis. Adequate HIV care engagement was defined as at least one viral load (VL) test or one CD4 test every six months, beginning six months after HIV diagnosis. The HIV care engagement rates were divided into three tertiles - low, medium, and high – calculated from the number of observed and expected HIV laboratories based on HIV diagnosis dates. Individuals who have low HIV care engagement had ≤30%; medium HIV care engagement had between 31%-80%; and high HIV-care engagement had >80% of the suggested number of VL or CD4 tests. Hurdle regression was used to determine if race and level of HIV care engagement since 2004 was a predictor of the number of new reportable STDs acquired after HIV diagnosis.

    Results: Among individuals who had a high level of HIV care engagement, Black individuals had a significantly higher mean number of new STDs after HIV diagnosis than White individuals (ARR=1.47; 95% CI=1.07-2.04).  Among individuals who had a medium level of HIV care engagement, no significant differences in the mean number of new STDs after HIV diagnosis were detected among White, Black, or Other individuals. Among individuals who had a low level of HIV care engagement, Other individuals had a significantly higher probability of zero new STDs after HIV diagnosis than White individuals (AOR=2.46; 95% CI=1.14-5.31)

    Conclusion: These results suggest that as part of the Treatment as Prevention strategy, public health officials need to address STD incidence reduction for HIV-positive individuals that are tailored to race and level of HIV care engagement.


    Subject Category: H. HIV/AIDS and other retroviruses

    Yohance Whiteside, MSPH1, Hussey James, PhD1 and Wayne Duffus, MD, PhD2,3, (1)Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, (2)South Carolina Dept. of Health and Environmental Control, Columbia, SC, (3)Internal Medicine, University of South Carolina School of Medicine, Columbia, SC

    Disclosures:

    Y. Whiteside, None

    H. James, None

    W. Duffus, None

    Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.