Partner Counseling, Referral Service Effective in Identifying People With Undiagnosed HIV in N.C., CDC Study Says
Voluntary partner counseling and referral services in North Carolina are effective methods to help identify individuals with undiagnosed HIV and could lead to behavior change that helps limit the spread of the virus, according to a study published in the Dec. 5 issue of the CDC's Morbidity and Mortality Weekly Report, Reuters reports. About one-quarter of the approximately 950,000 HIV-positive individuals in the United States are not aware of their HIV status, according to Reuters. Dr. Sam Dooley, associate director for science in the CDC's Division of HIV/AIDS Prevention, and colleagues analyzed North Carolina health data collected in 2001 to determine whether the state's PCRS program is effective at identifying sex and needle-sharing partners of recently diagnosed HIV-patients and encouraging those individuals to be tested (Simao, Reuters, 12/4). As part of the program -- which was established by the North Carolina Department of Health and Human Service in 1989 -- a disease intervention specialist conducts interviews with individuals newly diagnosed with HIV to learn about their sex and needle-sharing partners in the previous year. After receiving partner information, the specialist searches public health records to determine if any partners previously had been diagnosed as HIV-positive and then contacts remaining partners to notify them that they may have been exposed to HIV.
In 2001, 1,603 individuals tested HIV-positive in North Carolina, and specialists identified through interviews 1,532 sex or needle-sharing partners from 1,379 newly infected individuals. Of the partners identified, 173 could not be contacted; 592 previously had been tested for HIV, with 404 testing positive, and 188 had tested HIV-negative, of whom 122 were retested. Seventeen of the individuals who retested were HIV-positive. Of the individuals who previously had not been tested, 488 were tested following PCRS, with 108, or 22%, testing HIV-positive, according to the study. The researchers concluded that North Carolina's PCRS program can effectively identify sex and needle-sharing partners with previously undiagnosed HIV (Foust et al., MMWR, 12/5).
Dooley "praised" North Carolina for allocating the resources and preparing the public for the PCRS program, according to Reuters. "If [PCRS] were done to this extent and this degree of success across the board, we would see a significant number of those folks who don't know they're infected learning that they are," Dooley said (Reuters, 12/5). The researchers said that after testing HIV-positive, individuals often reduce behaviors that might further spread the disease (MMWR, 12/5). A "disturbing" rise in sexually transmitted diseases led the CDC earlier this year to change its HIV/AIDS prevention strategy, according to Reuters (Reuters, 12/5). The CDC in April announced a new HIV/AIDS prevention strategy that shifts funding distribution away from community groups that provide education aimed at reducing unsafe sexual and drug-use behaviors in people who have not contracted HIV. According to the strategy, the government will invest most heavily in initiatives that focus on identifying people who are already HIV-positive, including the expansion of routine HIV testing to include pregnant women, injection drug users and individuals who engage in unprotected sex. The CDC has said that the current emphasis on community outreach prevention programs has proven ineffective, citing annual increases in the number of new HIV cases nationwide (Kaiser Daily HIV/AIDS Report, 8/18).