Identifying the Correlates of Membership in HIV-Serodiscordant Partnerships in New York City

Braunstein, Sarah L. PhD, MPH; Udeagu, Chi-Chi MPH; Bocour, Angelica MPH; Renaud, Tamar MPH; Shepard, Colin W. MD

doi: 10.1097/OLQ.0000000000000007
Original Study

Background: Identification and characterization of patients in HIV-serodiscordant partnerships can inform strategies to improve HIV prevention efforts for this group.

Methods: We conducted a case-control analysis using New York City Department of Health and Mental Hygiene HIV surveillance and partner services (PS) data from July 2006 to July 2010. HIV-infected index patients reported and interviewed for PS who named 1 or more sex and/or syringe-sharing partner (n = 1309) and their sex partners notified by New York City Department of Health and Mental Hygiene with confirmed HIV serostatus (n = 1564) were selected for analysis. Index patients were classified into either serodiscordant or seroconcordant-positive partnerships based on the HIV serostatus of their partner(s). Multivariable regression analysis was conducted to examine the likelihood of membership in a serodiscordant partnership by a range of individual- and partnership-level variables.

Results: Of the 1309 index patients, 624 (48%) were in HIV-serodiscordant partnerships. In multivariable analysis, the likelihood of serodiscordant partnership membership was slightly higher among women, individuals with unknown HIV transmission risk, and those with 2 to 3 named partners versus 1. Index patients claimed more partners than they named; for example, index patients who named 1 partner claimed an average of 2.3 partners in the past 12 months.

Conclusions: Many HIV-infected patients who received PS were in HIV-serodiscordant partnerships, with characteristics indicating potential for HIV transmission. Our findings suggest several potential programmatic and policy needs, including enhanced linkage-to-care efforts for this population, especially HIV-infected individuals with uncontrolled viremia; ongoing PS for individuals with evidence of continuing exposure of others; and participation by patients and their serodiscordant, steady partners in local prevention interventions.

An analysis of New York City HIV surveillance and partner services data found a large proportion of HIV-serodiscordant partnerships, with characteristics that may increase likelihood of HIV transmission.

From the HIV Epidemiology and Field Services Program, New York City Department of Health and Mental Hygiene, New York City, NY

Acknowledgment: The authors are grateful to the HIV Field Services Unit and HIV Surveillance Unit staff for their ongoing dedication to curb HIV transmission in New York City.

Supported in part by the Centers for Disease Control and Prevention cooperative agreement nos. U62/CCU223460-06-1 and U62/CCU223460-05-4. The findings and conclusions in this article are those of the authors and do not necessarily reflect the views of the Centers for Disease Control and Prevention.

Conflicts of interest: The authors have no conflicts of interest to disclose.

Correspondence: Sarah L. Braunstein, PhD, MPH, New York City Department of Health and Mental Hygiene, 42-09 28th St, CN44, Queens, NY 11101. E-mail: sbraunstein@health.nyc.gov.

Received for publication March 22, 2013, and accepted June 3, 2013.

© Copyright 2013 American Sexually Transmitted Diseases Association