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Recently diagnosed sexually HIV-infected patients: seroconversion interval, partner notification period and a high yield of HIV diagnoses among partners.

We collected data on the outcome of partner notification (PN) for 356 index patients (iPs) newly diagnosed with HIV, all sexually infected, in six European countries, 1995-96. The PN period (the period during which exposed partners should be notified about their risk of being HIV infected) could be defined on the basis of last negative HIV test in 170/356 (48%), from other key dates for 12, and for 14 more on the sole basis of known HIV exposure (total 196/356, 55%). However, of the 170 iPs with a last negative HIV test date, PN period was not defined in 52 (31%), even though 28/52 were recent seroconverters (negative HIV test within 24 months of HIV diagnosis). Discrepancies in PN period evaluation were common: of the 85 iPs for whom PN period was reportedly defined as '3 months before last HIV-negative date', the period actually used was equal to this in only 12. A user-friendly worksheet would simplify the task of eliciting and using key dates to define the PN period. Forms on PN outcome were received for 166/200 (83%) reported current partners, but only 124/508 (24%) ex-partners. Fifty-two of 290 (18%) notified partners already knew they were HIV-positive, and 38/130 (29%) notified partners for whom pre-PN status was negative or unknown were HIV-positive on post-PN testing. Results of HIV tests (if any) after PN were unknown for 37/133 (28%) current partners not already known to be HIV-positive, and for 71/105 (68%) ex-partners-a doubling of the information loss rate. Notification of 133 current and 105 ex-partners not previously identified as HIV-positive thus produced 28 (21%) and 10 (10%) new HIV diagnoses, respectively. The total yield of HIV diagnoses was 38/100 (38%) partners of recent seroconverters (22 already known plus 16 PN-diagnosed), compared with 52/190 (27%) partners of other iPs (30 already known plus 22 PN-diagnosed). We propose prioritization for PN of partners of recent seroconverters, augmented surveillance for HIV diagnoses and recurrence in PN networks of at-risk, non-notified partners, and new measures that preserve anonymity to alert potential and past sexual contacts of HIV-diagnosed individuals who are unable or unwilling to assist in PN.

Adult↗

Patterns and trends in clinically recognized HIV seroconversions among all newly diagnosed HIV-infected homo-/bisexual men in Denmark, 1991-1994.

OBJECTIVE: To analyse patterns and trends in recently acquired HIV infections among newly diagnosed homo-/bisexual men. DESIGN AND METHODS: All newly diagnosed HIV-positive homo-/bisexual men reported to the mandatory national HIV reporting system in Denmark in 1991-1994. RESULTS: A total of 495 homo-/bisexual men were diagnosed with HIV infection for the first time; 45% had previously been tested HIV-negative, among whom 68% were known to have seroconverted 4 years or less prior to the positive diagnosis. Both proportions increased significantly from 1991 to 1994. Among men previously tested negative, the median interval between last negative and first positive HIV test was 902 days (range, 14-4459 days); 21.3% had seroconverted within 1 year and 55.1% within 3 years. Men previously tested negative were significantly younger than men never tested. Sex with a known HIV-positive partner was associated with having had a previous negative test and with being young. Half of the men had HIV-associated symptoms when diagnosed with HIV. Using a logistic regression model the following variables were associated with being a clinically recognized recent seroconverter: young age, no HIV-associated symptoms when diagnosed as HIV-infected, and ever having sex with an HIV-infected man. CONCLUSION: An increasing proportion of homo-/bisexual men diagnosed with HIV in Denmark in the early 1990s had had a negative HIV test 4 years or less before being diagnosed as HIV-positive. These men were younger and had HIV-associated symptoms less often than men not previously tested. The national HIV reporting system provides valuable information for planning primary HIV prevention programmes.

AIDS Serodiagnosis↗