Skip to main content
Erschienen in: AIDS and Behavior 6/2009

01.12.2009 | Original Paper

Identifying People with Acute HIV Infection: Demographic Features, Risk Factors, and Use of Health Care among Individuals with AHI in North Carolina

verfasst von: Lisa B. Hightow-Weidman, Carol E. Golin, Kelly Green, Eva N. P. Shaw, Pia D. M. MacDonald, Peter A. Leone

Erschienen in: AIDS and Behavior | Ausgabe 6/2009

Einloggen, um Zugang zu erhalten

Abstract

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.
Literatur
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
Zurück zum Zitat 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. 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.
Zurück zum Zitat CDC. (2007). Cases of HIV infection and AIDS in the United States and dependent areas, 2005. HIV/AIDS Surveillance Report, 17. CDC. (2007). Cases of HIV infection and AIDS in the United States and dependent areas, 2005. HIV/AIDS Surveillance Report, 17.
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
Zurück zum Zitat 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. 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.
Zurück zum Zitat Daar, E. S., Little, S., Pitt, J., Santangelo, J., Ho, P., Harawa, N., et al. (2001). Diagnosis of primary HIV-1 Infection. Annals of Internal Medicine, 134, 25–29.PubMed Daar, E. S., Little, S., Pitt, J., Santangelo, J., Ho, P., Harawa, N., et al. (2001). Diagnosis of primary HIV-1 Infection. Annals of Internal Medicine, 134, 25–29.PubMed
Zurück zum Zitat 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. 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.
Zurück zum Zitat Doll, L. S., Petersen, L. R., White, C. R., Johnson, E. S., & Ward, J. S. (1992). Homosexually and nonhomosexually identified men who have sex with men: A behavioral comparison. Journal of Sex Research, 29, 1–14.CrossRef Doll, L. S., Petersen, L. R., White, C. R., Johnson, E. S., & Ward, J. S. (1992). Homosexually and nonhomosexually identified men who have sex with men: A behavioral comparison. Journal of Sex Research, 29, 1–14.CrossRef
Zurück zum Zitat 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. 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.
Zurück zum Zitat 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.CrossRef 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.CrossRef
Zurück zum Zitat Hecht, F. M., Busch, M. P., Rawal, B. D., Webb, M., Rosenberg, E., Swanson, M., et al. (2002). Use of laboratory tests and clinical symptoms for identification of primary HIV infection. AIDS (London, England), 16, 1119–1129. doi:10.1097/00002030-200205240-00005. Hecht, F. M., Busch, M. P., Rawal, B. D., Webb, M., Rosenberg, E., Swanson, M., et al. (2002). Use of laboratory tests and clinical symptoms for identification of primary HIV infection. AIDS (London, England), 16, 1119–1129. doi:10.​1097/​00002030-200205240-00005.
Zurück zum Zitat Jacquez, J. A., Koopman, J. S., Simon, C. P., & Longini, L. M. (1994). Role of the primary infection in epidemics of HIV infection in gay Cohorts. Journal of Acquired Immune Deficiency Syndromes, 7, 1169–1184.PubMed Jacquez, J. A., Koopman, J. S., Simon, C. P., & Longini, L. M. (1994). Role of the primary infection in epidemics of HIV infection in gay Cohorts. Journal of Acquired Immune Deficiency Syndromes, 7, 1169–1184.PubMed
Zurück zum Zitat Kennamer, J. D., Honnold, J., Bradford, J., & Hendricks, M. (2000). Differences in disclosure of sexuality among African American and white gay/bisexual men: Implications for HIV/AIDS prevention. AIDS Education and Prevention, 12, 519–531.PubMed Kennamer, J. D., Honnold, J., Bradford, J., & Hendricks, M. (2000). Differences in disclosure of sexuality among African American and white gay/bisexual men: Implications for HIV/AIDS prevention. AIDS Education and Prevention, 12, 519–531.PubMed
Zurück zum Zitat 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.CrossRef 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.CrossRef
Zurück zum Zitat Koopman, J. S., Jacquez, J. A., Welch, G. W., Simon, C. P., Foxman, B., Pollock, S. M., et al. (1997). The role of early HIV infection in the spread of HIV through populations. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 14, 249–258.PubMed Koopman, J. S., Jacquez, J. A., Welch, G. W., Simon, C. P., Foxman, B., Pollock, S. M., et al. (1997). The role of early HIV infection in the spread of HIV through populations. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 14, 249–258.PubMed
Zurück zum Zitat Leynaert, B., Downs, A. M., & de Vincenzi, I. (1998). Heterosexual transmission of human immunodeficiency virus: Variability of infectivity throughout the course of infection. American Journal of Epidemiology, 148, 88–96.PubMed Leynaert, B., Downs, A. M., & de Vincenzi, I. (1998). Heterosexual transmission of human immunodeficiency virus: Variability of infectivity throughout the course of infection. American Journal of Epidemiology, 148, 88–96.PubMed
Zurück zum Zitat Lindback, S., Thorstensson, R., Karlsson, A. C., Sydow, M., Flamholc, L., Blaxhult, A., et al. (2000). Diagnosis of primary HIV-1 infection and duration of follow-up after HIV exposure. AIDS (London, England), 14, 2333–2339. doi:10.1097/00002030-200010200-00014. Lindback, S., Thorstensson, R., Karlsson, A. C., Sydow, M., Flamholc, L., Blaxhult, A., et al. (2000). Diagnosis of primary HIV-1 infection and duration of follow-up after HIV exposure. AIDS (London, England), 14, 2333–2339. doi:10.​1097/​00002030-200010200-00014.
Zurück zum Zitat McKirnan, D. J., Vanable, P. A., Ostrow, D. G., & Hope, B. (2001). Expectancies of sexual “escape” and sexual risk among drug and alcohol-involved gay and bisexual men. Journal of Substance Abuse, 13, 137–154. doi:10.1016/S0899-3289(01)00063-3.CrossRefPubMed McKirnan, D. J., Vanable, P. A., Ostrow, D. G., & Hope, B. (2001). Expectancies of sexual “escape” and sexual risk among drug and alcohol-involved gay and bisexual men. Journal of Substance Abuse, 13, 137–154. doi:10.​1016/​S0899-3289(01)00063-3.CrossRefPubMed
Zurück zum Zitat Millett, G., Malebranche, D., Mason, B., & Spikes, P. (2005). Focusing “down low”: Bisexual black men, heterosexual black women, and HIV risk. Journal of the National Medical Association, 97, 52S–59S.PubMed Millett, G., Malebranche, D., Mason, B., & Spikes, P. (2005). Focusing “down low”: Bisexual black men, heterosexual black women, and HIV risk. Journal of the National Medical Association, 97, 52S–59S.PubMed
Zurück zum Zitat Ostrow, D. G., Whitaker, R. E., Frasier, K., Cohen, C., Wan, J., Frank, C., et al. (1991). Racial differences in social support and mental health in men with HIV infection: A pilot study. AIDS Care, 3, 55–62. doi:10.1080/09540129108253047.CrossRefPubMed Ostrow, D. G., Whitaker, R. E., Frasier, K., Cohen, C., Wan, J., Frank, C., et al. (1991). Racial differences in social support and mental health in men with HIV infection: A pilot study. AIDS Care, 3, 55–62. doi:10.​1080/​0954012910825304​7.CrossRefPubMed
Zurück zum Zitat Pao, D., Fisher, M., Hue, S., Dean, G., Murphy, G., Cane, P. A., et al. (2005). Transmission of HIV-1 during primary infection: Relationship to sexual risk and sexually transmitted infections. AIDS (London, England), 19, 85–90. doi:10.1097/00002030-200501030-00010. Pao, D., Fisher, M., Hue, S., Dean, G., Murphy, G., Cane, P. A., et al. (2005). Transmission of HIV-1 during primary infection: Relationship to sexual risk and sexually transmitted infections. AIDS (London, England), 19, 85–90. doi:10.​1097/​00002030-200501030-00010.
Zurück zum Zitat Pilcher, C. D., Eron, J. J., Vemazza, P. L., Battegay, M., Harr, T., Yerly, S., et al. (2001a). Sexual transmission during the incubation period of primary HIV infection. Journal of the American Medical Association, 286, 1713–1714. doi:10.1001/jama.286.14.1713.CrossRefPubMed Pilcher, C. D., Eron, J. J., Vemazza, P. L., Battegay, M., Harr, T., Yerly, S., et al. (2001a). Sexual transmission during the incubation period of primary HIV infection. Journal of the American Medical Association, 286, 1713–1714. doi:10.​1001/​jama.​286.​14.​1713.CrossRefPubMed
Zurück zum Zitat Pilcher, C. D., Fiscus, S. A., Nguyen, T. Q., Foust, E., Wolf, L., Williams, D., et al. (2005). Detection of acute infections during HIV testing in North Carolina. The New England Journal of Medicine, 352, 1873–1883. doi:10.1056/NEJMoa042291.CrossRefPubMed Pilcher, C. D., Fiscus, S. A., Nguyen, T. Q., Foust, E., Wolf, L., Williams, D., et al. (2005). Detection of acute infections during HIV testing in North Carolina. The New England Journal of Medicine, 352, 1873–1883. doi:10.​1056/​NEJMoa042291.CrossRefPubMed
Zurück zum Zitat 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. 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.
Zurück zum Zitat Pilcher, C. D., Tien, C. H., Eron, J. J., Vernazza, P. L., Leu, S. Y., Stewer, P. W., et al. (2004). Brief but efficient: Acute HIV infection and the sexual transmission of HIV. The Journal of Infectious Diseases, 189, 1785–1792. doi:10.1086/386333.CrossRefPubMed Pilcher, C. D., Tien, C. H., Eron, J. J., Vernazza, P. L., Leu, S. Y., Stewer, P. W., et al. (2004). Brief but efficient: Acute HIV infection and the sexual transmission of HIV. The Journal of Infectious Diseases, 189, 1785–1792. doi:10.​1086/​386333.CrossRefPubMed
Zurück zum Zitat Pincus, J. M., Crosby, S. S., Losina, E., King, E. R., LaBelle, C., & Freedberg, K. A. (2003). Acute human immunodeficiency virus infection in patients presenting to an Urban Urgent Care Center. Clinical Infectious Diseases, 37, 1699–1704. doi:10.1086/379772.CrossRefPubMed Pincus, J. M., Crosby, S. S., Losina, E., King, E. R., LaBelle, C., & Freedberg, K. A. (2003). Acute human immunodeficiency virus infection in patients presenting to an Urban Urgent Care Center. Clinical Infectious Diseases, 37, 1699–1704. doi:10.​1086/​379772.CrossRefPubMed
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
Zurück zum Zitat Schacker, T., Collier, A. C., Hughes, J., Shea, T., & Corey, L. (1996). Clinical and epidemiologic features of primary HIV infection. Annals of Internal Medicine, 125, 257–264.PubMed Schacker, T., Collier, A. C., Hughes, J., Shea, T., & Corey, L. (1996). Clinical and epidemiologic features of primary HIV infection. Annals of Internal Medicine, 125, 257–264.PubMed
Zurück zum Zitat Schacker, T. W., Hughes, J. P., Shea, T., Coombs, R. W., & Corey, L. (1998). Biological and virologic characteristics of primary HIV infection. Annals of Internal Medicine, 128, 613–620.PubMed Schacker, T. W., Hughes, J. P., Shea, T., Coombs, R. W., & Corey, L. (1998). Biological and virologic characteristics of primary HIV infection. Annals of Internal Medicine, 128, 613–620.PubMed
Zurück zum Zitat 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.PubMed 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.PubMed
Zurück zum Zitat Siegel, K., Karus, D., & Raveis, V. H. (1997). Testing and treatment behaviour of HIV-infected women: White, African-American, Puerto Rican comparisons. AIDS Care, 9, 297–309.PubMedCrossRef Siegel, K., Karus, D., & Raveis, V. H. (1997). Testing and treatment behaviour of HIV-infected women: White, African-American, Puerto Rican comparisons. AIDS Care, 9, 297–309.PubMedCrossRef
Zurück zum Zitat Vanhems, P., Allard, R., Cooper, D. A., Perrin, L., Vizzard, J., Hirschel, B., et al. (1997). Acute human immunodeficiency virus type 1 disease as a mononucleosis-like illness: Is the diagnosis too restrictive? Clinical Infectious Diseases, 24, 965–970.PubMed Vanhems, P., Allard, R., Cooper, D. A., Perrin, L., Vizzard, J., Hirschel, B., et al. (1997). Acute human immunodeficiency virus type 1 disease as a mononucleosis-like illness: Is the diagnosis too restrictive? Clinical Infectious Diseases, 24, 965–970.PubMed
Zurück zum Zitat Wawer, M. J., Gray, R. H., Sewankambo, N. K., Serwadda, D., Li, X., Laeyendecker, O., et al. (2005). Rates of HIV-1 transmission per coital act, by stage of HIV-1 infection, in Rakai, Uganda. The Journal of Infectious Diseases, 191, 1403–1409. doi:10.1086/429411.CrossRefPubMed Wawer, M. J., Gray, R. H., Sewankambo, N. K., Serwadda, D., Li, X., Laeyendecker, O., et al. (2005). Rates of HIV-1 transmission per coital act, by stage of HIV-1 infection, in Rakai, Uganda. The Journal of Infectious Diseases, 191, 1403–1409. doi:10.​1086/​429411.CrossRefPubMed
Zurück zum Zitat Wohl, A. R., Johnson, D. F., Lu, S., Jordan, W., Beall, G., Currier, J., et al. (2002). HIV risk behaviors among African American men in Los Angeles county who self-identify as heterosexual. Journal of Acquired Immune Deficiency Syndromes, 31, 354–360.PubMed Wohl, A. R., Johnson, D. F., Lu, S., Jordan, W., Beall, G., Currier, J., et al. (2002). HIV risk behaviors among African American men in Los Angeles county who self-identify as heterosexual. Journal of Acquired Immune Deficiency Syndromes, 31, 354–360.PubMed
Zurück zum Zitat Yerly, S., Vora, S., Rizzardi, P., Chave, J. P., Vernazza, P. L., Flepp, M., et al. (2001). Acute HIV infection: Impact on the spread of HIV and transmission of drug resistance. AIDS (London, England), 15, 2287–2292. doi:10.1097/00002030-200111230-00010. Yerly, S., Vora, S., Rizzardi, P., Chave, J. P., Vernazza, P. L., Flepp, M., et al. (2001). Acute HIV infection: Impact on the spread of HIV and transmission of drug resistance. AIDS (London, England), 15, 2287–2292. doi:10.​1097/​00002030-200111230-00010.
Metadaten
Titel
Identifying People with Acute HIV Infection: Demographic Features, Risk Factors, and Use of Health Care among Individuals with AHI in North Carolina
verfasst von
Lisa B. Hightow-Weidman
Carol E. Golin
Kelly Green
Eva N. P. Shaw
Pia D. M. MacDonald
Peter A. Leone
Publikationsdatum
01.12.2009
Verlag
Springer US
Erschienen in
AIDS and Behavior / Ausgabe 6/2009
Print ISSN: 1090-7165
Elektronische ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-008-9519-5

Weitere Artikel der Ausgabe 6/2009

AIDS and Behavior 6/2009 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.