Prevalence of HIV in the US Household Population. The National Health and Nutrition Examination Surveys, 1988 to 2002
|
|
- Augustus Lee
- 6 years ago
- Views:
Transcription
1 EPIDEMIOLOGY AND SOCIAL SCIENCE Prevalence of HIV in the US Household Population The National Health and Nutrition Examination Surveys, 1988 to 2002 Geraldine M. McQuillan, PhD,* Deanna Kruszon-Moran, MS,* Benny J. Kottiri, PhD,* Laurie A. Kamimoto, MD, Lee Lam, MS, M. Faye Cowart, MT(ASCP), Marjorie Hubbard, MT(ASCP), MS, and Thomas J. Spira, MD Summary: To examine trends in HIV prevalence in the US household population, serum or urine samples from 2 National Health and Nutrition Examinations Surveys (NHANES) (1988 Y1994 and 1999Y2002), were tested for HIV antibody. In the 1999 to 2002 survey, data on risk behaviors, CD4 T lymphocytes, and antiretroviral therapy (ART) were also available. In the 1988 to 1994 survey, there were 59 positive individuals of 11,203 tested. In NHANES 1999 to 2002, there were 32 positive individuals of 5926 tested. The prevalence of HIV infection among those aged 18 to 39 years in NHANES 1988 to 1994 was 0.38% (95% confidence interval [CI]: 0.22Y0.68) as compared with 0.37% (95% CI: 0.17 to 0.80) in 1999 to Prevalence did not change significantly between surveys in any race and/or ethnic or gender group among 18- to 39-year-old participants. HIV prevalence was 3.58% (95% CI: 1.88 to 6.71) among non-hispanic blacks in the 40- to 49-year-old age group in 1999 to 2002, but the age range available in NHANES 1988 to 1994 was 18 to 59 years and does not allow direct comparison of prevalence. Cocaine use and the presence of herpes simplex virus- 2 antibody were the only significant risk factors for HIV infection for non-hispanic blacks. Fifty-eight percent of infected individuals not reporting ART had CD4 T-lymphocyte counts G200 cells/mm 3 compared with 18.2% on therapy and 12.5% of participants newly informed of their HIV status. Key Words: national survey, HIV antibody, prevalence (J Acquir Immune Defic Syndr 2006;41:651Y656) As part of the overall surveillance activities to monitor the HIV epidemic in the United States, testing for HIV antibody has been included in 2 National Health and Nutrition Examination Surveys (NHANES III conducted in 1988 Y1994 Received for publication April 18, 2005; accepted October 21, From the *Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD; Division of HIV/AIDS PreventionYSurveillance and Epidemiology, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA; and HIV Clinical Diagnostics Program, HIV Immunology and Diagnostics Branch, Division of HIV/AIDS Prevention, Center for HIV, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA. This was a federally funded survey with no other source of support. All authors are employed by the Federal Government. Reprints: Geraldine M. McQuillan, National Center for Health Statistics, 3311 Toledo Road, Room 4204, Hyattsville, MD, ( GMM2@CDC.GOV). Copyright * 2006 by Lippincott Williams & Wilkins and NHANES 1999 Y2002). The prevalence of HIV from NHANES III was 0.33% for those aged 18 to 59 years, with a population estimate ranging from 290,000 to 733,000 infected individuals based on this representative sample of the civilian noninstitutionalized household population of the United States. 1,2 Data from NHANES 1999 to 2002 provide the opportunity to estimate the change in HIV prevalence in the general household population since NHANES III. In the 10 years between the 2 surveys, the number of new AIDS cases and deaths declined substantially after the introduction of combination antiretroviral therapy (ART) in the late 1990s. The number of estimated new HIV infections has remained stable at approximately 40,000 per year; therefore, the Centers for Disease Control and Prevention (CDC) has estimated that the number of individuals living with HIV infection continues to increase. 3 Surveillance data of persons diagnosed with HIV infection has also demonstrated a changing epidemic that now disproportionately affects poor and minority individuals. 4 The NHANES 1999 to 2002 HIV prevalence provides an estimate of the current epidemiology of infection in the general household population. CD4 T-lymphocyte testing was also conducted on HIV-positive individuals and age-matched controls to examine the current state of immune function in infected participants compared with noninfected individuals. In addition, selfreported data on medication use in this survey provided insight into treatment of HIV-infected individuals, and data on selfreported risk behaviors provided information on the contribution of these behaviors in the general household population. METHODS Study Populations and Sample Design The NHANES are a series of cross-sectional surveys designed to provide national statistics on the health and nutritional status of the general household population through household interviews, standardized physical examinations, and the collection of biologic samples in special mobile examination centers (MECs). The sampling plan of each survey has been a stratified, multistage, probability cluster design that selected a sample representative of the US civilian noninstitutionalized population. 5,6 In NHANES III, conducted from 1988 to 1994, 11,203 participants aged 18 to 59 years were anonymously tested for antibody to HIV. Because the testing was conducted J Acquir Immune Defic Syndr & Volume 41, Number 5, April 15,
2 McQuillan et al J Acquir Immune Defic Syndr & Volume 41, Number 5, April 15, 2006 anonymously, the only information linked to the HIV antibody status was age group (18 Y 39 years and 40 Y59 years), race and/or ethnicity, and gender. In 1999, the NHANES became a continuous survey with data released in 2-year cycles. HIV antibody prevalence estimates from 1999 to 2002 are presented in this article. During these survey years, HIV testing was not anonymous and was performed on participants aged 18 to 49 years. Because age by individual years was not associated with information on HIV status in NHANES III, it is not possible to construct comparable age groups for those aged 40 or more years across the 2 surveys. In NHANES III and NHANES 1999 to 2002, race and/or ethnicity was categorized as non-hispanic white, non-hispanic black, and Mexican American. Persons not fitting these categories were classified as Bother[ and included in the total population. In both surveys, Mexican Americans and black Americans were sampled at a higher rate than other persons. The HIV antibody test results were reported to participants in NHANES 1999 to 2002 with other sexually transmitted disease (STD) laboratory results using a call-in password-protected system. If participants did not call for the results, they were sent 3 reminder letters to encourage them to call. Information on previous knowledge of HIV status was obtained as part of the posttest counseling. In the 1999 to 2002 survey, the HIV results can be analyzed with other NHANES components and data. Variables analyzed include poverty index ratio calculated by dividing total family income by the poverty threshold index adjusted for family size at year of interview and categorized as below poverty (G1) or at or above poverty (1 or above) 7 and education measured as last year of school completed and grouped into 2 levels (less than high school graduate and high school completed or more education) as well as marital status grouped as married, living as married, or widowed; divorced or separated; and never married. The sexual behavior and drug use data were collected in a private room in the MEC using an audio computer-assisted self-interviewing technique (ACASI). The variables collected include use of cocaine and intravenous drugs, age at first intercourse, lifetime number of sexual partners, and history of male-to-male sex. The NHANES 1999 to 2002 prescription drug use data were collected during the household interview. Respondents were asked: BHave you taken or used any medicines for which a doctor`s ordentist`s prescription is needed in the past month?[ For each medication reported, the interviewer asked to see the medication container to record the product names from the label. If the container was unavailable (17% of all reported products), the interviewer probed the subject for this information. 8 In both surveys, informed consent was obtained from all participants and the National Center for Health Statistics, CDC Ethical Review Board approved the protocols. 652 Laboratory Methods In NHANES III, serum specimens were tested for HIV- 1 antibody using a US Food and Drug Administration (FDA) Y licensed enzyme immunoassay kit (Genetic Systems, Redmond, WA or Organon-Teknika Corporation, Durham, NC). Positive specimens were retested and confirmed by an FDAlicensed Western blot assay (Biotech/Dupont, Rockville, MD) and interpreted according to the Association of State and Territorial Public Health Laboratory Directors (ASTPHLD)/CDC criteria. 9 In NHANES 1999 to 2002, serum specimens were tested for HIV-1 and HIV-2 antibody (HIV-1/HIV-2 Peptide EIA, Genetic Systems). HIV-1 was not differentiated from HIV-2 during these survey years; thus, positive results are identified as HIV-positive without an indication of subtype in this article. All repeatedly positive specimens were confirmed by Western blot analysis (Calypte Serum Western blot; Calypte Biomedical Corporation, Pleasanton, CA). NHANES participants who consented to the HIV test but did not have venipuncture or did not have sufficient serum available for the serum antibody test were tested for HIV antibody using urine (Calypte HIV-1 Peptide EIA; Calypte Biomedical Corporation). Positive specimens were retested and confirmed by Western blot analysis (Calypte Urine Western blot; Calypte Biomedical Corporation). 10 Enumeration of CD4 T lymphocytes from NHANES 1999 to 2002 HIV-positive participants and age-matched controls was performed on cryopreserved whole blood using the method reported by Fiebig et al. 11 Samples were batchthawed quickly with 8 to 10 samples per batch in a 37-C water bath and analyzed within 2 hours of setup. The CD4 T-lymphocyte cell counts were obtained using the Becton Dickinson MultiTEST reagent in TrueCOUNT tubes (Becton Dickinson Immunocytometry Systems, San Jose, CA). Comparison of this method with fresh normal whole blood resulted in a correlation coefficient of 0.97, with a slope of 0.92 and a mean bias of j67.2 (CDC, unpublished data). Antibody to herpes simplex virus (HSV)-2 was determined by a type-specific immunodot assay. Details about this method have been previously reported. 12 Statistical Analyses Prevalence estimates for both surveys were weighted to represent the total civilian noninstitutionalized US household population in the age groups covered in each survey and to account for oversampling and nonresponse to the household interview and physical examination but not for nonresponse to phlebotomy. The weights were further ratio-adjusted by age, gender, and race and/or ethnicity to the US population control estimates from the current population survey adjusted for undercounts. 13 Standard errors were calculated using SUDAAN (Research Triangle Institute, Research Triangle Park, NC), 14 a family of statistical procedures for analysis of data from complex sample surveys. Ninety-five percent confidence intervals (CIs) were estimated using the logit transformation. 15 To examine possible predictors of seropositivity, differences in prevalence were evaluated by examining P values calculated using a univariate t statistic obtained from a general linear contrast procedure in SUDAAN. For total comparisons between NHANES III and NHANES 1999 to 2002, data were age-adjusted by the direct method to the 2000 US population. 16 Because the estimates are of small magnitude relative to their standard errors (RSEs), all prevalence estimates except for the total estimate in each survey were outside the accepted RSE reliability cut point of less than 30%. 17 * 2006 Lippincott Williams & Wilkins
3 J Acquir Immune Defic Syndr & Volume 41, Number 5, April 15, 2006 Prevalence of HIV in US Household Population The percentage of individuals on ART by CD4 T- lymphocyte counts are not weighted because they are provided to describe the characteristics of the HIV-positive individuals in the survey rather than to provide national estimates of these characteristics. Response Rates In NHANES III, 82.4% of selected participants aged 18 to 59 years agreed to be interviewed and 86.0% of these (11,203 of 13,022 participants) agreed to the examination and had sufficient serum available for the HIV assay. Response rates were similar for both sexes (85.7% male and 87.5% female) and age groups as well as for non-hispanic whites and blacks (85.7% and 85.9%, respectively) but were higher for Mexican Americans (88.3%). No significant difference in response rates was observed by demographic subgroup, although the lowest response rate to the survey in this age range was among never-married participants (84.3%). An analysis of the potential effect of the differential response using imputation of HIV results in nonrespondents resulted in a reduction in prevalence. 2 Overall, 81.5% of selected participants aged 18 to 49 years in NHANES 1999 to 2002 agreed to be interviewed, and 91.8% of these (5926 of 6458 participants) agreed to the examination and had blood or urine for the HIV test. Response rates were similar for both sexes (92.2% of male participants and 91.4% of female participants) and age groups as well as for non-hispanic whites and blacks (91.7% and 91.9%, respectively) and were higher for Mexican Americans (92.7%). There were no significant differences in response rates by poverty index, education, or marital status. Only 1 person (a 44-year-old black man) who reported using HIV medications in the last 30 days during the household interview did not have a blood or urine sample available for HIV testing. RESULTS The prevalence of HIV infection among those aged 18 to 39 years in NHANES 1999 to 2002 (0.37%, 95% CI: 0.17 to 0.80) was not statistically different from the estimate from NHANES III (0.38%, 95% CI: 0.22 to 0.68) for the same age group (Table 1). The estimate among those aged 40 years and older in NHANES 1999 to 2002 was 0.54% (95% CI: 0.29 to 1.03). The range of the estimated number of 18- to 49-yearold individuals living with HIV infection in the United States in 1999 to 2002 was 323,000 to 929,000. It is not possible to compare prevalence estimates between the 2 surveys for those aged 40 years and older, because data from a comparable age group are not available. In NHANES 1999 to 2002, the prevalence in non-hispanic blacks aged 40 to 49 years was 3.58% (95% CI: 1.88 to 6.71); non-hispanic black men aged 40 to 49 years (4.54%, 95% CI: 2.24 to 8.97) had the highest prevalence. In NHANES III, prevalence among non-hispanic blacks can only be examined for the broader age range of 40 to 59 years of age; therefore, direct comparison of the prevalence of 0.86% (95% CI: 0.37 to 1.99) with the current survey cannot be made. If HIV status were imputed for the 1 44-year-old black man in NHANES 1999 to 2002 who reported using HIV medications in the last 30 days during the household interview but did not have a blood or urine sample available for HIV testing, the overall prevalence estimate for the total population and for non-hispanic blacks would not change. This individual was excluded from subsequent analyses. In NHANES 1999 to 2002, HIV testing was linked to survey data so that information on the demographic TABLE 1. Age-Stratified Prevalence of HIV Antibody From NHANES III (1988Y1994) and NHANES (1999Y2004) by Demographic Variables HIV Antibody NHANES III (1988Y1994) NHANES (1999Y2002) 18Y39 Years 40Y59 Years* 18Y39 Years 40Y49 Years* N Pos % (95% CI) N Pos % (95% CI) N Pos % (95% CI) N Pos % (95% CI) Total (0.22 to 0.68) (0.14 to 0.47) (0.17 to 0.80) (0.29 to 1.03) Gender Male (0.29 to 1.20) (0.24 to 0.89) (0.23 to 1.50) (0.34 to 1.60) Female (0.07 to 0.48) (0.02 to 0.18) (0.05 to 0.38) (0.14 to 0.92) NH White (0.10 to 0.56) (0.07 to 0.45) (0.05 to 1.24) (0 to 0.45) Male (0.13 to 1.03) (0.14 to 0.92) (0.11 to 2.45) (0 to 0.89) Female (0.02 to 0.75) (0 to 0.30) (0.0 to 0.31) (0 to 0.92) NH Black (0.86 to 1.96) (0.37 to 1.99) (0.71 to 2.84) (1.88 to 6.71) Male (1.22 to 3.67) (0.55 to 3.19) (0.77 to 4.72) (2.24 to 8.97) Female (0.29 to 1.33) (0.15 to 1.52) (0.36 to 2.84) (1.00 to 7.45) Mexican American (0.18 to 0.80) (0.17 to 1.15) (0.05 to 0.91) (0.09 to 1.92) Male (0.24 to 1.18) (0.25 to 2.24) (0.10 to 1.67) (0.05 to 3.66) Female (0.05 to 0.82) (0.02 to 0.84) (0.0 to 0.42) (0.05 to 3.42) *In NHANES 1999 to 2002, the age tested was 18 to 49 years; in NHANES III, the HIV file was anonymized with 2 age groups (18Y39 years and 40Y59 years). Totals differ from the sums for non-hispanic whites, non-hispanic blacks, and Mexican Americans, because other racial and/or ethnic groups are included in the totals. NH indicates non-hispanic; Pos, Positive. * 2006 Lippincott Williams & Wilkins 653
4 McQuillan et al J Acquir Immune Defic Syndr & Volume 41, Number 5, April 15, 2006 characteristics and risk behaviors could be made available for analyses along with HIV status (Table 2). Because there were only 3 non-hispanic white and 4 Mexican-American HIVpositive individuals, sample sizes were too small to describe associations with potential risk factors for these 2 groups in any detail. Data are thus presented for the non-hispanic blacks and the total population. Despite this categorization, low prevalence in all groups limited the statistical power to identify significant differences between subgroups, although most associations were in the expected direction. Only the presence of antibody to HSV-2 was significantly associated with increased in HIV positivity in the total and non-hispanic black populations. Non-Hispanic blacks who reported ever using cocaine or street drugs had a significant increase in the prevalence of infection (5.12%, 95% CI: 3.06 to 8.42 for users vs. 1.73%, 95% CI: 0.97 to 3.07 for nonusers). To provide an estimate of the current status of immune function among infected NHANES 1999 to 2002 participants, CD4 T lymphocytes were measured on the HIV-positive blood samples and age-matched controls. Ten of 31 positive samples (the other HIV-positive result was from a urine sample with no blood obtained) had CD4 T-lymphocyte counts of less than 200 cells/mm 3. Testing of 34 age-matched HIV-antibody Y negative controls resulted in 1 individual with a CD4 T-lymphocyte count less than 350 cells/mm 3 (actual value of 273 cells/mm 3 ), and 1 individual had a count of 457 cells/mm 3. All other individuals had cell counts ranging from 538 to 1640 cells/mm 3. The CD4 T-lymphocyte distribution for the 12 individuals with a blood sample for testing who were newly diagnosed or did not report ART (No-ART) is presented in Table 3. Seven of the 12 had CD4 T-lymphocyte counts less than 200 cells/mm 3 compared with 2 of the 11 on ART. Among the 8 individuals who called in and reported that they were newly diagnosed, only 1 had a CD4 T- lymphocyte count of G200 cells/mm 3. Skin testing for Mycobacterium tuberculosis (TB) was included in NHANES TABLE 2. Prevalence of HIV Infection by Demographic Variables and Risk Behaviors for Total Population and Non-Hispanic Blacks: NHANES 1999 to 2002 Total Non-Hispanic Blacks N* No. Positive Percent Prevalence (95% CI) N No. Positive Percent Prevalence (95% CI) Total (0.25 to 0.72) (1.46 to 3.04) Education Less than high school (0.37 to 0.98) (2.08 to 4.61) High school or more (0.17 to 0.77) (0.76 to 2.78) Poverty index G (0.29 to 1.51) (1.40 to 7.41) Q (0.15 to 0.74) (0.57 to 2.32) Marital Status Married/living together (ref) (0.08 to 0.46) (0.75 to 3.56) Divorced/separated (0.24 to 0.99) (1.25 to 4.75) Never married (0.34 to 1.93) (1.01 to 3.54) Age at first intercourse G18 years (0.34 to 1.02) (1.50 to 3.82) Q18 years (0.10 to 0.75) (0.63 to 6.72) Lifetime sexual partners 0Y1 (ref) (0.08 to 0.74) (1.09 to 9.93) 2Y (0.20 to 0.58) (1.03 to 2.93) (1.29 to 9.11) (2.33 to 16.0) Male-to-male sex Yes (2.59 to 24.40) (1.77 to 90.4) No (0.17 to 0.65) (1.30 to 4.04) Ever used cocaine/street drugs Yes (0.38 to 1.40) (3.06 to 8.42) No (0.20 to 0.70) (0.97 to 3.07) Ever injected drugs Yes (0.67 to 7.44) (2.93 to 48.4) No (0.23 to 0.77) (1.35 to 3.08) HSV-2 antibody Positive (0.94 to 2.58) (2.55 to 5.68) Negative (0.06 to 0.42) (0.21 to 2.30) *Sample sizes differ in each category because of item nonresponse. P G RSE 9 30%. Ref indicates reference category. 654 * 2006 Lippincott Williams & Wilkins
5 J Acquir Immune Defic Syndr & Volume 41, Number 5, April 15, 2006 Prevalence of HIV in US Household Population TABLE 3. Distribution of CD4 T-Lymphocyte Counts by ART: NHANES 1999 to 2002 Number of Individuals in Each Category CD4 Count No-ART ART Newly Informed (cells/mm 3 ) N (%) N (%) N (%) Q200 5 (41.7%) 9 (81.8%) 7 (77.7%) G200 7 (58.3%) 2 (18.2%) 1 (12.5%) 1999 to None of the 18 HIV-positive individuals tested in these years had a positive TB skin test. Overall 4.2% (95% CI: 3.2 to 5.2) of NHANES participants aged 1 or more years had a reactive TB skin test (CDC, unpublished data). DISCUSSION The NHANES are the only national population-based surveys that provide an estimate of HIV antibody prevalence in the US household population. Estimates from these surveys can be used with those from national surveillance from selected populations to provide a more complete picture of the HIV/AIDS epidemic in the United States. Prevalence estimates from the 2 surveys conducted approximately 10 years apart for those aged 18 to 39 years were not statistically different. Data from NHANES 1999 to 2002 estimated that between 270,000 and 905,000 individuals aged 18 to 49 years are living with HIV infection in the US household population. The upper limit of this estimate is similar to the CDC 2003 estimate of 1,039,000 to 1,185,000 persons in the United States living with HIV/AIDS. 18 HIV antibody prevalence in NHANES 1999 to 2002 was higher among persons with known risk behaviors and among non-hispanic blacks, which is consistent with other CDC HIV antibody prevalence surveys. 19 Data from the CDC`s 1997 unlinked prevalence surveys in selected STD clinics, drug treatment centers, and adolescent medicine clinics 19 had a black/white ratio that ranged from 1.5 among men who have sex with men (MSM) and women attending STD clinics to 4.3 among participants in the Young`s Men`s Survey (MSM aged 15Y22 years who attended public venues frequented by MSM in 7 cities during 1994Y1998). 20 Among non-hispanic blacks, a history of use of cocaine or other street drugs had the strongest effect on infection. The impact of drug use on HIV transmission through use of contaminated needles or indirect transmission to sexual partners or via maternal-child transmission has been well documented and accounts for nearly half of the annual total number of HIV cases in the United States. 21 A 10-year prospective study in Baltimore has demonstrated that risk factors for HIV seroconversion differed by sex. 22 For male participants, needle sharing and male-to-male sex increased HIV incidence, whereas for female participants, high-risk sexual behavior was more significant than drug use behavior. 22 The only other significant variable in NHANES 1999 to 2002 was the presence of antibody to HSV-2, which was associated with an increase in HIV seroprevalence in the total and non-hispanic black populations. HSV-2 infection has been demonstrated to double the risk of HIV acquisition; 23 thus, this association was not unexpected. There is evidence that among those who are coinfected with HIV and HSV-2, there is a significant biologic interaction between these 2 viruses, resulting in more efficient sexual transmission of HIV and an increased HIV viral load during clinical and subclinical HSV-2 reactivation. 24,25 Because data from previous NHANES demonstrated that 21% (95% CI: 19.1 to 23.1) of the population had antibody to HSV-2 and that prevalence was greater than 50% among non-hispanic blacks aged 30 years or older, 12 a substantial percentage of the population has this additional added risk associated with increased prevalence of HIV infection. Prescription drug use was obtained from all HIVpositive persons during the household interview, and CD4 T- lymphocyte counts were performed on all HIV-positive blood samples. These data provide a cross-sectional estimate of immune function among HIV-positive individuals in the general population. Seven of the 12 individuals who did not report current treatment had CD4 T-lymphocyte counts G200 cells/mm 3 compared with 2 of the 11 who reported treatment, demonstrating that receiving ART treatment was associated with better immune function in this population. Among the newly informed individuals, only 1 individual (12.5%) had a count G200 cells/mm 3. HIV antibody prevalence estimates in the 2 NHANES conducted approximately 10 years apart assist in monitoring the changing HIV epidemic in the United States, but because of the low prevalence and the small number of HIV-positive persons, these data need to be interpreted carefully. The NHANES are designed to provide reliable estimates of conditions by demographic groups based on a 10% prevalence with an RSE of G30%. The magnitudes of HIV antibody prevalence in both NHANES do not meet these standards, and the RSEs are greater than 30% for most demographic groups. The NHANES are also limited by the fact that many high-risk populations are not sampled, such as prisoners and other institutionalized populations. In addition, individuals who did not have a stable household would be less likely to be sampled. Finally, the age range tested was only 18 to 49 years in the most recent survey; thus, estimates on individuals outside this range were not provided. Despite these limitations, a comparison across surveys provides some insight into the HIV epidemic trends in the United States. The concentration of the HIV epidemic in the non-hispanic black population seen in many CDC surveillance programs 4 was also observed in this household population. On the positive side, individuals on antiretroviral medication had improved immune function. In January 2001, the CDC published an HIV prevention strategic plan 26 with an overarching goal of reducing by at least 50% the number of new infections and of eliminating racial and ethnic disparities. Emphasis was shifted from focusing largely on prevention of transmission to those not infected with HIV to preventing transmission from HIVpositive persons. 26 These strategies require that individuals know their HIV status and that they have access to adequate medical care and prevention counseling. At least 25% of the NHANES HIV positive population did not know their test results (8 individuals who called in for their results of the 32 positive participants), which is consistent with other * 2006 Lippincott Williams & Wilkins 655
6 McQuillan et al J Acquir Immune Defic Syndr & Volume 41, Number 5, April 15, 2006 estimates. 18 Increased testing in the general population, which has been demonstrated to be justified on clinical and costeffective grounds, should help to reduce this gap in knowledge and, hopefully, to reduce the disparities seen in this representative sample of the US population. 27,28 Data from future NHANES should continue to provide an estimate of the prevalence of HIV infection in the general household population. REFERENCES 1. McQuillan GM, Khare M, Ezzatti-Rice TM, et al. The seroepidemiology of human immunodeficiency virus in the United States household population: NHANES III, 1988Y1994. J Acquir Immune Defic Syndr. 1994;7:1195Y McQuillan GM, Khare M, Karon JM, et al. Update on the seroepidemiology of human immunodeficiency virus in the United States household population: NHANES III, 1988Y J Acquir Immune Defic Syndr. 1997;14:355Y Centers for Disease Control and Prevention. Advancing HIV prevention: new strategies for a changing epidemicvunited States, MMWR. 2003;52:329Y Karon JM, Fleming PL, Steketee RW, et al. HIV in the United States at the turn of the century: an epidemic in transition. Am J Public Health. 2001;91:1060Y National Center for Health Statistics. Plan and operation of the third National Health and Nutrition Examination Survey, 1988Y1994. Vital Health Stat ; National Center for Health Statistics. NHANES 1999Y Available at: Accessed March 29, Bureau of the Census. Poverty in the United States: In: Current Population Reports, Series P-60. Washington, DC:US Government Printing Office; National Center for Health Statistics. NHANES 1999Y 2000 prescription medication questionnaire file documentation. Available at: cdc.gov/nchs/data/nhanes/frequency/rxq_rxdoc.pdf. Accessed July 29, Centers for Disease Control. Interpretation and use of the Western blot assay for serodiagnosis of human immunodeficiency virus type 1 infections. MMWR. 1989;38(S-7):1 Y Berrios DC, Avins AL, Haynes-Sanstad K, et al. Screening for human immunodeficiency virus antibody in urine. Arch Pathol Lab Med. 1995;119:139Y Fiebig EW, Johnson DK, Hirschkorn DF, et al. Lymphocyte subset analysis on frozen whole blood. Cytometry. 1997;29:340Y Lee FK, Coleman M, Pereira L, et al. Detection of herpes simplex virus type-2-specific antibody with glycoprotein G. J Clin Microbiol. 1985;22:641Y Mohadjer L, Montaquila J, Waksberg J. National Health and Nutrition Examination Survey III: weighting and examination methodology. Prepared by Westat for National Center for Health Statistics, Hyattsville, MD. February Shah BV, Barnwell BG, Bieler GS, et al. SUDAAN Users Manual, release 7.0 [computer program]. Research Triangle Park, NC: Research Triangle Institute; Wolter K. Introduction to Variance Estimation. New York: Springer-Verlag; Kahn HA, Sempos CT. Statistical Methods in Epidemiology. New York: Oxford University Press; National Center for Health Statistics. NHANES 1999Y2002. Available at: june_04.pdf. Accessed March 29, Glynn M, Rhodes P. Estimated HIV prevalence in the United States at the end of 2003 [abstract 595]. Presented at: National HIV Prevention Conference, 2005, Atlanta. 19. Centers for Disease Control and Prevention. National HIV Prevalence Surveys, 1997 Summary. Atlanta: Centers for Disease Control and Prevention; 1998:1Y Valleroy LA, MacKellar DA, Karon JM, et al. HIV prevalence and associated risks in young men who have sex with men. JAMA. 2000;284:198Y Holmberg SD. The estimated prevalence and incidence of HIV in 96 large US metropolitan areas. Am J Public Health. 1996;86:643Y Strathdee SA, Galai N, Safaiean M. Sex differences in risk factors for HIV seroconversion among injection drug users. Arch Intern Med. 2001;161:1281 Y Wald A, Link K. Risk of human immunodeficiency virus infection in herpes simplex virus type 2-seropositive persons: a meta-analysis. J Infect Dis. 2002;185:45Y McClelland RS, Wang CC, Overbaugh J, et al. Association between cervical shedding of herpes simplex virus and HIV-1. AIDS. 2002;16:2425Y Schacker T. The role of HSV in the transmission and progression of HIV. Herpes. 2001;8:46Y Centers for Disease Control and Prevention. HIV strategic plan through Available at: Accessed March 29, Sanders GD, Ahmed MB, Sundaram V, et al. Cost effectiveness of screening for HIV in the era of highly active antiretroviral therapy. N Engl J Med. 2005;352:570Y Paltiel AD, Weinstein MC, Kimmel AD, et al. Expanded screening for HIV in the United StatesVan analysis of cost-effectiveness. N Engl J Med. 2005;352:586Y * 2006 Lippincott Williams & Wilkins
Cytomegalovirus Seroprevalence among Children 1-5 Years of Age in the United States: The National Health and Nutrition Examination Survey,
CVI Accepts, published online ahead of print on 17 December 2014 Clin. Vaccine Immunol. doi:10.1128/cvi.00697-14 Copyright 2014, American Society for Microbiology. All Rights Reserved. 1 2 Cytomegalovirus
More informationHERPES SIMPLEX VIRUS TYPE 2
ORIGINAL CONTRIBUTION Trends in Herpes Simplex Virus Type 1 and Type 2 Seroprevalence in the United States Fujie Xu, MD, PhD Maya R. Sternberg, PhD Benny J. Kottiri, PhD Geraldine M. McQuillan, PhD Francis
More informationSelected Oral Health Indicators in the United States,
NCHS Data Brief No. 96 May 01 Selected Oral Health Indicators in the United States, 005 008 Bruce A. Dye, D.D.S., M.P.H.; Xianfen Li, M.S.; and Eugenio D. Beltrán-Aguilar, D.M.D., M.S., Dr.P.H. Key findings
More informationEDMA HIV-AIDS TEAM Fact Sheet November 2007
EDMA HIV-AIDS TEAM Fact Sheet November 2007 1. HIV Facts AIDS epidemic update UNAIDS Epidemic Update, November 2007 (1) 760,000 people to be living with HIV in Western and Central Europe in 2007. 31,000
More informationState of Alabama HIV Surveillance 2013 Annual Report Finalized
State of Alabama HIV Surveillance 2013 Annual Report Finalized Prepared by: Division of STD Prevention and Control HIV Surveillance Branch Contact Person: Allison R. Smith, MPH Allison.Smith@adph.state.al.us
More informationState of Alabama HIV Surveillance 2014 Annual Report
State of Alabama HIV Surveillance 2014 Annual Report Prepared by: Division of STD Prevention and Control HIV Surveillance Branch Contact Person: Richard P. Rogers, MS, MPH richard.rogers@adph.state.al.us
More informationSTD Epidemiology. Jonathan Zenilman, MD Johns Hopkins University
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike License. Your use of this material constitutes acceptance of that license and the conditions of use of materials on this
More informationThe New England Journal of Medicine
The New England Journal of Medicine Copyright, 1997, by the Massachusetts Medical Society VOLUME 337 O CTOBER 16, 1997 NUMBER 16 HERPES SIMPLEX VIRUS TYPE 2 IN THE UNITED STATES, 1976 TO 1994 DOUGLAS T.
More informationCalories Consumed From Alcoholic Beverages by U.S. Adults,
NCHS Data Brief No. November Calories Consumed From Alcoholic Beverages by U.S. Adults, 7 Samara Joy Nielsen, Ph.D., M.Div.; Brian K. Kit, M.D., M.P.H.; Tala Fakhouri, Ph.D., M.P.H.; and Cynthia L. Ogden,
More informationHIV Testing Survey, 2002
Special Surveillance Report Number 5 HIV Testing Survey, 2002 DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service Centers for Disease Control and Prevention Atlanta, Georgia 30333 . The HIV/AIDS
More informationAge of Drinking Onset, Driving After Drinking, and Involvement in Alcohol Related Motor Vehicle Crashes
Title: Age of Drinking Onset, Driving After Drinking, and Involvement in Alcohol Related Motor Vehicle Crashes Author(s): Affiliation: Hingson, R., Heeren, T., Levenson, S., Jamanka, A., Voas, R. Boston
More informationThe New England Journal of Medicine THE PREVALENCE OF HEPATITIS C VIRUS INFECTION IN THE UNITED STATES, 1988 THROUGH 1994
THE OF HEPATITIS C VIRUS INFECTION IN THE UNITED STATES, 1988 THROUGH 1994 MIRIAM J. ALTER, PH.D., DEANNA KRUSZON-MORAN, M.S., OMANA V. NAINAN, PH.D., GERALDINE M. MCQUILLAN, PH.D., FENGXIANG GAO, M.D.,
More informationKey Results Liberia Demographic and Health Survey
Key Results 2013 Liberia Demographic and Health Survey The 2013 Liberia Demographic and Health Survey (LDHS) was implemented by the Liberia Institute of Statistics and Geo-Information Services (LISGIS)
More informationPS : Comprehensive HIV Prevention Programs for Health Departments
PS12-1201: Comprehensive HIV Prevention Programs for Health Departments Program Overview Erica K. Dunbar, MPH Program Leader, Health Department Initiatives National Center for HIV/AIDS, Viral Hepatitis,
More informationEstimates of New HIV Infections in the United States
Estimates of New HIV Infections in the United States CDC HIV/AIDS FACT S A UGUS T 28 Accurately tracking the HIV epidemic is essential to the nation s HIV prevention efforts. Yet monitoring trends in new
More informationGender Disparities in Viral Suppression and Antiretroviral Therapy Use by Racial and Ethnic Group Medical Monitoring Project,
Gender Disparities in Viral Suppression and Antiretroviral Therapy Use by Racial and Ethnic Group Medical Monitoring Project, 2009-2010 Linda Beer PhD, Christine L Mattson PhD, William Rodney Short MD,
More informationNATIONAL SURVEY OF YOUNG ADULTS ON HIV/AIDS
NATIONAL SURVEY OF YOUNG ADULTS ON HIV/AIDS Kaiser Family Foundation November 30, 2017 Introduction More than three and a half decades have passed since the first case of AIDS. An entire generation has
More informationAwareness and Use of the Prostate-Specific Antigen Test among African-American Men
O R I G I N A L C O M M U N I C A T I O N Awareness and Use of the Prostate-Specific Antigen Test among African-American Men Louie E. Ross, PhD; Robert J. Uhler, MA; and Kymber N. Williams, MA Atlanta,
More informationSecond generation HIV surveillance: Better data for decision making
Second generation HIV surveillance: Better data for decision making Prof Thomas M Rehle, MD, PhD Human Sciences Research Council, South Africa HAI Conference on Prevention and Control of the HIV Epidemic
More informationSTD & HIV ANNUAL REPORT. An Annual Review of HIV and STD s reported in Oakland County, Michigan
STD & HIV ANNUAL REPORT 2016 An Annual Review of HIV and STD s reported in Oakland County, Michigan Similar to numbers reported statewide, Oakland County saw an increase in the number of reported cases
More informationCigarette Smoking and Lung Obstruction Among Adults Aged 40 79: United States,
NCHS Data Brief No. 8 January 25 Cigarette Smoking and Lung Obstruction Among Adults Aged 4 79: United States, 27 22 Ryne Paulose-Ram, Ph.D., M.A.; Timothy Tilert, B.S.; Charles F. Dillon, M.D., Ph.D.;
More informationNational Survey of Young Adults on HIV/AIDS
REPORT National Survey of Young Adults on HIV/AIDS November 2017 Kaiser Family Foundation Introduction More than three and a half decades have passed since the first case of AIDS. An entire generation
More information2017 EPIDEMIOLOGY REPORT
2017 EPIDEMIOLOGY REPORT Volume 4, July 2017 A report on sexually transmitted infection and human immunodeficiency virus testing, positivity, and behavioral trends from 2012 2016 HOWARD BROWN HEALTH 2017
More informationMissouri St. Louis TGA 2016 HIV Epidemiological Profile
Missouri St. Louis TGA 2016 HIV Epidemiological Profile St. Louis TGA Part A Planning Council Prepared by the City of St. Louis Department of Health Center for Health Information, Research, and Planning
More informationEstimates of New HIV Infections in the United States
Estimates of New HIV Infections in the United States CDC HIV/AIDS FactS A u g u s t 28 Accurately tracking the HIV epidemic is essential to the nation s HIV prevention efforts. Yet monitoring trends in
More informationReceptive Anal Intercourse and HIV Infection
World Journal of AIDS, 2017, 7, 269-278 http://www.scirp.org/journal/wja ISSN Online: 2160-8822 ISSN Print: 2160-8814 Receptive Anal Intercourse and HIV Infection Gilbert R. Lavoie 1, John F. Fisher 2
More informationCo-Variation in Sexual and Non-Sexual Risk Behaviors Over Time Among U.S. High School Students:
Co-Variation in Sexual and Non-Sexual Risk Behaviors Over Time Among U.S. High School Students: 1991-2005 John Santelli, MD, MPH, Marion Carter, PhD, Patricia Dittus, PhD, Mark Orr, PhD APHA 135 th Annual
More informationJudy Kruger, PhD, MS, Deborah A. Galuska, PhD, MPH, Mary K. Serdula, MD, MPH, Deborah A. Jones, PhD
Attempting to Lose Weight Specific Practices Among U.S. Adults Judy Kruger, PhD, MS, Deborah A. Galuska, PhD, MPH, Mary K. Serdula, MD, MPH, Deborah A. Jones, PhD Background: Methods: Results: Conclusions:
More informationU.S. Counties Vulnerability to Rapid Dissemination of HIV/HCV Infections Among People Who Inject Drugs
U.S. Counties Vulnerability to Rapid Dissemination of HIV/HCV Infections Among People Who Inject Drugs Michelle Van Handel, MPH Health Scientist National Center for HIV/AIDS, Viral Hepatitis, STDs and
More informationMMWR Analysis Provides New Details on HIV Incidence in U.S. Populations
MMWR Analysis Provides New Details on HIV Incidence in U.S. Populations CDC HIV/AIDS Fa c t s S e p t e m b e r 2008 On August 6, 2008, the Centers for Disease Control and Prevention (CDC) released a new
More informationSetting the Context: Understanding the Numbers, Vulnerable Populations and Federal Public Health Policy
Setting the Context: Understanding the Numbers, Vulnerable Populations and Federal Public Health Policy David B. Johnson STD Disparities Coordinator, Division of STD Prevention National Center for HIV/AIDS,
More informationNikhil Prachand, MPH Britt Skaathun
HIV Prevalence and Unrecognized Infection among Men Who Have Sex With Men in Chicago Chicago HIV Behavioral Surveillance - 2008 Nikhil Prachand, MPH Britt Skaathun HIV/AIDS Surveillance, Epidemiology and
More informationNumber September 15, Abstract. Highlights. Overview
Number 362 + September 15, 2005 DatainTables8,10,12,andAppendixtable4havebeenrevised. Numberscitedintextonpages3,4,and13havebeenrevised. Sexual Behavior and Selected Health Measures: Men and Women 15 44
More informationhiv testing among los angeles county adults
February 2007 hiv testing among los angeles county adults Human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) are major causes of illness and death in the United States and
More informationReducing the Sexual Transmission of Genital Herpes
CLINICAL GUIDELINE Reducing the Sexual Transmission of Genital Herpes Compiled by Adrian Mindel Introduction People diagnosed with genital herpes usually have many questions and concerns, a key one being
More informationIntroduction to NHANES and NAMCS
Introduction to NHANES and NAMCS CMU Summer Institute 2002 NHANES: National Health and Nutrition Examination Survey Home Page: http://www.cdc.gov/nchs/nhanes.htm Goal: To provide national estimates of
More informationThe cost-effectiveness of expanded testing for primary HIV infection Coco A
The cost-effectiveness of expanded testing for primary HIV infection Coco A Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract
More informationHIV Epidemiology March 7, Stefanie Rhodes Inova Juniper Program
HIV Epidemiology March 7, 2019 Stefanie Rhodes Inova Juniper Program Stefanie.Rhodes@inova.org Human Immunodeficiency Virus Virus that attacks and weakens immune system Can be treated, but not cured Transmitted
More informationPractice Steps for Implementation of Guidelines Recommendations The guideline recommendations are shown schematically -
ASK SCREEN Test for HIV and STI Practice Steps for Implementation of Guidelines Recommendations The guideline recommendations are shown schematically - Routinely obtain a thorough sexual history from all
More informationDisparities in Tobacco Product Use in the United States
Disparities in Tobacco Product Use in the United States ANDREA GENTZKE, PHD, MS OFFICE ON SMOKING AND HEALTH CENTERS FOR DISEASE CONTROL AND PREVENTION Surveillance & Evaluation Webinar July 26, 2018 Overview
More informationNonresponse Adjustment Methodology for NHIS-Medicare Linked Data
Nonresponse Adjustment Methodology for NHIS-Medicare Linked Data Michael D. Larsen 1, Michelle Roozeboom 2, and Kathy Schneider 2 1 Department of Statistics, The George Washington University, Rockville,
More informationTrends in HIV Incidence and Prevalence in the United States
Trends in HIV Incidence and Prevalence in the United States Irene Hall, PhD, FACE 7th International Workshop on HIV Transmission Washington, DC, July 20, 2012 National Center for HIV/AIDS, Viral Hepatitis,
More informationThe prevalence of obesity has increased markedly in
Brief Communication Use of Prescription Weight Loss Pills among U.S. Adults in 1996 1998 Laura Kettel Khan, PhD; Mary K. Serdula, MD; Barbara A. Bowman, PhD; and David F. Williamson, PhD Background: Pharmacotherapy
More informationThe Heterosexual HIV Epidemic in Chicago: Insights into the Social Determinants of HIV
The Heterosexual HIV Epidemic in Chicago: Insights into the Social Determinants of HIV Nikhil Prachand, MPH Board of Health Meeting January 19, 2011 STI/HIV/AIDS Division Today s Presentation Epidemiology
More informationAfrican Americans Views of the HIV/AIDS Epidemic at 20 Years
THE HENRY J. KAISER FAMILY FOUNDATION African Americans Views of the HIV/AIDS Epidemic at 20 Years FINDINGS FROM A NATIONAL SURVEY 2001 Prepared by Regina Aragón, Health Policy & Communications Consultant,
More informationFULTON COUNTY GOVERNMENT RYAN WHITE PART A PROGRAM. Atlanta Eligible Metropolitan Area HIV/AIDS Unmet Need Estimate
FULTON COUNTY GOVERNMENT RYAN WHITE PART A PROGRAM Atlanta Eligible Metropolitan Area HIV/AIDS Unmet Need Estimate Southeast AIDS Training and Education Center Department of Family and Preventative Medicine
More informationKnowledge about AIDS and HIV in. the Local Incidence of AIDS
Knowledge about AIDS and HIV in the US Adult Population: Influence of the Local Incidence of AIDS WINI;N i.w=.ffl Lida F. McCaig, MPH, Ann M. Hardy, DrPH, and Deborah M. Wuzn, PhD Introduction On the national
More informationTrends in Reportable Sexually Transmitted Diseases in the United States, 2007
Trends in Reportable Sexually Transmitted Diseases in the United States, 2007 National Surveillance Data for Chlamydia, Gonorrhea, and Syphilis Sexually transmitted diseases (STDs) remain a major public
More informationUse of molecular surveillance data to identify clusters of recent and rapid HIV transmission
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Use of molecular surveillance data to identify clusters of recent and rapid HIV transmission Alexa Oster, MD Acting Lead, Incidence
More informationTB/HIV/STD Epidemiology and Surveillance Branch. First Annual Report, Dated 12/31/2009
TB/HIV/STD Epidemiology and Surveillance Branch First Annual Report, Dated 12/31/29 This Enhanced Perinatal Surveillance Report is the first annual report generated by the Texas Department of State Health
More informationINTERNATIONAL JOURNAL OF PHARMACEUTICAL RESEARCH AND BIO-SCIENCE
Ankamma A,, 2014; Volume 3(5): 510-515 INTERNATIONAL JOURNAL OF PHARMACEUTICAL RESEARCH AND BIO-SCIENCE STUDY OF SEROPREVALENCE OF HSV-2 AMONG HIV SEROPOSITIVE INDIVIDUALS AT S.V.R.R.G.G.H TIRUPATI ANKAMMA
More informationPatterns of Union Formation Among Urban Minority Youth in the United States
Archives of Sexual Behavior, Vol. 29, No. 2, 2000 Patterns of Union Formation Among Urban Minority Youth in the United States Kathleen Ford, Ph.D. 1 and Anne Norris, Ph.D., RN 2 Since 1990, several large
More informationState of California Health and Human Services Agency Department of Health Services
State of California Health and Human Services Agency Department of Health Services SANDRA SHEWRY Director ARNOLD SCHWARZENEGGER Governor TO: INTERESTED PARTIES SUBJECT: CALIFORNIA HIV SEROPREVALENCE ANNUAL
More informationFactors Associated with Non-Acceptance of HIV Screening Test among Pregnant Women
Research Article imedpub Journals http://www.imedpub.com/ Journal of HIV & Retro Virus DOI: 10.21767/2471-9676.100027 Factors Associated with Non-Acceptance of HIV Screening Test among Pregnant Women Ricardo
More informationNational Health Statistics Reports
National Health Statistics Reports 107 January 25, 2018 Main Reasons for Never Testing for HIV Among Women and Men Aged 15 44 in the United States, 2011 2015 by Isaedmarie Febo-Vazquez, M.S., Casey E.
More information26/09/2014. Types of Viral Hepatitis. Prevention of Viral Hepatitis as a Health Disparity for American Indians: Successes and Challenges
Rate per, Types of Viral Hepatitis A E B D C Prevention of Viral Hepatitis as a Health Disparity for American Indians: Successes and Challenges Source of virus Feces Feces Blood/bloodderived body fluids
More informationTHE PREVALENCE OF OVERweight
ORIGINAL CONTRIBUTION Prevalence and Trends in Overweight Among US Children and Adolescents, 1999-2000 Cynthia L. Ogden, PhD Katherine M. Flegal, PhD Margaret D. Carroll, MS Clifford L. Johnson, MSPH THE
More informationTHE DECLINE IN CERVICAL CANCER incidence
Cervical Cancer in North Carolina Incidence, Mortality and Risk Factors Deborah S. Porterfield, MD, MPH; Genevieve Dutton, MA; Ziya Gizlice, PhD THE DECLINE IN CERVICAL CANCER incidence and mortality seen
More informationTrends in HIV Incidence Among Young Adults in the United States
Trends in HIV Incidence Among Young Adults in the United States Philip S. Rosenberg, PhD; Robert J. Biggar, MD Context. Behaviors that result in potential exposure to human immunodeficiency virus (HIV)
More informationThe New England Journal of Medicine
The New England Journal of Medicine Copyright 2001 by the Massachusetts Medical Society VOLUME 345 A UGUST 16, 2001 NUMBER 7 CHARACTERISTICS OF PATIENTS WITH UNCONTROLLED IN THE UNITED STATES DAVID J.
More informationWomen at Risk for HIV/AIDS. November 1, 2010 UMDNJ RWJMS Department of Obstetrics, Gynecology and Reproductive Health Charletta A.
Women at Risk for HIV/AIDS November 1, 2010 UMDNJ RWJMS Department of Obstetrics, Gynecology and Reproductive Health Charletta A. Ayers, MD, MPH Objectives What is the prevalence of HIV in the US? Who
More informationImplementation of testing (and other interventions along the Continuum of Care)
Implementation of testing (and other interventions along the Continuum of Care) Jonathan Mermin, MD, MPH National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention U.S. Centers for Disease Control
More informationWillingness to Use Instant Home HIV Tests Data from the California Behavioral Risk Factor Surveillance Survey
Willingness to Use Instant Home HIV Tests Data from the California Behavioral Risk Factor Surveillance Survey Kathryn A. Phillips, PhD, James L. Chen, MPH Objective: Methods: Results: Conclusion: Although
More informationInfectious Diseases Florida Department of Health, HIV/AIDS Section/ Division of Disease Control and Health Protection Tallahassee, Florida
Infectious Diseases Florida Department of Health, HIV/AIDS Section/ Division of Disease Control and Health Protection Tallahassee, Florida Assignment Description The Fellow will be placed in the Florida
More informationAbstract. Keywords: Sexual behavior; oral sex; sexual orientation; National Survey of Family Growth
Number 36, March 2011 Sexual Behavior, Sexual Attraction, and Sexual Identity in the United States: Data from the 2006-2008 National Survey of Family Growth By Anjani Chandra, PhD, William D. Mosher, PhD,
More informationHIV and AIDS: A Health Crisis for African Americans
Fighting HIV among African Americans HIV is a crisis in African American communities, threatening the health, well-being and potential of African American men and women of all ages in the United States.
More informationState of Alabama HIV Surveillance 2012 Annual Report Finalized
State of Alabama HIV Surveillance 2012 Annual Report Finalized Prepared by: Division of HIV/AIDS Prevention and Control HIV Surveillance Branch Contact Person: Allison R. Smith, MPH Allison.Smith@adph.state.al.us
More informationBassett Medical Center PPS Community Profile
Bassett Medical Center PPS Community Profile Counties served: Delaware, Herkimer, Madison, Otsego, and Schoharie DEMOGRAPHICS 1 The Bassett Medical Center PPS s total population is 278,214. Age: Residents
More informationDHMH Activities toward Implementing Requirements of Md. Code Ann., Health-General , Hepatitis C Prevention and Control within Maryland
DHMH Activities toward Implementing Requirements of Md. Code Ann., Health-General 18-1001, Hepatitis C Prevention and Control within Maryland Submitted by: Maryland Department of Health and Mental Hygiene
More informationARCHITECT HIV Ag/Ab Combo: Moving HIV Diagnostics Forward in the U.S.
ARCHITECT HIV Ag/Ab Combo: Moving HIV Diagnostics Forward in the U.S. Catherine Brennan, Ph.D. Research Fellow Infectious Diseases Research Abbott Diagnostics 1 Agenda ARCHITECT HIV Ag/Ab Combo Assay What
More informationHIV and Syphilis Co-Infection in Maricopa County
HIV and Syphilis Co-Infection in Maricopa County Item Type Thesis Authors Thomas, Sarah Rights Copyright is held by the author. Digital access to this material is made possible by the College of Medicine
More informationSummary Guidelines for the Use of Herpes Simplex Virus (HSV) Type 2 Serologies
Summary Guidelines for the Use of Herpes Simplex Virus (HSV) Type 2 Serologies Genital herpes is one of the most prevalent sexually transmitted diseases, affecting more than one in five sexually active
More informationTo provide you with the basic concepts of HIV prevention using HIV rapid tests combined with counselling.
Module 2 Integration of HIV Rapid Testing in HIV Prevention and Treatment Programs Purpose Pre-requisite Modules Learning Objectives To provide you with the basic concepts of HIV prevention using HIV rapid
More informationEstimating HIV incidence in the United States from HIV/AIDS surveillance data and biomarker HIV test results
STATISTICS IN MEDICINE Statist. Med. 2008; 27:4617 4633 Published online 4 August 2008 in Wiley InterScience (www.interscience.wiley.com).3144 Estimating HIV incidence in the United States from HIV/AIDS
More informationSUPPLEMENT ARTICLE. Jennifer Kates 1 and Jeffrey Levi 2,3
SUPPLEMENT ARTICLE Insurance Coverage and Access to HIV Testing and Treatment: Considerations for Individuals at Risk for Infection and for Those with Undiagnosed Infection Jennifer Kates 1 and Jeffrey
More informationClinical and Behavioral Characteristics of HIV-infected Young Adults in Care in the United States
Clinical and Behavioral Characteristics of HIV-infected Young Adults in Care in the United States Linda Beer, PhD, Christine L. Mattson, PhD, Joseph Prejean, PhD, and Luke Shouse, MD 10 th International
More informationProfessor Adrian Mindel
Causes of genital ulceration viruses and others Professor Adrian Mindel University of Sydney VIM 16 th August 2012 Outline Definition Causes Epidemiology Diagnosis Definition of genital ulcer A defect
More informationCenters for Disease Control and Prevention. Recommendations for Providers Counseling Male Patients and
This document is scheduled to be published in the Federal Register on 12/02/2014 and available online at http://federalregister.gov/a/2014-27814, and on FDsys.gov BILLING CODE: 4163-18-P DEPARTMENT OF
More informationMinneapolis Department of Health and Family Support HIV Surveillance
Rate per 1, persons 2 21 22 23 24 25 26 27 28 29 21 Rate per 1, persons Minneapolis Department of Health and Family Support HIV Surveillance Research Brief, September 212 Human immunodeficiency virus (HIV)
More informationHIV/AIDS MODULE. Rationale
HIV/AIDS MODULE Rationale According to WHO HIV/AIDS remains one of the world's most significant public health challenges, particularly in low- and middle-income countries. As a result of recent advances
More informationForsyth County, North Carolina 2013 HIV/STD Surveillance Report
Forsyth County, North Carolina 2013 HIV/STD Surveillance Report Forsyth County Department of Public Health Division of Epidemiology and Surveillance 799 N. Highland Avenue Winston-Salem, NC 27102-0686
More informationTrends in Allergic Conditions Among Children: United States,
Trends in Allergic Conditions Among Children: United States, 1997 2011 Kristen D. Jackson, M.P.H.; LaJeana D. Howie, M.P.H., C.H.E.S.; Lara J. Akinbami, M.D. Key findings Data from the National Health
More informationCONSEQUENCES OF MARIJUANA USE FOR DEPRESSIVE DISORDERS. Master s Thesis. Submitted to: Department of Sociology
CONSEQUENCES OF MARIJUANA USE FOR DEPRESSIVE DISORDERS Master s Thesis Submitted to: Department of Sociology Virginia Polytechnic Institute and State University In partial fulfillment of the requirement
More informationEstimated HIV Incidence in the United States,
, 2006 2009 Joseph Prejean 1 *, Ruiguang Song 1, Angela Hernandez 1, Rebecca Ziebell 2, Timothy Green 1, Frances Walker 1, Lillian S. Lin 1, Qian An 1, Jonathan Mermin 1, Amy Lansky 1, H. Irene Hall 1,
More informationARTICLE. Prevalence of Diabetes and Impaired Fasting Glucose Levels Among US Adolescents. National Health and Nutrition Examination Survey,
ARTICLE Prevalence of Diabetes and Impaired Fasting Glucose Levels Among US Adolescents National Health and Nutrition Examination Survey, 1999-2002 Glen E. Duncan, PhD, RCEPSM Objective: To determine the
More informationGlossary of Acronyms. AIDS - Acquired Immunodeficiency Syndrome. CDC - Centers for Disease Control and Prevention. DHS - Department of Health Services
Acknowledgements This report was developed by the California Department of Health Services, Office of AIDS (DHS/OA) under cooperative agreement. U6/CCU965-- with support from the Centers for Disease Control
More informationTHE RISK OF HIV/AIDS AMONG THE POOR RURAL FAMILIES IN RURAL COMMUNITIES IN SOUTH WESTERN-NIGERIA 1, 2
THE RISK OF HIV/AIDS AMONG THE POOR RURAL FAMILIES IN RURAL COMMUNITIES IN SOUTH WESTERN-NIGERIA 1, 2 Bisiriyu, L.A. 1 and Adewuyi A.A. 1. 1. Demography and Social Statistics Department, Obafemi Awolowo
More informationReturn on Public Health Investment: CDC s Expanded HIV Testing Initiative ACCEPTED
JAIDS Journal of Acquired Immune Deficiency Syndromes Publish Ahead of Print DOI: 10.1097/QAI.0b013e31823e5bee 10.7.11 Return on Public Health Investment: CDC s Expanded HIV Testing Initiative Angela B
More informationCommunicable Diseases
Communicable Diseases Communicable diseases are ones that can be transmitted or spread from one person or species to another. 1 A multitude of different communicable diseases are currently reportable in
More informationForsyth County, North Carolina 2012 HIV/STD Surveillance Report
Forsyth County, North Carolina 2012 HIV/STD Surveillance Report Forsyth County Department of Public Health Division of Epidemiology and Surveillance 799 N. Highland Avenue Winston-Salem, NC 27102-0686
More informationSupplementary Material. In this supplement we derive the full form of the monetary and health costs of testing
Supporting document Supplementary Material In this supplement we derive the full form of the monetary and health costs of testing every years, and ; we derive the approximation shown in (1); and we justify
More informationBLACK RESIDENTS VIEWS ON HIV/AIDS IN THE DISTRICT OF COLUMBIA
PUBLIC OPINION DISPARITIES & PUBLIC OPINION DATA NOTE A joint product of the Disparities Policy Project and Public Opinion and Survey Research October 2011 BLACK RESIDENTS VIEWS ON HIV/AIDS IN THE DISTRICT
More informationORIGINAL ARTICLE. Confirmations and Surprises in the Association of Tobacco Use With Sinusitis
Confirmations and Surprises in the Association of Tobacco Use With Sinusitis Judith E. C. Lieu, MD; Alvan R. Feinstein, MD ORIGINAL ARTICLE Objective: To generate estimates of sinusitis prevalence for
More informationStuck : Contextualizing the U.S. HIV epidemic among black MSM. Greg Millett amfar April 2, 2015
Stuck : Contextualizing the U.S. HIV epidemic among black MSM Greg Millett amfar April 2, 2015 New HIV Infections, 2010 2008-2010 Women: 21% decrease MSM: 12% increase Young MSM: 22% increase Lifetime
More informationInfertility services reported by men in the United States: national survey data
MALE FACTOR Infertility services reported by men in the United States: national survey data John E. Anderson, Ph.D., Sherry L. Farr, Ph.D., M.S.P.H., Denise J. Jamieson, M.D., M.P.H., Lee Warner, Ph.D.,
More informationIllustrating HIV/AIDS in the United States Update
Illustrating HIV/AIDS in the United States 2016 Update About AIDSVu AIDSVu is a compilation of interactive, online maps that allows users to visually explore the HIV epidemic in the U.S. alongside critical
More informationSan Francisco Medical Monitoring Project (MMP) Maree Kay Parisi Applied Research, Community Health Epidemiology and Surveillance
San Francisco Medical Monitoring Project (MMP) Maree Kay Parisi Applied Research, Community Health Epidemiology and Surveillance Medical Monitoring Project Overview National prospective Local data and
More informationCentral New York Care Collaborative, Inc. PPS Community Profile
Central New York Care Collaborative, Inc. PPS Community Profile Counties served: Cayuga, Lewis, Madison, Oneida, Onondaga, and Oswego DEMOGRAPHICS 1 The total population of the Central New York Care Collaborative
More informationFrequent Screening for Syphilis as Part of HIV Monitoring Increases the Detection of Early Asymptomatic Syphilis Among HIV-Positive Homosexual Men
CLINICAL SCIENCE Frequent Screening for Syphilis as Part of HIV Monitoring Increases the Detection of Early Asymptomatic Syphilis Among HIV-Positive Homosexual Men Melanie Bissessor, FRACGP,* Christopher
More information