Use of HIV case surveillance system to design and evaluate site-randomized interventions in an HIV prevention study: HPTN 065

Deborah J Donnell, H Irene Hall, Theresa Gamble, Geetha Beauchamp, Angelique B Griffin, Lucia V Torian, Bernard Branson, Wafaa M El-Sadr, Deborah J Donnell, H Irene Hall, Theresa Gamble, Geetha Beauchamp, Angelique B Griffin, Lucia V Torian, Bernard Branson, Wafaa M El-Sadr

Abstract

Introduction: Modeling studies suggest intensified HIV testing, linkage-to-care and antiretroviral treatment to achieve viral suppression may reduce HIV transmission and lead to control of the epidemic. To study implementation of strategy, population-level data are needed to monitor outcomes of these interventions. US HIV surveillance systems are a potential source of these data.

Methods: HPTN065 (TLC-Plus) Study is evaluating the feasibility of a test, linkage-to-care, and treat strategy for HIV prevention in two intervention communities - the Bronx, NY, and Washington, DC. Routinely collected laboratory data on diagnosed HIV cases in the national HIV surveillance system were used to select and randomize sites, and will be used to assess trial outcomes.

Results: To inform study randomization, baseline data on site-aggregated study outcomes was provided from HIV surveillance data by New York City and Washington D.C. Departments of Health. The median site rate of linkage-to-care for newly diagnosed cases was 69% (IQR 50%-86%) in the Bronx and 54% (IQR 33%-71%) in Washington, D.C. In participating HIV care sites, the median site percent of patients with viral suppression (<400 copies/mL) was 57% (IQR 53%-61%) in the Bronx and 64% (IQR 55%-72%) in Washington, D.C.

Conclusions: In a novel use of site-aggregated surveillance data, baseline data was used to design and evaluate site randomized studies for both HIV test and HIV care sites. Surveillance data have the potential to inform and monitor sitelevel health outcomes in HIV-infected patients.

Keywords: HIV; linkage-to-care; site randomized; surveillance; test and treat; viral load suppression..

Figures

Fig. (1)
Fig. (1)
Selection of test sites.
Fig. (2)
Fig. (2)
Selection of care sites.

References

    1. Attia S, Egger M, Muller M, Zwahlen M, Low N. Sexual transmission of HIV according to viral load and antiretroviral therapy: systematic review and meta-analysis. AIDS. 2009;23(11 ):1397–404.
    1. Donnell D, Baeten JM, Kiarie J. Heterosexual HIV-1 transmission after initiation of antiretroviral therapy: a prospective cohort analysis. Lancet. 2010;375(9731 ):2092–8.
    1. Cohen MS, Chen YQ, McCauley M, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365(6 ):493–505.
    1. Law MG, Prestage G, Grulich A, Van de Ven P, Kippax S. Modelling the effect of combination antiretroviral treatments on HIV incidence. AIDS. 2001;15(10 ):1287–94.
    1. Blower SM, Gershengorn HB, Grant RM. A tale of two futures: HIV and antiretroviral therapy in San Francisco. Science. 2000;287(5453 ):650–4.
    1. Granich RM, Gilks CF, Dye C, De Cock KM, Williams BG. Universal voluntary HIV testing with immediate antiretroviral therapy as a strategy for elimination of HIV transmission: a mathematical model. Lancet. 2009;373(9657 ):48–57.
    1. Lima VD, Johnston K, Hogg RS, et al. Expanded access to highly active antiretroviral therapy: a potentially powerful strategy to curb the growth of the HIV epidemic. J Infect Dis. 2008;198(1 ):59–67.
    1. Dieffenbach CW, Fauci AS. Universal voluntary testing and treatment for prevention of HIV transmission. JAMA. 2009;301(22 ):2380–2.
    1. Marks G, Crepaz N, Senterfitt JW, Janssen RS. Meta-analysis of high-risk sexual behavior in persons aware and unaware they are infected with HIV in the United States: implications for HIV prevention programs. J Acquir Immune Defic Syndr. 2005;39(4 ):446–53.
    1. Graham SM, Holte SE, Peshu NM, et al. Initiation of antiretroviral therapy leads to a rapid decline in cervical and vaginal HIV-1 shedding. AIDS. 2007;21(4 ):501–7.
    1. Vergidis PI, Falagas ME, Hamer DH. Meta-analytical studies on the epidemiology, prevention, and treatment of human immunodeficiency virus infection. Infect Dis Clin North Am. 2009;23(2 ):295–308.
    1. Campsmith ML, Rhodes PH, Hall HI, Green TA. Undiagnosed HIV prevalence among adults and adolescents in the United States at the end of 2006. J Acquir Immune Defic Syndr. 2010;53(5 ):619–24.
    1. Vital signs: HIV testing and diagnosis among adults--United States, 2001-2009. MMWR Morb Mortal Wkly Rep. 2010;59(47 ):1550–5.
    1. HIV prevalence estimates--United States, 2006. MMWR Morb Mortal Wkly Rep. 2008;57(39 ):1073–6.
    1. Torian LV, Wiewel EW, Liu KL, Sackoff JE, Frieden TR. Risk factors for delayed initiation of medical care after diagnosis of human immunodeficiency virus. Arch Intern Med. 2008;168(11 ):1181–7.
    1. Giordano TP, Gifford AL, White AC , Jr , et al. Retention in care: a challenge to survival with HIV infection. Clin Infect Dis. 2007;44(11 ):1493–9.
    1. Torian LV, Wiewel EW. Continuity of HIV-related medical care, New York City, 2005-2009: Do patients who initiate care stay in care? AIDS Patient Care STDS. 2011;25(2 ):79–88.
    1. Marks G, Gardner LI, Craw J, Crepaz N. Entry and retention in medical care among HIV-diagnosed persons: a meta-analysis. AIDS. 2010;24(17 ):2665–78.
    1. Zetola NM, Bernstein K, Ahrens K, et al. Using surveillance data to monitor entry into care of newly diagnosed HIV-infected persons: San Francisco, 2006-2007. BMC Public Health. 2009;9:17.
    1. Meyerson BE, Klinkenberg WD, Perkins DR, Laffoon BT. Who's in and who's out: use of primary medical care among people living with HIV. Am J Public Health. 2007;97(4 ):744–9.
    1. Torian LV, Henning KJ, Kellerman SE, Frieden TR. Striving toward comprehensive HIV/AIDS surveillance: the view from New York City. Public Health Rep. 2007;122(Suppl 1 ):4–6.
    1. Hayes RJ, Moulton L. Cluster Randomised Trials. UK: Chapman & Hall/CRC Interdisciplinary Statistics; 2009.
    1. Hayes RJ, Bennett S. Simple sample size calculation for cluster-randomized trials. Int J Epidemiol. 1999;28(2 ):319–26.
    1. Thomson A, Hayes R, Cousens S. Measures of between-cluster variability in cluster randomized trials with binary outcomes. Stat Med . 2009;28(12 ):1739–51.
    1. Das M, Chu PL, Santos GM, et al. Decreases in community viral load are accompanied by reductions in new HIV infections in San Francisco. PLoS One. 2010;5(6 ):e11068.
    1. Des Jarlais DC, Arasteh K, Perlis T, et al. Convergence of HIV seroprevalence among injecting and non-injecting drug users in New York City. AIDS. 2007;21(2 ):231–5.
    1. Donnell D, Hughes JP, Fleming TR. Challenges in the design of HIV prevention trials in the United States. J Acquir Immune Defic Syndr . 2010;55(S2 ):S136–S40.
    1. Hughes JP. Using baseline data to design a group randomized trial. Stat Med. 2005;24(13 ):1983–94.
    1. Branson BM, Handsfield HH, Lampe MA, et al. Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings. MMWR Recomm Rep. 2006;55(RR-14):1–17.

Source: PubMed

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