BACKGROUND: The Southern Nevada Health District has recently designed and implemented a single surveillance/investigation system for HIV/AIDS, STDs, and TB using EpiTrax. The integration of surveillance systems not only allows for the delivery of seamless comprehensive services to co-infected persons from multiple programs without repeated procedures and waiting periods but to also readily monitor trends and patterns of the co-infected populations. The objective of this analysis was to examine demographic and risk profiles of co-infected persons to identify target population for high impact prevention.
METHODS: After compiling a list of persons living with HIV/AIDS in Clark County, Nevada in 2014, using data from the enhanced HIV/AIDS reporting system (eHARS), we matched it to EpiTrax using the eHARS state number to identify individuals with at least one STD diagnosis (Early Syphilis, Gonorrhea, or Chlamydia) in 2014. Using multiple logistic regression, we first assessed the association of co-infected group versus HIV only group with MSM status, age, race, and AIDS diagnosis status; then we assessed the relationship between internet versus other type of places met partners and contact ratio (defined as total number of partners contacted/ total number of partners named) controlling for age and race.
RESULTS: Of the 8,548 persons living with HIV/AIDS in Clark County at one point in 2014, 363 (4%) had at least one STD diagnosis and 8,185 (96%) had no STD diagnoses. Among the HIV/STD co-infected individuals, 96% were male and 4% were female. MSM was independently associated with co-infection group (AOR=6.3; 95% CI, 4.2-9.4). Ages 45-54, and 55 and over were twice as likely to be co-infected compared to 25-34 year olds (AOR= 2.3; 95% CI, 1.7-3.1; AOR=1.9; 95% CI, 1.2-3.2, respectively). Compared to ages 25-34, ages 24 and younger were less likely to be co-infected (AOR=0.7; 95% CI, 0.5-0.9). Compared to non-Hispanic White, non-Hispanic Black and Hispanic were more likely to be co-infected (AOR=1.8; 95% CI, 1.3-2.3; AOR=1.5; 95% CI, 1.2-2.0, respectively). Having no AIDS diagnosis compared to individuals diagnosed with AIDS after 3 months of HIV diagnosis were more likely to be co-infected (AOR=2.8; 95% CI, 2.0-3.8). Contact ratio was not associated with meeting partners via the internet after controlling for age and race (AOR= 1.18; 95% CI, 0.6-2.2).
CONCLUSIONS: Many of the same high risk groups for HIV infections are also more likely to be co-infected with STDs, except for age, where older groups have higher risk of co-infection.