Early and aggressive HIV testing may reduce HIV incidence, according to a data analysis of new HIV diagnoses in San Diego.
From 2006 to 2012, an average of 471 new HIV diagnoses were made in San Diego County annually. Given the increased risk of HIV transmission from recently infected individuals, the San Diego Department of Public Health designed an early testing program to screen those persons at high risk of HIV, wrote Dr. Sanjay R. Mehta of the University of California, San Diego, and colleagues, in Clinical Infectious Diseases (Clin Infect Dis. 2016 May 11. doi:10.1093/cid/ciw161).
Dr. Sanjay Mehta
HIV testing in San Diego between 1998 and 2012 was relatively stable, and ranged from approximately 9,236 tests in 2006 to approximately 16,797 in 1999. However, the expanded testing program – implemented in late 2011 – resulted in 39,688 tests performed in 2012, and the Early Test identified an average of 17 acute HIV infections (20% of Early Test diagnoses) and 21 early infections (24% of Early Test diagnoses) per year between 2008 and 2012.
Two zip codes in the central region of San Diego County associated with the gay community had the highest prevalence of HIV infection. Zip codes 92103 and 92104 had the highest net HIV importation of all the county zip codes, and several neighboring zip codes had the highest net exportation. “This suggested increased HIV transmission chain termination in the 92103 and 92104 zip codes, areas targeted by the Early Test program,” the researchers said.
“Our analysis demonstrated that the observed decrease in incident diagnoses was associated with the steady increase in testing by the Early Test program and not with an appreciable increase in ART uptake or effectiveness or a decrease in other STIs in the community,” Dr. Mehta and his colleagues added.
The study was supported in part by a grant from the National Institutes of Health. Dr. Mehta had no financial conflicts to disclose.