Sexually Transmitted Diseases Vol. 39; No. 1: P. 65-71
In North Carolina, disease intervention specialists (DIS) have
less time to conduct partner notification activities because
of competing responsibilities and growing case loads due to
expanded HIV testing. In the current study, the researchers
developed a model to predict undiagnosed HIV infection in
sexual partners in order to prioritize DIS interviews.
Using DIS records of HIV-infected persons reported in two
North Carolina surveillance regions from Jan. 1, 2003 to Dec.
31, 2007, the team abstracted demographic, behavioral and
partnership data. A predictive model and risk scores among
newly diagnosed persons and their partners were developed
using multiple logistic regression with generalized estimating
equations. Sensitivities and specificities of risk scores at
varying cutoffs were used to examine algorithm performance.
The results showed that five factors predicted a partnership
between a person newly diagnosed as HIV-positive and an
undiagnosed partner: 1) a period of four weeks or less between
HIV diagnosis and DIS interview; 2) no history of crack use;
3) no anonymous sex; 4) fewer total sexual partners reported
to DIS; and 5) sexual partnerships between an older index case
and younger partner. "Using this model, DIS could choose an
appropriate cutoff for locating a particular partner by
determining the weight of false negatives relative to false
positives," the authors wrote.
"Although the overall predictive power of the model is low, it
is possible to reduce the number of partners that needs to be
located and interviewed while maintaining high sensitivity. If
DIS continue to pursue all partners, the model would be useful
in identifying partners in whom to invest more resources for
locating," the team concluded.