AEGiS-15IAC: Building on Russian HIV surveillance: the CDC Orel AIDS Center Enhanced Surveillance Project, 2002-2003.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

Building on Russian HIV surveillance: the CDC Orel AIDS Center Enhanced Surveillance Project, 2002-2003.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. C10443)

Santibanez SS, Sofronova R, Nelson RJ, Broyles LN, Garfein RS, Vitek C, Abdul-Quader AS, Gusseynova N, Molotilov VF, Paxton LA
Centers for Disease Control and Prevention (CDC), Atlanta GA, United States

BACKGROUND: Russia is experiencing one of the world's fastest growing HIV epidemics. Although the Russian HIV surveillance system detects and follows many HIV positive individuals, the effects of repeat testing, low-risk tests, and incomplete risk factor data on rate estimates, and the extent that changes in case counts reflect actual rates are unknown. We reviewed the HIV surveillance system in Orel, Russia and suggest enhancements.

METHODS: We supplemented Nov. 2002- July 2003 surveillance data (HIV positives only) with additional data for all persons tested, and behavioral surveillance data from 1211 persons presenting to an Anonymous Testing AIDS Center Site (ATACS). We identified repeat tests using a name/date-of-birth-based unique identifier, identified low-risk (routine/mandatory) tests, and compared HIV surveillance risk codes (HSRCs) with self-reported behaviors.

RESULTS: Of 82,148 adult HIV tests, 14,863 (18%) were repeats. In addition to 20,349 antenatal and 10,295 blood/tissue screening tests, routine/mandatory screening included 2,530 tests for routine job requirements and 496 tests of foreigners -- two categories which detected only one case each. One-third of all persons tested were assigned HSRC "other". Of the 367 persons surveyed at ATACS who reported drug use behavior, HSRCs identified only 91 (25%). There was no HSRC to quantify heterosexual risk, although 221 (60%) of drug users had >2 sex partners in the past year and only 76 (21%) always used condoms with casual sex partners.

CONCLUSIONS: We demonstrate that the performance of existing Russian HIV surveillance can be improved. We suggest (i) reducing repeat and low-risk tests, (ii) eliminating the HSRC "other" as the large number assigned to this category severely limits rate calculation by risk group, (iii) adding an HSRC for heterosexual risk, and (iv) making HSRCs non-mutually exclusive.

Keywords: AEGIS, Acquired Immunodeficiency Syndrome, HIV Seropositivity, Centers for Disease Control and Prevention (U.S.), Risk Factors, Condoms, Heterosexuality, Anonymous Testing, Mandatory Testing, Russia, Adult, epidemiology

040711
C10443