Faculty Collaboration Database

Using sexually transmitted disease incidence as a surrogate marker for HIV incidence in prevention trials: a modeling study. Sex Transm Dis 2002 May;29(5):298-307

Date

05/02/2002

Pubmed ID

11984448

DOI

10.1097/00007435-200205000-00009

Scopus ID

2-s2.0-0036255254 (requires institutional sign-in at Scopus site)   26 Citations

Abstract

BACKGROUND: Because many of the sexual behaviors that place individuals at risk of acquiring HIV are the same as those that place them at risk for other sexually transmitted diseases (STDs), researchers and policymakers have called for the use of non-HIV STDs as surrogate markers for HIV infection.

GOALS: This study examined the epidemiologic conditions under which changes in STD incidence are associated with changes in HIV incidence.

STUDY DESIGN: A mathematical model of HIV/STD transmission was applied to empirical data from a large HIV prevention intervention. The association between participants' HIV infection risk reduction scores and their STD risk reduction scores was measured with use of the Pearson product-moment correlation. The authors examined how the strength of association varied across different epidemiologic parameters and heterosexual behaviors.

RESULTS: Moderate to strong associations were noted when the infectivity of the STD was similar to the infectivity of HIV. The association was attenuated for larger STD infectivity values. The prevalence of STD infection was a less important determinant of the strength of association. Stronger associations were obtained when the number of sex partners was large or the number of sex acts was small.

CONCLUSIONS: Easily transmitted STDs, such as gonorrhea, are unsuitable for general use as surrogate markers for HIV infection. Hepatitis B, syphilis, and chlamydial infection have more promising epidemiologic profiles. Careful studies of STD infectivity are needed to aid in the identification of potential marker STDs.

Author List

Pinkerton SD, Layde PM, NIMH multisite HIV prevention trial group

MESH terms used to index this publication - Major topics in bold

Female
HIV Infections
Humans
Incidence
Male
Models, Statistical
Prevalence
Randomized Controlled Trials as Topic
Risk Factors
Risk-Taking
Sexual Behavior
Sexually Transmitted Diseases
United States