title: Use of sentinel surveillance and geographic information systems to monitor trends in HIV prevalence, incidence, and related risk behavior among women undergoing syphilis screening in a jail setting.
abstract: Innovative methods are needed to systematically track the HIV epidemic and appropriately target prevention and care programs in vulnerable populations of women. We conducted sentinel surveillance among women entering the jail system of San Francisco from 1999 to 2001 to track trends in HIV incidence, HIV prevalence, and related risk behavior. Using geographic information software (GIS), we triangulated findings to examine the spatial distribution of risk and disease. A total of 1,577 female arrestees voluntarily screened for sexually transmitted diseases at intake were included. HIV incidence, estimated using the serologic testing algorithm for recent HIV seroconversion (STARHS), was 0.4% per year (95% confidence interval [95%CI]=0.1-2.1). HIV prevalence was 1.8% (95%CI=1.1-2.4). HIV infection was independently associated with age 30 to 39 years compared to all other ages, African-American race/ethnicity vs. non-African-American, and recent injection drug use. Maps showed that the communities in which arrested women reside are also those with the highest concentrations of newly detected female HIV cases, AIDS cases, and clients of substance use programs. The combined strategy of using sentinel surveillance in the jail setting and GIS to map the spatial distribution of disease provides a useful tool to identify patterns of risk in hard-to-reach, vulnerable populations of women.
authors.affiliation: San Francisco Department of Public Health, San Francisco, CA 94132, USA.
authors.forename: Andrea A
authors.initials: AA
authors.lastname: Kim
authors.forename: Alexis N
authors.initials: AN
authors.lastname: Martinez
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Klausner
authors.forename: Joe
authors.initials: J
authors.lastname: Goldenson
authors.forename: Charlotte
authors.initials: C
authors.lastname: Kent
authors.forename: Sally
authors.initials: S
authors.lastname: Liska
authors.forename: Willi
authors.initials: W
authors.lastname: McFarland
mesh_terms: D000328:Adult; D017677:Age Distribution; D005260:Female; D040362:Geographic Information Systems / Q000706:statistics & numerical data*; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology*; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D015995:Prevalence; D011330:Prisons / Q000706:statistics & numerical data*; D012309:Risk-Taking; D018571:Sentinel Surveillance; D012725:Sexual Behavior; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders; D013587:Syphilis / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*
references.citation: J Public Health Manag Pract. 2007 Jan;Suppl:S72-9
references.pmid: 17159472
references.citation: Am J Public Health. 2002 Mar;92(3):388-94
references.pmid: 11867317
references.citation: AIDS Care. 1999 Aug;11(4):437-42
references.pmid: 10533536
references.citation: Sex Transm Dis. 2002 Dec;29(12):834-9
references.pmid: 12466728
references.citation: Indian J Med Res. 1999 Jun;109:199-201
references.pmid: 10491909
references.citation: J Acquir Immune Defic Syndr. 2003 Aug 15;33(5):625-34
references.pmid: 12902808
references.citation: Sex Transm Infect. 2007 Aug;83(5):416-8
references.pmid: 17567685
references.citation: Int J STD AIDS. 1994 Mar-Apr;5(2):124-9
references.pmid: 8031914
references.citation: Public Health Rep. 1990 Mar-Apr;105(2):113-9
references.pmid: 2157233
references.citation: BMC Med. 2006 Dec 13;4:31
references.pmid: 17166257
references.citation: J Acquir Immune Defic Syndr. 2000 Dec 15;25 Suppl 2:S115-9
references.pmid: 11256731
references.citation: J Urban Health. 2007 May;84(3):423-35
references.pmid: 17265133
references.citation: AIDS. 2002 Nov 8;16(16):2236-8
references.pmid: 12409752
references.citation: J Acquir Immune Defic Syndr. 2007 Sep 1;46(1):101-11
references.pmid: 17972366
references.citation: JAMA. 1998 Jul 1;280(1):42-8
references.pmid: 9660362
references.citation: Health Soc Care Community. 2006 Jan;14(1):37-48
references.pmid: 16324186
references.citation: Sex Transm Infect. 2006 Oct;82(5):418-22
references.pmid: 16854996
references.citation: Public Health Rep. 2001 May-Jun;116(3):191-6
references.pmid: 12034907
references.citation: J Urban Health. 2004 Jun;81(2):268-77
references.pmid: 15136660
references.citation: Sex Transm Dis. 2002 May;29(5):271-6
references.pmid: 11984443
references.citation: AIDS Res Hum Retroviruses. 2002 Mar 1;18(4):295-307
references.pmid: 11860677
references.citation: J Acquir Immune Defic Syndr. 1999 Aug 1;21(4):338-46
references.pmid: 10428114