title: Ten Years of Screening and Testing for Acute HIV Infection in North Carolina.
abstract: OBJECTIVE
  To describe demographic and behavioral characteristics of persons with acute HIV infection (AHI) over time.
  
  
  METHODS
  We conducted a retrospective assessment of AHI identified through the Screening and Tracing Active Transmission (STAT) program from 2003 to 2012 in North Carolina (NC). AHI was identified using pooled nucleic acid amplification for antibody negative samples and individual HIV-1 RNA for antibody indeterminate samples. The STAT program provides rapid notification and evaluation. We compared STAT-collected demographic and risk characteristics with all persons requesting tests and all non-AHI diagnoses from the NC State Laboratory of Public Health.
  
  
  RESULTS
  The STAT Program identified 236 AHI cases representing 3.4% (95% confidence interval: 3.0% to 3.9%) of all HIV diagnoses. AHI cases were similar to those diagnosed during established HIV. On pretest risk-assessments, AHI cases were predominately black (69.1%), male (80.1%), young (46.8% < 25 years), and men who have sex with men (MSM) (51.7%). Per postdiagnosis interviews, the median age decreased from 35 (interquartile range 25-42) to 27 (interquartile range 22-37) years, and the proportion <25 years increased from 23.8% to 45.2% (trend P = 0.04) between 2003 and 2012. AHI men were more likely to report MSM risk post-diagnosis than on pretest risk-assessments (64%-82.9%; P < 0.0001). Post-diagnosis report of MSM risk in men with AHI increased from 71.4% to 96.2%.
  
  
  CONCLUSIONS
  In NC, 3.4% of individuals diagnosed with HIV infection have AHI. AHI screening provides a real-time source of incidence trends, improves the diagnostic yield of HIV testing, and offers an opportunity to limit onward transmission.
authors.affiliation: *Division of Infectious Disease, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC;†Division of Public Health, North Carolina Department of Health and Human Services, Raleigh, NC; and‡Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
authors.forename: JoAnn D
authors.initials: JD
authors.lastname: Kuruc
authors.forename: Anna B
authors.initials: AB
authors.lastname: Cope
authors.forename: Lynne A
authors.initials: LA
authors.lastname: Sampson
authors.forename: Cynthia L
authors.initials: CL
authors.lastname: Gay
authors.forename: Rhonda M
authors.initials: RM
authors.lastname: Ashby
authors.forename: Evelyn M
authors.initials: EM
authors.lastname: Foust
authors.forename: Myra
authors.initials: M
authors.lastname: Brinson
authors.forename: John E
authors.initials: JE
authors.lastname: Barnhart
authors.forename: David
authors.initials: D
authors.lastname: Margolis
authors.forename: William C
authors.initials: WC
authors.lastname: Miller
authors.forename: Peter A
authors.initials: PA
authors.lastname: Leone
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Eron
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology*; D015497:HIV-1; D018451:Homosexuality, Male / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult