LETTER TO
In Response to Surveillance of HIV in the United States and England, Wales, and Northern Ireland: What Have We Learned and What Do We Do About It? To the Editor: e recently published an analysis of data from the National Health and Nutritional Examination Survey (NHANES) that examined the prevalence of HIV, other sexually transmitted infections, and viral hepatitis in particular geographic areas among specific risk groups in the United States.1 We greatly appreciate the editorial published in the same issue,2 which highlights this work. However, we would like to correct one inaccuracy in the editorial. The editorial correctly states that the prevalence of HIV among men who have sex with men (MSM) in our NHANES analysis, which was 14.5% in large central metropolitan areas and 16.9% in large fringe metropolitan areas, is similar to that reported by the National HIV Behavioral Surveillance System (NHBS), which was 19% in 2008 and 18% in 2011.3,4 We agree that
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this underscores the high prevalence of HIV among MSM, who should remain a priority population for HIV prevention. The editorial also states incorrectly that the slightly lower prevalence among MSM found in NHANES compared to NHBS is likely due to use of respondent-driven sampling in the latter. Although NHBS does use respondent-driven sampling to recruit injection drug users and heterosexuals,5,6 MSM are recruited using venue-based sampling. In addition, the HIV prevalence among MSM obtained from NHBS falls well within the confidence limits of the NHANES estimate. Behavioral surveillance remains essential for characterizing and monitoring the burden of HIV infection and sexual and behavioral risks. These types of analyses allow us to better understand the populations we reach with different sampling methods and appropriately translate these data to prevention. Conflicts of interest: None declared. Alexandra M. Oster, MD Gabriela Paz-Bailey, MD, PhD, MSc Division of HIV/AIDS Prevention Centers for Disease Control and Prevention Atlanta GA [email protected]
Sexually Transmitted Diseases
REFERENCES 1. Oster AM, Sternberg M, Nebenzahl S, et al. Prevalence of HIV, sexually transmitted infections, and viral hepatitis by urbanicity, among men who have sex with men, injection drug users, and heterosexuals in the United States. Sex Transm Dis 2014; 41:272Y279. 2. Gay C, Adimora A, Miller W, et al. Surveillance of HIV in the United States and England, Scotland, and Northern Ireland: What have we learned and what do we do about it? Sex Transm Dis 2014; 41:266Y267. 3. Wejnert C, Le B, Rose CE, et al. HIV infection and awareness among men who have sex with men-20 cities, United States, 2008 and 2011. PLoS One 2013; 8:e76878. 4. Centers for Disease Control and Prevention. Prevalence and awareness of HIV infection among men who have sex with menV21 Cities, United States, 2008. MMWR Morb Mortal Wkly Rep 2010; 59:1201Y1207. 5. Centers for Disease Control and Prevention. HIV infection among heterosexuals at increased riskVUnited States, 2010. MMWR Morb Mortal Wkly Rep 2013; 62:183Y188. 6. Centers for Disease Control and Prevention. HIV infection and HIV-associated behaviors among injecting drug usersV20 Cities, United States, 2009. MMWR Morb Mortal Wkly Rep 2012; 61:133Y138.
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Volume 41, Number 8, August 2014
Copyright © 2014 by the American Sexually Transmitted Diseases Association. Unauthorized reproduction of this article is prohibited.
In Response to Surveillance of HIV in the United States and England, Wales, and Northern Ireland: What Have We Learned and What Do We Do About It? To the Editor: e recently published an analysis of data from the National Health and Nutritional Examination Survey (NHANES) that examined the prevalence of HIV, other sexually transmitted infections, and viral hepatitis in particular geographic areas among specific risk groups in the United States.1 We greatly appreciate the editorial published in the same issue,2 which highlights this work. However, we would like to correct one inaccuracy in the editorial. The editorial correctly states that the prevalence of HIV among men who have sex with men (MSM) in our NHANES analysis, which was 14.5% in large central metropolitan areas and 16.9% in large fringe metropolitan areas, is similar to that reported by the National HIV Behavioral Surveillance System (NHBS), which was 19% in 2008 and 18% in 2011.3,4 We agree that
W
518
THE
EDITOR
this underscores the high prevalence of HIV among MSM, who should remain a priority population for HIV prevention. The editorial also states incorrectly that the slightly lower prevalence among MSM found in NHANES compared to NHBS is likely due to use of respondent-driven sampling in the latter. Although NHBS does use respondent-driven sampling to recruit injection drug users and heterosexuals,5,6 MSM are recruited using venue-based sampling. In addition, the HIV prevalence among MSM obtained from NHBS falls well within the confidence limits of the NHANES estimate. Behavioral surveillance remains essential for characterizing and monitoring the burden of HIV infection and sexual and behavioral risks. These types of analyses allow us to better understand the populations we reach with different sampling methods and appropriately translate these data to prevention. Conflicts of interest: None declared. Alexandra M. Oster, MD Gabriela Paz-Bailey, MD, PhD, MSc Division of HIV/AIDS Prevention Centers for Disease Control and Prevention Atlanta GA [email protected]
Sexually Transmitted Diseases
REFERENCES 1. Oster AM, Sternberg M, Nebenzahl S, et al. Prevalence of HIV, sexually transmitted infections, and viral hepatitis by urbanicity, among men who have sex with men, injection drug users, and heterosexuals in the United States. Sex Transm Dis 2014; 41:272Y279. 2. Gay C, Adimora A, Miller W, et al. Surveillance of HIV in the United States and England, Scotland, and Northern Ireland: What have we learned and what do we do about it? Sex Transm Dis 2014; 41:266Y267. 3. Wejnert C, Le B, Rose CE, et al. HIV infection and awareness among men who have sex with men-20 cities, United States, 2008 and 2011. PLoS One 2013; 8:e76878. 4. Centers for Disease Control and Prevention. Prevalence and awareness of HIV infection among men who have sex with menV21 Cities, United States, 2008. MMWR Morb Mortal Wkly Rep 2010; 59:1201Y1207. 5. Centers for Disease Control and Prevention. HIV infection among heterosexuals at increased riskVUnited States, 2010. MMWR Morb Mortal Wkly Rep 2013; 62:183Y188. 6. Centers for Disease Control and Prevention. HIV infection and HIV-associated behaviors among injecting drug usersV20 Cities, United States, 2009. MMWR Morb Mortal Wkly Rep 2012; 61:133Y138.
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Volume 41, Number 8, August 2014
Copyright © 2014 by the American Sexually Transmitted Diseases Association. Unauthorized reproduction of this article is prohibited.
