CDC Ramps Up HIV Behavioral Surveillance

Ask public health officials what behaviors are driving the recent syphilis epidemics, and their answers are limited at best. That may change in the next year as CDC implements behavioral surveillance systems in 15 U.S. cities. "We don't have a good surveillance system in place to know what have been the trends in common over time," said Matthew McKenna, MD, director of CDC's HIV Incidence and Case Surveillance Branch. "Nor do we have a good system that allows us to tie together whether persons are being influenced by prevention programs."

The initiative, which received $5.8 million in federal funds this year, will focus on setting up sustainable systems with standardized methods of sampling. The strategy includes developing formative research with community groups, identifying community members who can develop sampling frames, such as venue-based and "snowball" sampling, and developing standardized questionnaires. "We plan to be in these areas for years to come," McKenna said.

Six of the 15 sites have been conducting the Serological Testing Algorithm for Recent HIV Seroconversion research, as well, which found high rates of new HIV infections among young men who have sex with men. CDC plans to repeat the methodology of those studies and try to better identify the behaviors responsible for the infections. The first year of the project will focus on injection drug users and MSM, and then expand to high-risk heterosexual populations. Data from the sites will help public health officials get a handle on which behaviors are responsible for syphilis outbreaks and whether they are also responsible for increasing rates of HIV transmission.

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