Interrupting Transmission of HIV and Other Sexually Transmitted Infections in Rhode Island

Transmission of human immunodeficiency virus (HIV) and other sexually transmitted infections (STI) in Rhode Island, a central New England location for many gay sex club venues,1 continues to be a public health challenge despite close collaboration between health care providers, community-based agencies, and the RI Department of Health (HEALTH).2 In December 2010, HEALTH requested assistance from the Centers for Disease Control and Prevention (CDC) to further understand a recent increase in syphilis and HIV infections among men who have sex with men (MSM) in RI. MSM comprise the majority of persons diagnosed with both syphilis and HIV infection in RI; increasing from 79% (27/34) in 2009 to 89% (54/61) in 2010 among new syphilis cases, and increasing from 47% (59/125) in 2009 to 51% (54/106) in 2010 among newly diagnosed HIV infections.2 The CDC evaluation highlighted HIV testing deficits among MSM and the need to increase HIV and STI testing, as well as early diagnosis. Many MSM in RI were not routinely tested for HIV and other STI, nor were they linked to appropriate care upon diagnosis, regardless of having a primary care provider. A key to effectively reducing HIV and other STI transmission in RI is understanding the epidemiology of those infections and their transmission from index cases to their sexual partners, which depend on routine testing, timely case reporting, and appropriate treatment. In this paper we highlight the epidemiology of HIV and other STI transmission in RI and the methods in place to interrupt it.