J. Hodge

Bio: J. Hodge is an academic researcher from South Carolina Department of Health and Environmental Control. The author has contributed to research in topics: Public health & Public health surveillance. The author has an hindex of 1, co-authored 1 publications receiving 52 citations.

Health information privacy and syndromic surveillance systems.

Abstract: The development of syndromic surveillance systems to detect potential terrorist-related outbreaks has the potential to be a useful public health surveillance activity However, the perception of how the Health Insurance Portability and Accountability Act of1996 (HIPAA) Privacy Rule applies to the disclosure of certain public health information might affect the ability of state and local health departments to implement syndromic surveillance systems within their jurisdictions To assess this effect, a multiple-question survey asked respondents to share their experiences regarding patient confidentiality and HIPAA Privacy Rule requirements when imple menting syndromic surveillance systems This assessment summarizes the results of a national survey of state terrorism-preparedness coordinators and state epidemiologists and reflects the authors' and others' experiences with implementation

Performance of an oral fluid rapid HIV-1/2 test : experience from four CDC studies. Commentary

Abstract: Objective: To evaluate the performance of a rapid HIV antibody test used with whole blood and oral fluid in settings where the test is likely to be used. Design: In four separate studies, we compared the accuracy of the rapid test performed on whole blood and oral fluid specimens with the results of conventional HIV tests. Methods: Oral fluid and whole blood from persons of unknown HIV status recruited from clinics, labor and delivery units, and outreach venues were tested with the OraQuick Advance rapid HIV-1/2 antibody test. Sensitivity and specificity were compared with results of the enzyme immunoassay (EIA) and Western blot algorithm used by the study sites. Results: OraQuick sensitivity was 99.7% with whole blood and 99.1 % with oral fluid from 327 persons who were HIV antibody positive by the conventional algorithm. OraQuick specificity was 99.9% with whole blood and 99.6% with oral fluid from 12 010 HIV-negative persons; EIA specificity was 99.7%. A cluster of 16 false-positive oral fluid tests occurred in one study, in which specificity was lower (99.0%) than in the other three studies (99.6-99.8%). Conclusions: In diverse settings in four studies, the OraQuick test showed high sensitivity and specificity for HIV antibody in whole blood and oral fluid specimens. Slightly more false-positive and false-negative results occurred with oral fluid than with whole blood, but performance with both specimen types was similar to, or better than, that of conventional ElAs.

Performance of an oral fluid rapid HIV-1/2 test: experience from four CDC studies.

Abstract: Objective To evaluate the performance of a rapid HIV antibody test used with whole blood and oral fluid in settings where the test is likely to be used. Design In four separate studies, we compared the accuracy of the rapid test performed on whole blood and oral fluid specimens with the results of conventional HIV tests. Methods Oral fluid and whole blood from persons of unknown HIV status recruited from clinics, labor and delivery units, and outreach venues were tested with the OraQuick Advance rapid HIV-1/2 antibody test. Sensitivity and specificity were compared with results of the enzyme immunoassay (EIA) and Western blot algorithm used by the study sites. Results OraQuick sensitivity was 99.7% with whole blood and 99.1% with oral fluid from 327 persons who were HIV antibody positive by the conventional algorithm. OraQuick specificity was 99.9% with whole blood and 99.6% with oral fluid from 12 010 HIV-negative persons; EIA specificity was 99.7%. A cluster of 16 false-positive oral fluid tests occurred in one study, in which specificity was lower (99.0%) than in the other three studies (99.6-99.8%). Conclusions In diverse settings in four studies, the OraQuick test showed high sensitivity and specificity for HIV antibody in whole blood and oral fluid specimens. Slightly more false-positive and false-negative results occurred with oral fluid than with whole blood, but performance with both specimen types was similar to, or better than, that of conventional EIAs.

Evaluation of the Performance Characteristics of 6 Rapid HIV Antibody Tests

Abstract: Background. Since 2002, the US Food and Drug Administration has approved 6 rapid human immuno-deficiency virus (HIV) tests for use in the United States. To date, there has been no direct comparison of theperformance of all 6 tests.Methods. Persons known to be HIV-infected and persons who sought HIV testing at 2 clinical sites in LosAngeles, California, were recruited for evaluation of 6 rapid HIV tests with whole blood, oral fluid, serum, andplasmaspecimens.Sensitivityandspecificityoftherapidtestswerecomparedwithvirallysateandimmunoglobulin(Ig) M–sensitive peptide HIV enzyme immunoassays (EIAs).Results. A total of 6282 specimens were tested. Sensitivity was .95% and specificity was .99% for all rapidtests.ComparedwiththeIgM-sensitiveEIA,rapidtestsgavefalse-negativeresultswithanadditional2–5specimens.All rapid tests had statistically equivalent performance characteristics, based on overlapping confidence intervals forsensitivity and specificity, compared with either conventional EIA.Conclusions. All 6 rapid tests have high sensitivity and specificity, compared with that of conventional EIAs. Becauseperformance was similar for all tests and specimen types, other characteristics, such as convenience, time to result,shelflife,andcostwilllikelybedeterminingfactorsforselectionofarapidHIVscreeningtestforaspecificapplication.In 1998, when the Centers for Disease Control andPrevention (CDC) encouraged the use of rapid humanimmunodeficiency virus (HIV) tests to increase the re-ceipt of results among persons tested for HIV [1], onlytheSingleUseDiagnosticSystemforHIV-1(SUDS)wascommercially available in the United States [2]. Since2002, the US Food and Drug Administration (FDA) hasapproved 6 rapid HIV tests [3] that have become in-tegral to initiatives designed to promote more wide-spread HIV testing [4–10].Rapid HIV antibody tests provide results in ,30min [3]. FDA-approved rapid HIV tests (Table 1)employ either immunochromatography (lateralflow) or immunoconcentration (flow-through) tech-niques [11] and contain antigens that correspond toenvelope regions of HIV-1 (gp41, gp120, or both).Some tests also have an HIV type 2 (HIV-2) envelope(gp36) antigen. However, recent studies have docu-mented that rapid HIV tests have lower sensitivity,especially during early infection, than that of someconventional assays [12–14]. False-negative test re-sults have also been observed in individuals with ad-vanced disease [15] and in some persons who arereceiving effective antiretroviral therapy (ART) [16,17]. Because test manufacturers do not explicitlyidentify which reference tests were used to calculatesensitivity and specificity (Table 1), this study wasundertakentocomparecontemporaryrapidHIVtestsand conventional enzyme immunoassays (EIAs) whenperformed on specimens fromthesamepersons.METHODSThe two-phase field study was conducted at the Los An-geles Gay and Lesbian Center (LAGLC), an HIV testing

HIV infection and awareness among men who have sex with men-20 cities, United States, 2008 and 2011.

Abstract: Over half of HIV infections in the United States occur among men who have sex with men (MSM) Awareness of infection is a necessary precursor to antiretroviral treatment and risk reduction among HIV-infected persons We report data on prevalence and awareness of HIV infection among MSM in 2008 and 2011, using data from 20 cities participating in the 2008 and 2011 National HIV Behavioral Surveillance System (NHBS) among MSM Venue-based, time-space sampling was used to recruit men for interview and HIV testing We analyzed data for men who reported ≥ 1 male sex partner in the past 12 months Participants who tested positive were considered to be aware of their infection if they reported a prior positive HIV test We used multivariable analysis to examine differences between results from 2011 vs 2008 HIV prevalence was 19% in 2008 and 18% in 2011 (p = 014) In both years, HIV prevalence was highest among older age groups, blacks, and men with lower education and income In multivariable analysis, HIV prevalence did not change significantly from 2008 to 2011 overall (p = 051) or in any age or racial/ethnic category (p>015 in each category) Among those testing positive, a greater proportion was aware of their infection in 2011 (66%) than in 2008 (56%) (p<0001) In both years, HIV awareness was higher for older age groups, whites, and men with higher education and income In multivariable analysis, HIV awareness increased from 2008 to 2011 overall (p<0001) and for all age and racial/ethnic categories (p<001 in each category) In both years, black MSM had the highest HIV prevalence and the lowest awareness among racial/ethnic groups These findings suggest that HIV-positive MSM are increasingly aware of their infections

State of the Art for Diagnosis of HIV Infection

Abstract: Diagnostic tests for human immunodeficiency virus (HIV) infection have undergone considerable evolution since the first enzyme immunoassay (EIA) and Western blot were introduced 2 decades ago. Newer methods detect infection sooner and yield results much faster. Rapid tests represent a major advance for HIV screening in the United States. Six rapid tests for detection of HIV antibody have been approved by the Food and Drug Administration (FDA) since November 2002. Four of these tests can be done in point-of-care and nonclinical settings because they use whole blood or oral fluid and are simple to perform. An assay for detection of HIV-1 RNA has been approved by the FDA to detect HIV infection before seroconversion has occurred and to confirm results of reactive screening tests; pooled testing of specimens for HIV-1 RNA has increased the cost-effectiveness of this screening tool. These new testing technologies offer unique opportunities to diagnose HIV infection among the estimated 252,000-312,000 persons in the United States who are currently unaware they are infected.