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Why is "Acute HIV Infection" not classified as a sexually transmitted disease in SNOMED-CT?

I’m trying to compile a list of sexually transmitted diseases using SNOMED-CT (I happen to be using OHDSI/OMOP concept tables in Databricks as my source for SNOMED-CT).

Querying the SNOMED-CT data from OHDSI Athena in OHDSI/OMOP using the query below, I get the results shown below. Notably missing from the ancestors is any indication that HIV is a sexually transmitted disease/infection.

Is there a way to use SNOMED-CT to create a somewhat comprehensive list of sexually transmitted diseases? Is there a better way to get to a list of codes (SNOMED or other, e.g. ICD) for sexually transmitted diseases/infections?

select distinct
  parent.concept_id,
  parent.concept_code,
  parent.vocabulary_id,
  parent.concept_name,
  an.max_levels_of_separation,
  an.min_levels_of_separation
from 
  concept con
  join concept_ancestor an on 1=1
    and an.descendant_concept_id = con.concept_id
  join concept parent on 1=1
    and parent.concept_id = an.ancestor_concept_id
where 1=1 
  and con.vocabulary_id = 'SNOMED'
  and lower(con.concept_name) = 'acute hiv infection'
  and con.domain_id = 'Condition'
order by parent.concept_name
;

This finding seems to be confirmed using other SNOMED-CT browsers, for example:

https://browser.ihtsdotools.org/?perspective=full&conceptId1=62479008&edition=MAIN/SNOMEDCT-US/2022-03-01&release=&languages=en

The problem is simply that HIV can be transmitted through other routes as well. E.g. transfusions. Sounds like you need to do concept chasing and putting the list together by hand.

@greshje.gmail,

I emailed one of the terminologists at SNOMED with your question and use case, because the concept as it exists (in SNOMED) strikes me as ambiguous.

Per @Christian_Reich, the concept name (FSN) implies it represents infectious diseases that are transmitted exclusively throught sexual activity…

Based on the child concepts (e.g., congenital syphilis) is sure looks like the meaning of this concept is idea expressed by the SYN - Disease with a predominantly sexual mode of transmission

Child concepts not havng sexual mode of transmission:
image

I will post what I hear back from SNOMED,

Piper

@greshje.gmail and @Christian_Reich,
Talked to Jim Case and confirmed the following:

Concept 8098009 | Sexually transmitted infectious disease (disorder) | refers to any disease with a predominantly sexual mode of transmission (i.e., consistent with WHO definition)>

Regarding modification of subsumption relationships, the resonse was that AIDS will be placed under STDs. They are doing an analysis to assess the impact of moving HIV infection under STDs because there are lots of co-occurrent terms that will be affected.

Will post here as they progress with the analysis.

Best,
Piper

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