Surveillance data on HIV infections
provide a more complete picture of the
HIV/AIDS epidemic and the need for
prevention and care services than does the
picture provided by AIDS data alone. As of
April 2008, all 50 states, the District of
Columbia, and 5 dependent areas—American
Samoa, Guam, the Northern Mariana Islands,
Puerto Rico, and the U.S. Virgin Islands—use
the same confidential name-based reporting
system to collect HIV and AIDS data.
Before April 2008, some states and
dependent areas did not use confidential
name-based reporting to collect HIV data.
The different methods of collecting data
posed a challenge when compiling national
data. To address the
problem, CDC advised in 1999 that all U.S.
states and dependent areas conduct
confidential name-based HIV case
surveillance as part of their AIDS case
surveillance activities [1]. This advice was
strengthened to a recommendation in 2005
[2]. Compared with HIV
reporting systems based on other types of
identifiers (such as those based on a code
or name-to-code), confidential name-based
HIV reporting has proven to be more
cost-effective, and it routinely achieves
high levels of accuracy and reliability.
Confidential name-based HIV infection
reporting is consistent with reporting for
other infectious diseases, including AIDS,
and is now being conducted by all states,
the District of Columbia, and 5 dependent
areas.
To ensure the validity
of the data, CDC includes HIV infection data
from states and dependent areas that have
conducted confidential name-based HIV
infection reporting for at least 4 years
(i.e., since at least 2003) to allow for stabilization of data collection
and for adjustment of the data in order to
monitor trends. Therefore, CDC’s
HIV/AIDS
surveillance report for 2006, published in
2008, includes data from 33 states and 5
dependent areas [3]. (In
list below, these 33 states and 5 dependent
areas are shown in bold.)
It is important to keep
in mind that the number of new HIV diagnoses
does not necessarily reflect trends in HIV
incidence (i.e., new infections) because
some persons were infected recently and
others were infected some time in the past.
One method for estimating HIV incidence is
to apply the serologic testing algorithm for
recent HIV seroconversion (STARHS) to the
serum specimens from which the diagnosis of
HIV infection was made. As of January 2008,
25 states
are funded to
estimate population-based HIV incidence. The
monitoring of HIV incidence will be critical
in evaluating progress in decreasing the
number of HIV infections that occur each
year and in allocating resources and
evaluating the effectiveness of prevention
programs.
To safeguard the
confidentiality and security of the data,
CDC published
guidelines in 2006 to ensure
that data in the HIV/AIDS surveillance
system are held under the highest of
security standards and with the most
stringent protections [4]. The guidelines
were based on consultations with state
HIV/AIDS surveillance coordinators, CDC's
Divisions of STD Prevention and TB
Elimination, and security and computer staff
in other CDC centers and offices and were
reviewed by staff in the state and local
surveillance programs.
Name-Based |
Not Implemented |
Alabama
Alaska
American Samoa
Arizona
Arkansas
California1
Colorado
Connecticut1
Delaware1 District of Columbia1
Florida
Georgia1
Guam
Hawaii1
Idaho
Illinois1 Indiana
Iowa
Kansas
Kentucky1
Louisiana
Maine1
Maryland1 Massachusetts1
Michigan
Minnesota
Mississippi
Missouri
Montana1 Nebraska
Nevada
New
Hampshire1
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon1
Pennsylvania2
Puerto Rico
Rhode Island1 South
Carolina
South Dakota
Tennessee
Texas
U.S. Virgin Islands
Utah
Vermont1
Virginia
Washington1
West Virginia
Wisconsin
Wyoming |
Marshall
Islands
Palau
Federated States of Micronesia |
Note: States in
italics offer only confidential and not
anonymous HIV testing. All other U.S.
states and dependent areas offer both
confidential and anonymous testing.
1 |
Georgia switched to
name-based reporting December 2003.
Kentucky switched to name-based reporting
October 1, 2004.
Connecticut switched to name-based reporting
for all HIV cases January 2005.
New Hampshire switched to name-based
reporting January 2005.
Illinois and Maine switched
to name-based reporting January 1, 2006.
Delaware switched to name-based reporting
February 10, 2006.
Washington switched to name-based reporting
March 9, 2006. California switched to
name-based reporting April 17,
2006. Oregon switched to name-based
reporting April 17, 2006. Rhode
Island switched to name-based reporting July 14, 2006. Montana switched
to name-based reporting September 8,
2006. District of Columbia switched to
name-based reporting November 17, 2006.
Massachusetts switched to name-based
reporting January 1, 2007.
Maryland switched
to name-based reporting April 24, 2007.
Hawaii switched to name-based reporting
March 13, 2008.
Vermont switched
to name-based reporting April 1, 2008. |
2 |
Philadelphia, PA, switched to
name-based reporting October 2005. |
References
-
CDC.
Guidelines for national human
immunodeficiency virus case
surveillance, including monitoring for
human immunodeficiency virus infection
and acquired immunodeficiency syndrome.
MMWR 1999;48(RR-13);1–28.
-
CDC.
Dear Colleague letter re name-based HIV
reporting, from Julie Gerberding
.
July 2005.
-
CDC.
HIV/AIDS Surveillance Report, 2006.
Vol. 18. Atlanta: U.S. Department of
Health and Human Services, CDC;
2008:1–55.
-
Centers for Disease
Control and Prevention and Council of
State and Territorial Epidemiologists.
Technical Guidance for HIV/AIDS
Surveillance Programs, Volume III:
Security and Confidentiality Guidelines.
Atlanta, Georgia: Centers for Disease
Control and Prevention; 2006.
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