In December 2006, Congress enacted the Ryan White HIV/AIDS Treatment Modernization Act of 2006. The Act specifies the use of living HIV and AIDS case surveillance data in funding formulae for HIV care and services programs. The Ryan White HIV/AIDS Treatment Modernization Act of 2006 authorizes CDC to provide AIDS data to HRSA for use in their funding formulae for all jurisdictions and provide HIV non-AIDS case data for areas with accurate and reliable name-based reporting as specified in the Act. These areas include Alabama, Alaska, Arizona, Arkansas, Colorado, Florida, Idaho, Indiana, Iowa, Kansas, Louisiana, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, Wisconsin, Wyoming, Guam, and the Virgin Islands. Areas not specified in the Act could report those data directly to HRSA until such time that the areas—in consultation with the state epidemiologist and CDC—determine that their system has become operational and that their name-based HIV data are sufficiently accurate and reliable for CDC to provide those data to HRSA. The Act further specifies that the numbers submitted from these areas be modified to adjust for duplicative reporting by reducing the numbers by 5%. It was determined that areas with name-based HIV reporting systems in place prior to December 31, 2005 that are not specified in the Act as an eligible area meeting the standard, but were reporting HIV non-AIDS cases to CDC, could choose to submit their own numbers to HRSA or have CDC provide their reported data to HRSA and not have the 5% reduction applied. For FY2007, the following areas reported HIV data directly to HRSA: California, Delaware, District of Columbia, Hawaii, Illinois, Maine, Maryland, Massachusetts, Montana, Oregon, Pennsylvania, Rhode Island, Vermont, Washington, Marshall Islands, Palau, and Federated States of Micronesia. The Eligible Metropolitan Areas and Transitional Grant Areas in these states include the following: Los Angeles–Long Beach, CA; Oakland, CA; Orange County, CA; Riverside–San Bernardino, CA; Sacramento, CA; San Diego, CA; San Francisco, CA; San Jose, CA; Santa Rosa, CA; District Of Columbia; Chicago, IL; Baltimore, MD; Boston, MA; Portland, OR; Philadelphia, PA; and Seattle, WA. The following areas chose to have CDC report their HIV data to HRSA for funding allocation purposes under Part A and Part B (see Commentary for description of Part A and Part B): Connecticut, Georgia, Kentucky, New Hampshire, Puerto Rico, American Samoa and Northern Mariana Islands.

Data Requirements and Definitions

Case counts in all tables are presented by residence at earliest HIV diagnosis for HIV non-AIDS cases and residence at earliest AIDS diagnosis for AIDS cases. Data are presented by date of report rather than date of diagnosis (e.g., cases reported as alive as of December 31, 2005). Boundaries for metropolitan statistical areas (MSA) are based on 1994 U.S. Census MSA definitions for eligible metropolitan areas (EMA)/transitional grant areas (TGA) that became eligible prior to FY2007. Boundaries for newly eligible EMAs, TGAs and emerging communities (EC) are determined using applicable definitions based on the 2000 U.S. Census. Reported persons living with AIDS and five-year AIDS case counts are not adjusted for delays in reporting of cases or deaths. Reported persons living with AIDS are defined as persons reported as “alive” at last update.

HIV (non-AIDS) cases for code-based data submitted to HRSA and CDC data met the CDC surveillance case definition for definitive or presumptive HIV infection published in the CDC Guidelines for National Human Immunodeficiency Virus Case Surveillance [1].

References

1. 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):29–31.