Surveillance data on HIV infections provide a more complete picture of the HIV 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 6 dependent areas—American Samoa, Guam, the Northern Mariana Islands, Palau, Puerto Rico, and the U.S. Virgin Islands—used the same confidential name-based reporting standards to collect HIV surveillance data.
Before April 2008, some states and dependent areas did not use confidential name-based reporting to collect HIV infection 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 infection case surveillance as part of their AIDS case surveillance activities [1]. This advice was strengthened to a recommendation in 2005 [2]. Compared with HIV infection reporting systems based on other types of identifiers (such as those based on a code or name-to-code), confidential name-based HIV infection 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 6 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 to allow for stabilization of data collection and for adjustment of the data in order to monitor trends. Therefore, CDC’s 2008
HIV Surveillance Report, published in 2010, includes data from 37 states and 5 U.S. dependent areas with confidential name-based HIV infection reporting since at least January 2005 [3]. (In the list below, these 37 states and 5 dependent areas are shown in bold.)
It is important to keep in mind that the number of new diagnoses of HIV infection does not necessarily reflect trends in HIV incidence (i.e., new infections) because some persons were infected recently and others were infected sometime 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 2010, 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 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 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
Connecticut
Delaware1 District of Columbia1
Florida
Georgia
Guam
Hawaii1
Idaho
Illinois1 Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine1
Maryland1 Massachusetts1
Michigan
Minnesota
Mississippi
Missouri
Montana1 Nebraska
Nevada
New
Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon1 Palau3
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
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 |
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. |
3 |
Palau implemented name-based reporting in 2005 but was not authorized to report data on HIV infection to CDC until February 2010. |
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.
Diagnoses of HIV infection and AIDS in the United States and Dependent Areas, 2008.
Vol. 20. Atlanta: U.S. Department of Health and Human Services, CDC; 2008:1–143.
-
CDC.
Data Security and Confidentiality Guidelines for HIV, Viral Hepatitis,
Sexually Transmitted Disease, and Tuberculosis Programs: Standards to Facilitate
Sharing and Use of Surveillance Data for Public Health Action. Atlanta, Georgia:
Centers for Disease Control and prevention; 2011.
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