scholarly journals Shifting the Paradigm: Using HIV Surveillance Data as a Foundation for Improving HIV Care and Preventing HIV Infection

2013 ◽  
Vol 91 (3) ◽  
pp. 558-603 ◽  
Author(s):  
PATRICIA SWEENEY ◽  
LYTT I. GARDNER ◽  
KATE BUCHACZ ◽  
PAMELA MORSE GARLAND ◽  
MICHAEL J. MUGAVERO ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Surveillance Data ◽  
Hiv Care ◽  
Hiv Surveillance

scholarly journals Use of HIV Case Surveillance System to Design and Evaluate Site-Randomized Interventions in an HIV Prevention Study: HPTN 065

2012 ◽  
Vol 6 (1) ◽  
pp. 122-130 ◽  
Author(s):  
Deborah J Donnell ◽  
H Irene Hall ◽  
Theresa Gamble ◽  
Geetha Beauchamp ◽  
Angelique B Griffin ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Surveillance System ◽  
Viral Suppression ◽  
Laboratory Data ◽  
Linkage To Care ◽  
Baseline Data ◽  
Surveillance Data ◽  
Hiv Care ◽  
Hiv Surveillance ◽  
Hiv Test

Introduction:Modeling studies suggest intensified HIV testing, linkage-to-care and antiretroviral treatment to achieve viral suppression may reduce HIV transmission and lead to control of the epidemic. To study implementation of strategy, population-level data are needed to monitor outcomes of these interventions. US HIV surveillance systems are a potential source of these data.Methods:HPTN065 (TLC-Plus) Study is evaluating the feasibility of a test, linkage-to-care, and treat strategy for HIV prevention in two intervention communities - the Bronx, NY, and Washington, DC. Routinely collected laboratory data on diagnosed HIV cases in the national HIV surveillance system were used to select and randomize sites, and will be used to assess trial outcomes.Results:To inform study randomization, baseline data on site-aggregated study outcomes was provided from HIV surveillance data by New York City and Washington D.C. Departments of Health. The median site rate of linkage-to-care for newly diagnosed cases was 69% (IQR 50%-86%) in the Bronx and 54% (IQR 33%-71%) in Washington, D.C. In participating HIV care sites, the median site percent of patients with viral suppression (<400 copies/mL) was 57% (IQR 53%-61%) in the Bronx and 64% (IQR 55%-72%) in Washington, D.C.Conclusions:In a novel use of site-aggregated surveillance data, baseline data was used to design and evaluate site randomized studies for both HIV test and HIV care sites. Surveillance data have the potential to inform and monitor sitelevel health outcomes in HIV-infected patients.

scholarly journals HIV Infection-Related Care Outcomes among U.S.-Born and Non-U.S.-Born Blacks with Diagnosed HIV in 40 U.S. Areas: The National HIV Surveillance System, 2016

2018 ◽  
Vol 15 (11) ◽  
pp. 2404 ◽  
Author(s):  
Hanna Demeke ◽  
Anna Johnson ◽  
Hong Zhu ◽  
Zanetta Gant ◽  
Wayne Duffus ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Late Stage ◽  
Surveillance System ◽  
Viral Suppression ◽  
Hiv Infections ◽  
Retention In Care ◽  
Hiv Care ◽  
Hiv Diagnosis ◽  
Hiv Surveillance ◽  
Care Outcomes

HIV care outcomes must be improved to reduce new human immunodeficiency virus (HIV) infections and health disparities. HIV infection-related care outcome measures were examined for U.S.-born and non-U.S.-born black persons aged ≥13 years by using National HIV Surveillance System data from 40 U.S. areas. These measures include late-stage HIV diagnosis, timing of linkage to medical care after HIV diagnosis, retention in care, and viral suppression. Ninety-five percent of non-U.S.-born blacks had been born in Africa or the Caribbean. Compared with U.S.-born blacks, higher percentages of non-U.S.-born blacks with HIV infection diagnosed during 2016 received a late-stage diagnoses (28.3% versus 19.1%) and were linked to care in ≤1 month after HIV infection diagnosis (76.8% versus 71.3%). Among persons with HIV diagnosed in 2014 and who were alive at year-end 2015, a higher percentage of non-U.S.-born blacks were retained in care (67.8% versus 61.1%) and achieved viral suppression (68.7% versus 57.8%). Care outcomes varied between African- and Caribbean-born blacks. Non-U.S.-born blacks achieved higher care outcomes than U.S.-born blacks, despite delayed entry to care. Possible explanations include a late-stage presentation that requires immediate linkage and optimal treatment and care provided through government-funded programs.

scholarly journals New York City HIV Care Continuum Dashboards: Using Surveillance Data to Improve HIV Care Among People Living With HIV in New York City (Preprint)

2018 ◽  
Author(s):  
Sarah L Braunstein ◽  
Karen Coeytaux ◽  
Charulata J Sabharwal ◽  
Qiang Xia ◽  
Rebekkah S Robbins ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Surveillance Data ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Hiv Care Continuum ◽  
Viral Load Suppression ◽  
Care Continuum ◽  
Hiv Surveillance

BACKGROUND HIV surveillance data can be used to improve patient outcomes. OBJECTIVE This study aimed to describe and present findings from the HIV care continuum dashboards (CCDs) initiative, which uses surveillance data to quantify and track outcomes for HIV patients at major clinical institutions in New York City. METHODS HIV surveillance data collected since 2011 were used to provide high-volume New York City clinical facilities with their performance on two key outcomes: linkage to care (LTC), among patients newly diagnosed with HIV and viral load suppression (VLS), among patients in HIV care. RESULTS The initiative included 21 facilities covering 33.78% (1135/3360) of new HIV diagnoses and 46.34% (28,405/61,298) of patients in HIV care in New York City in 2011 and was extended to a total of 47 sites covering 44.23% (1008/2279) of new diagnoses and 69.59% (43,897/63,083) of New York City patients in care in 2016. Since feedback of outcomes to providers began, aggregate LTC has improved by 1 percentage point and VLS by 16 percentage points. CONCLUSIONS Disseminating information on key facility–level HIV outcomes promotes collaboration between public health and the clinical community to end the HIV epidemic. Similar initiatives can be adopted by other jurisdictions with mature surveillance systems and supportive laws and policies.

scholarly journals A Matter of Perspective: Comparison of the Characteristics of Persons with HIV Infection in the United States from the HIV Outpatient Study, Medical Monitoring Project, and National HIV Surveillance System

2015 ◽  
Vol 9 (1) ◽  
pp. 123-133 ◽  
Author(s):  
Kate Buchacz ◽  
Emma L. Frazier ◽  
H. Irene Hall ◽  
Rachel Hart ◽  
Ping Huang ◽  
...  
Keyword(s):  
United States ◽  
Hiv Infection ◽  
Surveillance System ◽  
The United States ◽  
Hiv Care ◽  
Medical Monitoring ◽  
Hiv Surveillance ◽  
The Us ◽  
Medical Monitoring Project ◽  
Outpatient Study

Comparative analyses of the characteristics of persons living with HIV infection (PLWH) in the United States (US) captured in surveillance and other observational databases are few. To explore potential joint data use to guide HIV treatment and prevention in the US, we examined three CDC-funded data sources in 2012: the HIV Outpatient Study (HOPS), a multisite longitudinal cohort; the Medical Monitoring Project (MMP), a probability sample of PLWH receiving medical care; and the National HIV Surveillance System (NHSS), a surveillance system of all PLWH. Overall, data from 1,697 HOPS, 4,901 MMP, and 865,102 NHSS PLWH were analyzed. Compared with the MMP population, HOPS participants were more likely to be older, non-Hispanic/Latino white, not using injection drugs, insured, diagnosed with HIV before 2009, prescribed antiretroviral therapy, and to have most recent CD4+ T-lymphocyte cell count ≥500 cells/mm3 and most recent viral load test<2 00 copies/mL. The MMP population was demographically similar to all PLWH in NHSS, except it tended to be slightly older, HIV diagnosed more recently, and to have AIDS. Our comparative results provide an essential first step for combined epidemiologic data analyses to inform HIV care and prevention for PLWH in the US.

scholarly journals Using HIV Surveillance Data to Link People to HIV Medical Care, 5 US States, 2012-2015

2018 ◽  
Vol 133 (4) ◽  
pp. 385-391 ◽  
Author(s):  
John Beltrami ◽  
Odessa Dubose ◽  
Reginald Carson ◽  
Janet C. Cleveland
Keyword(s):  
Public Health ◽  
Hiv Prevention ◽  
Linkage To Care ◽  
Surveillance Data ◽  
Hiv Care ◽  
Performance Standard ◽  
Health Staff ◽  
Health Departments ◽  
Hiv Surveillance ◽  
Prevention Activities

Introduction: From 2012 through 2015, the Centers for Disease Control and Prevention (CDC) provided funding to 5 health departments for demonstration projects using HIV surveillance data to link people with newly diagnosed HIV to care. We assessed how well these health departments established linkage to care, how the demonstration projects helped them with this work, and if they sustained these activities after CDC funding ended. Materials and Methods: We obtained quantitative and qualitative data on linkage-to-care activities from health department communications and progress reports submitted to CDC. We calculated and combined linkage-to-care results for the 5 health departments, and we compared these results with the combined linkage-to-care results for 61 health departments that received CDC funding for routine HIV prevention activities (eg, HIV testing, linkage to and reengagement in HIV care, HIV partner services) and for the same 5 health departments when they used only routine HIV prevention activities for linkage to care. Results: Of 1269 people with a new HIV diagnosis at the 5 health departments, 1124 (89%) were linked to care, a result that exceeded the 2010-2015 National HIV/AIDS Strategy goal (85%), the CDC Funding Opportunity Announcement performance standard (80%), and combined results for the 61 health departments (63%) and the same 5 health departments (66%) using routine HIV prevention activities. Benefits of the projects were improved collaboration and coordination and more accurate, up-to-date surveillance data. All health departments continued linkage-to-care activities after funding ended. Practice Implications: Using HIV surveillance data to link people with HIV to care resulted in substantial clinical and public health benefits. Our observations underscore the importance of collaboration among medical providers, public health staff members, community-based organizations, and people with HIV to ensure the best possible clinical and public health outcomes.

Risk Factors for Advanced HIV Disease and Late Entry to HIV Care: National 1994–2012 HIV Surveillance Data for Wuhan, China

2015 ◽  
Vol 29 (10) ◽  
pp. 541-549 ◽  
Author(s):  
Hongbo Jiang ◽  
Nianhua Xie ◽  
Yunzhou Fan ◽  
Zhixia Zhang ◽  
Jianhua Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surveillance Data ◽  
Hiv Care ◽  
Hiv Disease ◽  
Hiv Surveillance ◽  
Late Entry ◽  
Advanced Hiv Disease

scholarly journals Evaluating New Definitions of Acute and Early HIV Infection from HIV Surveillance Data

2014 ◽  
Vol 8 (1) ◽  
pp. 45-49 ◽  
Author(s):  
Susan E Buskin ◽  
Neway G Fida ◽  
Amy B Bennett ◽  
Matthew R Golden ◽  
Joanne D Stekler
Keyword(s):  
Hiv Infection ◽  
Staging System ◽  
Surveillance Data ◽  
Early Infection ◽  
Nucleic Acid Amplification ◽  
Successful Implementation ◽  
Acute Hiv Infection ◽  
Hiv Surveillance ◽  
Hiv Seroconversion ◽  
Sex With Men

Background : The U.S. HIV staging system is being revised to more comprehensively track early and acute HIV infection (AHI). We evaluated our ability to identify known cases of AHI using King County (KC) HIV surveillance data. Methodology : AHI cases were men who have sex with men (MSM) with negative antibody and positive pooled nucleic acid amplification (NAAT) tests identified through KC testing sites. We used KC surveillance data to calculate inter-test intervals (ITI, time from last negative to first positive test) and the serologic algorithm for recent HIV seroconversion (STARHS). For surveillance data, AHI was defined as an ITI of ≤ 30 days and early infection as an ITI ≤ 180 days or STARHS recent result. Dates of last negative HIV tests were obtained from lab reports in the HIV surveillance system or data collected for HIV Incidence Surveillance. Results : Between 2005 and 2011, 47 MSM with AHI were identified by pooled NAAT. Of the 47 cases, 36% had ITI < 1 day, 60% had an ITI < 30 days, and 70% (95% CI=55-82%) had an ITI ≤ 6 months and would have been identified as early HIV infection. Of the 47, 38% had STARHS testing and 94% were STARHS recent. Conclusion : MSM with known AHI were not identified by proposed definitions of AHI and early infection. These known AHI cases were frequently missed by HIV surveillance because concurrent negative antibody tests were not reported. Successful implementation of the revisions to the HIV staging system will require more comprehensive reporting.

Factors associated with late presentation of HIV infection in Catalonia, Spain

2012 ◽  
Vol 23 (7) ◽  
pp. 475-480 ◽  
Author(s):  
N Vives ◽  
D Carnicer-Pont ◽  
P Garcia De Olalla ◽  
N Camps ◽  
A Esteve ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Late Presentation ◽  
Late Diagnosis ◽  
Cd4 Cell Count ◽  
Hiv Surveillance ◽  
Factors Associated ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Populations At Risk ◽  
Cd4 Cell

We sought to describe the prevalence, trends and factors associated with late diagnosis of HIV infection between 2001 and 2008 in Catalonia, Spain. Adults over 13 years of age with available CD4 cell counts, who were notified to the Catalonia Voluntary HIV Surveillance System between January 2001 and December 2008, were included in the study. Late presentation for HIV infection was defined as a CD4 cell count <350 cells/μL or with an AIDS-defining condition at presentation. Multivariable logistic regression was used to identify factors independently associated with late diagnosis of HIV. Of the 4651 newly diagnosed HIV-infected individuals with available CD4 counts, 2598 (55.9%) were diagnosed late. The proportion of people with a late diagnosis decreased from 60.4% in 2001 to 50% in 2008, a significant trend ( P < 0.001). Older age, male gender, foreign birth, heterosexuality and injecting drug use were independent risk factors for late diagnosis. Strategies to actively promote HIV testing to populations at risk of late diagnosis of HIV or those never attending health systems should be implemented.

scholarly journals African American Clergy Perspectives About the HIV Care Continuum: Results From a Qualitative Study in Jackson, Mississippi

2018 ◽  
Vol 28 (2) ◽  
pp. 85 ◽  
Author(s):  
Amy Nunn ◽  
Sharon Parker ◽  
Katryna McCoy ◽  
Mauda Monger ◽  
Melverta Bender ◽  
...  
Keyword(s):  
African American ◽  
African Americans ◽  
Hiv Infection ◽  
Racial Disparities ◽  
Hiv Care ◽  
Hiv Care Continuum ◽  
Care Continuum ◽  
Adherence To Medication ◽  
African American Clergy ◽  
American Clergy

<p>Mississippi has some of the most pro­nounced racial disparities in HIV infection in the country; African Americans com­prised 37% of the Mississippi population but represented 80% of new HIV cases in 2015. Improving outcomes along the HIV care continuum, including linking and retaining more individuals and enhancing adherence to medication, may reduce the disparities faced by African Americans in Mississippi. Little is understood about clergy’s views about the HIV care continuum. We assessed knowledge of African American pastors and ministers in Jackson, Mississippi about HIV and the HIV care continuum. We also assessed their willingness to promote HIV screening and biomedical prevention technologies as well as efforts to enhance linkage and retention in care with their congregations. Four focus groups were conducted with 19 African American clergy. Clergy noted pervasive stigma associated with HIV and believed they had a moral imperative to promote HIV awareness and testing; they provided recommendations on how to normalize conversations related to HIV testing and treatment. Overall, clergy were willing to promote and help assist with linking and retaining HIV positive individu­als in care but knew little about how HIV treatment can enhance prevention or new biomedical technologies such as pre-expo­sure prophylaxis (PrEP). Clergy underscored the importance of building coalitions to promote a collective local response to the epidemic. The results of this study highlight important public health opportunities to engage African American clergy in the HIV care continuum in order to reduce racial disparities in HIV infection. <em></em></p><p><em>Ethn Dis.</em>2018; 28(2): 85-92; doi:10.18865/ed.28.2.85.</p>

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