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Evaluation of the National Human Immunodeficiency Virus Surveillance System for the 2011 diagnosis year

. 2014 Nov-Dec;20(6):598-607. doi: 10.1097/PHH.0000000000000033. Evaluation of the National Human Immunodeficiency Virus Surveillance System for the 2011 diagnosis year

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Evaluation of the National Human Immunodeficiency Virus Surveillance System for the 2011 diagnosis year

Debra L Karch et al. J Public Health Manag Pract. 2014 Nov-Dec.

. 2014 Nov-Dec;20(6):598-607. doi: 10.1097/PHH.0000000000000033. Affiliation

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Abstract

Context: In 2009, the Centers for Disease Control and Prevention completed migration of all 59 surveillance project areas (PAs) from the case-based HIV/AIDS Reporting System to the document-based Enhanced HIV/AIDS Reporting System.

Objectives: We conducted a PA-level assessment of Enhanced HIV/AIDS Reporting System process and outcome standards for HIV infection cases.

Design: Process standards were reported by PAs and outcome standards were calculated using standardized Centers for Disease Control and Prevention SAS code.

Setting: A total of 59 PAs including 50 US states, the District of Columbia, 6 separately funded cities (Chicago, Houston, Los Angeles County, New York City, Philadelphia, and San Francisco), and 2 territories (Puerto Rico and the Virgin Islands).

Participants: Cases diagnosed or reported to the PA surveillance system between January 1, 2011, and December 31, 2011, using data collected through December 2012.

Main outcome measures: Process standards for death ascertainment and intra- and interstate case de-duplication; outcome standards for completeness and timeliness of case reporting, data quality, intrastate duplication rate, risk factor ascertainment, and completeness of initial CD4 and viral load reporting.

Results: Fifty-five of 59 PAs (93%) reported linking cases to state vital records death certificates during 2012, 76% to the Social Security Death Master File, and 59% to the National Death Index. Seventy percent completed monthly intrastate, and 63% completed semiannual interstate de-duplication. Eighty-three percent met the 85% or more case ascertainment standard, and 92% met the 66% or more timeliness standard; 75% met the 97% or more data quality standard; all PAs met the 5% or less intrastate duplication rate; 41% met the 85% or more risk factor ascertainment standard; 90% met the 50% or more standard for initial CD4; and 93% met the same standard for viral load reporting. Overall, 7% of PAs met all 11 process and outcome standards.

Conclusions: Findings support the need for continued improvement in HIV surveillance activities and monitoring of system outcomes.

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Conflict of interest statement

The authors declare no conflicts of interest.

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    1. Centers for Disease Control and Prevention. CDC’s vision for public health surveillance in the 21st century. MMWR Surveill Summ. 2012;61(suppl):1–40. - PubMed
    1. Centers for Disease Control and Prevention. Updated guidelines for evaluating public health surveillance systems: recommendations from the guidelines working group. MMWR Recomm Rep. 2001;50(RR-13):1–35. - PubMed
    1. Centers for Disease Control and Prevention. Guidelines for national human immunodeficiency virus case surveillance, including monitoring for human immunodeficiency virus infection and acquired immunodeficiency syndrome. MMWR Recomm Rep. 1999;48(RR-13):1–36. - PubMed
    1. Hall HI, Mokotoff ED. Setting standards and an evaluation framework for human immunodeficiency virus/acquired immunodeficiency syndrome surveillance. J Public Health Manag Pract. 2007;13(5):519–523. - PubMed
    1. Centers for Disease Control and Prevention and Council of State and Territorial Epidemiologists. Technical Guidance for HIV/AIDS Surveillance Programs, Volume I: Policies and Procedures. Atlanta, GA: Centers for Disease Control and Prevention; 2005.

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