Community and Provider Perspectives on Molecular HIV Surveillance and Cluster Detection and Response for HIV Prevention

UNSTRUCTURED To guide HIV prevention and treatment activities up to 2020, we need to generate and make better use of high quality HIV surveillance data. To highlight our surveillance needs, a special collection of papers in JMIR Public Health and Surveillance has been released under the title “Improving Global and National Responses to the HIV Epidemic Through High Quality HIV Surveillance Data.” We provide a summary of these papers and highlight methods for developing a new HIV surveillance architecture.

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

The Open AIDS Journal ◽

10.2174/1874613601206010122 ◽

2012 ◽

Vol 6 (1) ◽

pp. 122-130 ◽

Cited By ~ 15

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.

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

Public Health Reports ◽

10.1177/0033354918772057 ◽

2018 ◽

Vol 133 (4) ◽

pp. 385-391 ◽

Cited By ~ 5

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.

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