Measuring the HIV care continuum using public health surveillance data in the United States

Details

• Alternative Title:
  J Acquir Immune Defic Syndr
• Personal Author:
  Lesko, Catherine R. ; Sampson, Lynne A. ; Miller, William C. ; Clymore, Jacquelyn ; Leone, Peter A. ; Swygard, Heidi ; Powers, Kimberly A.
• Description:
  The HIV care continuum is a critical framework for situational awareness of the HIV epidemic; yet challenges to accurate enumeration of continuum components hamper continuum estimation in practice. We describe local surveillance-based estimation of the HIV continuum in the United States, reviewing common practices as recommended by the Centers for Disease Control and Prevention. Furthermore, we review some challenges and biases likely to threaten existing continuum estimates. Current estimates rely heavily on the use of CD4 cell count and HIV viral load laboratory results reported to surveillance programs as a proxy for receipt of HIV-related outpatient care. As such, continuum estimates are susceptible to bias because of incomplete laboratory reporting and imperfect sensitivity and specificity of laboratory tests as a proxy for routine HIV care. Migration of HIV-infected persons between jurisdictions also threatens the validity of continuum estimates. Data triangulation may improve but not fully alleviate biases.
• Subjects:
  Anti-HIV Agents Continuity Of Patient Care Female HIV Infections Humans Male Population Surveillance Public Health Informatics United States
• Keywords:
  HIV Cascade Treatment As Prevention
• Source:
  J Acquir Immune Defic Syndr. 70(5):489-494
• Pubmed ID:
  26258570
• Pubmed Central ID:
  PMC4644460
• Document Type:
  Journal Article
• Funding:
  5U62PS003658-04/PS/NCHHSTP CDC HHSUnited States/ ; U62 PS003658/PS/NCHHSTP CDC HHSUnited States/ ; R03 MH100987/MH/NIMH NIH HHSUnited States/ ; H25 PS004349/PS/NCHHSTP CDC HHSUnited States/ ; KL2 TR001109/TR/NCATS NIH HHSUnited States/ ; P30 AI50410/AI/NIAID NIH HHSUnited States/ ; 1H25PS004349-03/PS/NCHHSTP CDC HHSUnited States/ ; P30 AI050410/AI/NIAID NIH HHSUnited States/
• Volume:
  70
• Issue:
  5
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:aa3f37748362430621253ee4cbe491b259b7a1aa8ca8729d0a6a1bfd8f1b6e35
• Download URL:
  https://stacks.cdc.gov/view/cdc/36482/cdc_36482_DS1.pdf
• File Type:
  [PDF - 92.23 KB ]