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An Introduction to HIV Incidence Surveillance (HIS) in California

An Introduction to HIV Incidence Surveillance (HIS) in California. California Department of Public Health Office of AIDS. An Introduction to HIV Incidence Surveillance (HIS) in California. Timeline of HIV Surveillance in California. Comparing Core & HIV Incidence Surveillance (HIS).

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An Introduction to HIV Incidence Surveillance (HIS) in California

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  1. An Introduction to HIV Incidence Surveillance (HIS) in California California Department of Public Health Office of AIDS

  2. An Introduction to HIV Incidence Surveillance (HIS) in California

  3. Timeline of HIV Surveillance in California

  4. Comparing Core & HIV Incidence Surveillance (HIS)

  5. Requirements for HIV Incidence Surveillance Remnant HIV+ Serum STARHS Testing Patient Testing and Treatment History Core demographic & clinical data from HIV/AIDS case reports HIV Incidence Estimation

  6. Requirements for HIV Incidence Surveillance Remnant HIV+ Serum STARHS Testing Patient testing and Treatment History Core demographic & clinical data from HIV/AIDS case reports HIV Incidence Estimation

  7. Antibody-based laboratory testing method that allows CDC to identify, with reasonable probability, how many newly reported HIV diagnoses represent recent infections. STARHSSerologic Testing Algorithm for Recent HIV Seroconversion

  8. Combination of two HIV antibody tests can detect recent HIV infection Standard HIV antibody test (EIA) STARHS test (HIV-1 BED Capture EIA) Average window period of 5 months to detect recent HIV-1 seroconversion. STARHSSerologic Testing Algorithm for Recent HIV Seroconversion

  9. STARHSSerologic Testing Algorithm for Recent HIV Seroconversion • Only approved for public health surveillance purposes. • Test results are not returned to the patient.

  10. STARHS Window Period NOT RECENT BED HIV-1 Capture EIA RECENT SEROCONVERSION (STARHS reactive) HIV IgG / Total IgG Standard EIA Incident case Prevalent case TIME INFECTION Ave. WindowPeriod = 153 days (~5 months); 95% CI 146 – 168 days

  11. Requirements for HIV Incidence Surveillance Remnant HIV+ Serum STARHS Testing Patient Testing and Treatment History Core demographic & clinical data from HIV/AIDS case reports HIV Incidence Estimation

  12. Patient Testing and Treatment History Calculate appropriate statistical weights to ensure incidence estimates can be generalized to the California population. Identify people with previous positive HIV test results and those already being treated for HIV infection. Distinguish between repeat HIV testers and new HIV testers; and measure HIV testing frequency. Allows us to:

  13. Key Non-Health Department Partners Providers: Ensure records for newly diagnosed HIV cases include testing and treatment history. First positive HIV Test Last negative HIV test, if any Exposure to antiretroviral medication(s) Facilitate completion of HIV/AIDS case report form when new HIV case is diagnosed.

  14. Key Non-Health Department Partners Laboratories: Ship remnant serum samples to central facility for STARHS testing

  15. Key Health Department Partners Local Health Departments Collect core surveillance variables and TTH data from providers and active surveillance Office of AIDS Raise awareness and interest Guidance, technical support and monitoring Data management and transfer to CDC Complete California incidence estimation

  16. Thank You! For more information please visit our websites: HIV/AIDS Surveillance in California www.cdph.ca.gov/programs/OAHIS HIV Incidence Surveillance in the U.S. www.cdc.gov/hiv/topics/surveillance/incidence.htm

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