New initiatives in HIV surveillance

Background: HIV surveillance no longer focuses solely on HIV and AIDS prevalence; it now encompasses incidence, HIV resistance, utilization of health care, and morbidity. The Centers for Disease Control and Prevention provides funding to areas to integrate new HIV surveillance initiatives with ongoing HIV/AIDS case surveillance. Methods: Serologic testing algorithm for recent HIV seroconversion (STARHS) enables us to distinguish between recent and long-standing HIV-1 infection. Variant, atypical, and resistant HIV surveillance (VARHS) evaluates the prevalence of HIV drug resistance among individuals newly diagnosed with HIV in public health settings. The Medical Monitoring Project (MMP) links patient reported behavioral information collected by a questionnaire with clinical information abstracted from provider medical charts. Results: From October 2004, to June 2006, we have received results on 1,574 STARHS specimens. Of these results, 385 (24.4%) were reported as “Recent” infections, and 1,189 (75.6%) were reported as “Long-term” infections. VARHS was implemented in three counties in September 2006. As of December 2006, we identified sixty-three specimens that meet the eligibility criteria for VARHS. The MMP team has begun surveying providers, and will begin interviews with patients and medical abstractions later this year. Conclusions: These new surveillance initiatives will allow public health officials to more effectively and completely monitor the epidemic, allocate resources, and plan and implement programs.