HIV/Aids Surveillance Systems: Are They Implemented Effectively?
HIV/AIDS Surveillance Systems:Are they implemented effectively? LORENZO HOPPER HIMA 5060 FINAL PROJECT
HIV/AIDs Epidemic First surfaced in United States in 1980s Acquired immune deficiency syndrome 6th leading cause of death in United States Transmission occurs through: Blood (needle use) Vaginal secretions Breast milk Semen 1.1 million Americans are living with HIV 21% of these persons do not know they are infected Source: CDC, 2012
Approaches to address HIV/AIDs Epidemic Obama Administration 2010 - initiated a National HIV/AIDS Strategy that established goals aimed at reducing HIV infection rates while increasing access to treatment Center for Disease Control and Prevention The CDC works with community, state, national, and international stakeholders in surveillance, research, and evaluation activities Surveillance Systems Improving the surveillance of the disease may have a major impact on the HIV/AIDs burden in America (Shortliffe, 2001)
Surveillance and Name Reporting HIV Surveillance Method of keeping a closer look at the activities of people and monitoring their behavior Name Reporting Reporting the names of all those who test positive for HIV to public health authorities AIDS listed as one of the notifiable diseases that state epidemiologists and the CDC have determined is of national significance and warrants routine, complete reporting. Sources: Shortliffe, 2001
Benefits of Surveillance Benefits Provide periodic approximations of the incidence and prevalence of diseases Information used to produce annual surveillance reports, published by the Division of HIV/AIDS Prevention (DHAP). Due to the long incubation period of HIV, surveillance and name reporting may be the only way to maximize the number of people who qualify for a very high risk of contraction to get tested as soon as possible
Benefits Benefits Information used to prevent transmission Give patients ability to seek new effective drug therapies Name reporting can enhance the current HIV surveillance methodology while enhancing epidemiological data, promoting rapid dissemination of new information to public health professionals (Shortliffe, 2001).
Barriers to Data Collection Access to Care HIV Testing Underreporting Physicians Clinicians The CDC estimates that the completeness of case reporting of HIV infection to be around 80% currently (CDC, 2012).
Barriers Lack of awareness of the reporting requirement and procedures for the provider Lack of motivation due to the extra work necessary and poor system processes Ethical Issues Oppositions also exist for the general idea of name reporting of HIV cases to government entities Confidentiality
NEDSS National Electronic Disease Surveillance System CDC uses in order to address changing information technology capabilities for local, State, and national public health surveillance. Works as a secure online infrastructure that provides healthcare professionals and government agencies with the opportunity to communicate about disease patterns and coordinate national responses Not implemented across the United States Source: NEDSS, 2007
ReferencesCenter for Disease Control and Prevention. HIV/AIDS Statistics and Surveillance. Department of Health and Human Services.Retrieved November 30, 2012.Chin, J. 1990. Public Health surveillance of AIDS and HIV infections. Bull World Health Organ. 68(5): 529-536Desai, D., Wu, G., Zaman, M.H. 2011. Tackling HIV through robust diagnostics in the developing world: current status andfuture opportunities. Lab Chip, 11, 194-211Ford, M.A., Spicer, C.M. 2012. Monitoring HIV Care in the United States: Indicators and Data Systems. ISBN 978-0-309-21850-4HIV Surveillance and Name Reporting: A Public Health Case for Protecting Civil Liberties. An American Civil Liberties UnionReport. October 1997Institute of Medicine. Monitoring HIV Care in the United States: Indicators and Data Systems. 2012. Report Brief. NationalAcademy of SciencesNational Electronic Disease Surveillance System. Center for Disease Control and Prevention. 2007, August. Retrieved fromhttp://www.cdc.gov/phin/library/phin_fact_sheets/111759_NEDSS.pdfPubmed Health. AIDS. A.D.A.M. Medical Encyclopedia. Retrieved November 30, 2012.Roberts, L. 2012. HIV/AIDS in America. Introduction to Special Issue. Science 13 July 2012: 337:6091 p. 167Savel, T.G., Foldy, S. 2012. The Role of Public Health Informatics in Enhancing Public Health Surveillance. Morbidity andMortality Weekly Report.Schwarcz, L., Chen, M., Vittinghoff, E., Hsu, L., Schwarcz, S. 2012. Declining Incidence of AIDS-defining opportunistic illnesses:results from 16 Years of population-based AIDS surveillance. AIDSShortliffe, E., Perreault, L.E., Wiederhold, G., Fagan, L.M. 2001. Medical Informatics: Computer Applications in Health Careand Biomedicine. 2nd Edition. Springer. P 407