TY - JOUR
T1 - Differences among U.S. states in estimating the number of people living with HIV/AIDS
T2 - Impact on allocation of federal Ryan White funding
AU - Nash, Denis
AU - Andreopoulos, Evie
AU - Horowitz, Deborah
AU - Sohler, Nancy
AU - Vlahov, David
N1 - Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2007
Y1 - 2007
N2 - Objective. We assessed the impact of differing laboratory reporting scenarios on the completeness of estimates of people living with human immunodefi-ciency virus (HIV)/acquired immunodeficiency syndrome (AIDS) (PLWHA) in the U.S., which are used to guide allocation of federal Ryan White funds. Methods. We conducted a four-year simulation study using clinical and laboratory data on 1,337 HIV-positive women, including 477 (36%) who did not have AIDS at baseline. We estimated the completeness of HIV (non-AIDS) case ascertainment for three laboratory reporting scenarios: CD4<200 cells/μL and detectable viral load (Scenario A); CD4<500 cells/μL and no viral load reporting (Scenario B); and CD4<500 cells/μL and detectable viral load (Scenario C). Results. Each scenario resulted in an increasing proportion of HIV (non-AIDS) cases being ascertained over time, with Scenario C yielding the highest by Year 4 (Year 1: 69.0%, Year 4: 88.1%), followed by Scenario A (Year 1: 63.3%, Year 4: 84.5%), and Scenario B (Year 1: 43.0%, Year 4: 67.7%). Overall completeness of PLWHA ascertainment after four years was highest for Scenario C (95.8%), followed by Scenario A (94.5%), and Scenario B (88.5%). Conclusions. Differences in laboratory reporting regulations lead to substantial variations in the completeness of PLWHA estimates, and may penalize jurisdictions that are most successful at treating HIV/AIDS patients or those with weak or incomplete HIV/AIDS surveillance systems.
AB - Objective. We assessed the impact of differing laboratory reporting scenarios on the completeness of estimates of people living with human immunodefi-ciency virus (HIV)/acquired immunodeficiency syndrome (AIDS) (PLWHA) in the U.S., which are used to guide allocation of federal Ryan White funds. Methods. We conducted a four-year simulation study using clinical and laboratory data on 1,337 HIV-positive women, including 477 (36%) who did not have AIDS at baseline. We estimated the completeness of HIV (non-AIDS) case ascertainment for three laboratory reporting scenarios: CD4<200 cells/μL and detectable viral load (Scenario A); CD4<500 cells/μL and no viral load reporting (Scenario B); and CD4<500 cells/μL and detectable viral load (Scenario C). Results. Each scenario resulted in an increasing proportion of HIV (non-AIDS) cases being ascertained over time, with Scenario C yielding the highest by Year 4 (Year 1: 69.0%, Year 4: 88.1%), followed by Scenario A (Year 1: 63.3%, Year 4: 84.5%), and Scenario B (Year 1: 43.0%, Year 4: 67.7%). Overall completeness of PLWHA ascertainment after four years was highest for Scenario C (95.8%), followed by Scenario A (94.5%), and Scenario B (88.5%). Conclusions. Differences in laboratory reporting regulations lead to substantial variations in the completeness of PLWHA estimates, and may penalize jurisdictions that are most successful at treating HIV/AIDS patients or those with weak or incomplete HIV/AIDS surveillance systems.
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U2 - 10.1177/003335490712200512
DO - 10.1177/003335490712200512
M3 - Article
C2 - 17877312
AN - SCOPUS:35148814895
VL - 122
SP - 644
EP - 656
JO - Public Health Reports
JF - Public Health Reports
SN - 0033-3549
IS - 5
ER -