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Nationwide New HIV Reporting to Bring Trends into Focus: Higher Proportions of Women & Minorities Being Infected
  New York Times
Feb 17, 2004
Lawrence K. Altman, MD
Understanding the evolving AIDS epidemic in the United States will become easier now that all states are reporting both newly identified HIV infections and AIDS cases. Georgia became the last state to begin reporting HIV infections Jan. 1. It is expected that HIV reporting will provide a more accurate view of recent transmission trends. The information will also help direct taxpayer money to the most effective programs and could affect allocations for HIV patient care, health officials say.
For years, states primarily reported AIDS cases to CDC. Colorado, Minnesota and Wisconsin began reporting HIV cases in 1986; by 1995, 30 states were providing the reports. But New York and California, which together have one-third of the nation's AIDS cases, only began reporting HIV cases in 2000 and 2002, respectively.
An initial but incomplete picture from HIV reporting puts a younger face on the epidemic, said Dr. Harold W. Jaffe, director of the CDC's AIDS program, and indicates higher proportions of women and minority groups infected.
The decision of states to report HIV cases was most influenced by the development of successful treatment, which allows many people with HIV to live healthier and longer. But that progress has made it hard for statisticians to calculate backward to estimate time of infection. "AIDS case reporting now has become much more of an indicator of who is getting treated, who is not getting tested early, and how effective therapy is," said Dr. Matthew T. McKenna, an AIDS epidemiologist at CDC.
Another factor in greater reliance on HIV reporting is that patients sometimes move from the state where their infection was diagnosed. McKenna said this underscores the need to check identifying characteristics to avoid duplications. CDC has long advocated reporting HIV cases by name. Concerns over confidentiality have led some states to identify cases by codes, a system that CDC says is not as accurate as reporting by names.
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