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Nationwide New HIV Reporting to Bring Trends into Focus: Higher Proportions
of Women & Minorities Being Infected
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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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