Improving HIV Surveillance Data by Using the ATra Black Box System to Assist Regional Deduplication Activities.

BACKGROUND: Focused attention on Data to Care underlines the importance of high-quality HIV surveillance data. This study identified the number of total duplicate and exact duplicate HIV case records in 9 separate Enhanced HIV/AIDS Reporting System (eHARS) databases reported by 8 jurisdictions and compared this approach to traditional Routine Interstate Duplicate Review resolution. METHODS: This study used the ATra Black Box System and 6 eHARS variables for matching case records across jurisdictions: last name, first name, date of birth, sex assigned at birth (birth sex), social security number, and race/ethnicity, plus 4 system-calculated values (first name Soundex, last name Soundex, partial date of birth, and partial social security number). RESULTS: In approximately 11 hours, this study matched 290,482 cases from 799,326 uploaded records, including 55,460 exact case pairs. Top case pair overlaps were between NYC and NYS (51%), DC and MD (10%), and FL and NYC (6%), followed closely by FL and NYS (4%), FL and NC (3%), DC and VA (3%), and MD and VA (3%). Jurisdictions estimated that they realized a combined 135 labor hours in time efficiency by using this approach compared with manual methods previously used for interstate duplication resolution. DISCUSSION: This approach discovered exact matches that were not previously identified. It also decreased time spent resolving duplicated case records across jurisdictions while improving accuracy and completeness of HIV surveillance data in support of public health program policies. Future uses of this approach should consider standardized protocols for postprocessing eHARS data.

Improving Retention in HIV Care Through New York's Expanded Partner Services Data-to-Care Pilot.

CONTEXT: Data to Care (DTC) represents a public health strategy using HIV surveillance data to link persons living with diagnosed HIV infection (PLWDHI) to HIV-related medical care. OBJECTIVE: To investigate the feasibility of the DTC approach applied to a Partner Services program serving a geographically diffuse area of New York State. DESIGN: Disease intervention specialists received training to function as Expanded Partner Services (ExPS) advocates. HIV surveillance data identified PLWDHI presumed to be out of care (OOC). ExPS advocates attempted to locate and reengage OOC individuals in HIV-related care. The pilot ran from September 1, 2013, to August 31, 2014. SETTING: Four upstate New York counties, home to one-third of all PLWDHI in upstate New York. PARTICIPANTS: A total of 1155 PLWDHI presumed to be OOC. MAIN OUTCOME MEASURES: Linked to HIV medical care-cases verified as attending 1 or more HIV medical appointments subsequent to case assignment; reengaging in HIV care-any HIV laboratory test in the 6 months following case closure; and retention in HIV care-2 or more HIV laboratory tests in the 6 months following case closure. RESULTS: The majority of assigned cases (85.3%) were located; 23.7% (n = 233) of located cases confirmed as OOC; and 71.2% of OOC cases (n = 166) were successfully relinked into care. Relinkage success did not differ by gender, transmission risk, or major race/ethnicity categories; however, there was a direct relationship between age and successful relinkage (P < .001). Ninety-five percent of relinked cases reengaged in medical care, and 63.3% were retained in care. Individuals relinked by ExPS advocates were more likely to reengage in care (95%) than individuals interviewed but not relinked to care by advocates (53.7%) and individuals ineligible for the ExPS intervention (34.2%). CONCLUSION: DTC can be effective when conducted outside large metropolitan areas and/or closed health care systems. It can also be effectively incorporated into existing Partner Services programs; however, the relative priority of DTC work must be established in this context.