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Results of the Expanded HIV Risk Factor Assessment Project (EHRAP).

K McDavid1, J E Gerstle, T A Hammett

  • 1Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. KMcDavid@cdc.gov

AIDS Care
|November 12, 2005
PubMed
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This study found that reviewing medical records significantly improves the identification of HIV risk factors in surveillance data. Enhancing data collection methods is crucial for accurate HIV/AIDS epidemiology.

Area of Science:

  • Public Health
  • Epidemiology
  • Infectious Disease Surveillance

Background:

  • HIV/AIDS surveillance relies on accurate risk factor information for effective public health strategies.
  • Routine surveillance data may have gaps in reported HIV risk factors.
  • The Electronic HIV Record Assessment Project (EHRAP) aimed to address these gaps.

Purpose of the Study:

  • To evaluate the completeness and accuracy of HIV risk factor information reported to the Centers for Disease Control and Prevention (CDC) through routine surveillance.
  • To assess the feasibility of using medical and ancillary records to identify HIV risk factors for surveillance purposes.

Main Methods:

  • Surveillance staff in Mississippi, South Carolina, and Virginia reviewed medical and ancillary records for a sample of HIV cases diagnosed in 1998-1999.

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  • Data on HIV risk factors were collected and compared to initially reported information.
  • Statistical analysis included calculating overall percent agreement and Cohen kappa statistics.

    • Main Results:

    • Of 160 cases initially reported without an identified risk factor, 86% were reclassified with a known risk factor.
    • An HIV risk factor was identified for 96% of all HIV infection cases reviewed.
    • Overall agreement between initially reported and EHRAP-verified risk factors was good (kappa = 0.89).
    • All participating states met the national goal of identifying risk factors for at least 85% of reported cases.

    Conclusions:

    • Routine HIV surveillance can be significantly improved by utilizing medical and ancillary records to identify risk factors.
    • Completeness of HIV risk factor collection and reporting for national surveillance needs enhancement.
    • The current national-level methods for risk factor redistribution warrant evaluation and potential revision.