Abstract
BackgroundThe National HIV/AIDS Strategy calls for active surveillance programs for human immunodeficiency virus (HIV) to more accurately measure access to and retention in care across the HIV care continuum for persons living with HIV within their jurisdictions and to identify persons who may need public health services. However, traditional public health surveillance methods face substantial technological and privacy-related barriers to data sharing.ObjectiveThis study developed a novel data-sharing approach to improve the timeliness and quality of HIV surveillance data in three jurisdictions where persons may often travel across the borders of the District of Columbia, Maryland, and Virginia.MethodsA deterministic algorithm of approximately 1000 lines was developed, including a person-matching system with Enhanced HIV/AIDS Reporting System (eHARS) variables. Person matching was defined in categories (from strongest to weakest): exact, very high, high, medium high, medium, medium low, low, and very low. The algorithm was verified using conventional component testing methods, manual code inspection, and comprehensive output file examination. Results were validated by jurisdictions using internal review processes.ResultsOf 161,343 uploaded eHARS records from District of Columbia (N=49,326), Maryland (N=66,200), and Virginia (N=45,817), a total of 21,472 persons were matched across jurisdictions over various strengths in a matching process totaling 21 minutes and 58 seconds in the privacy device, leaving 139,871 uniquely identified with only one jurisdiction. No records matched as medium low or low. Over 80% of the matches were identified as either exact or very high matches. Three separate validation methods were conducted for this study, and they all found ≥90% accuracy between records matched by this novel method and traditional matching methods.ConclusionsThis study illustrated a novel data-sharing approach that may facilitate timelier and better quality HIV surveillance data for public health action by reducing the effort needed for traditional person-matching reviews without compromising matching accuracy. Future analyses will examine the generalizability of these findings to other applications.
Highlights
The US National human immunodeficiency virus (HIV)/acquired immune deficiency syndrome Centers for Disease Control and Prevention (CDC) (AIDS) Strategy has an increased focus on retention and re-engagement in medical care and includes an action step to “strengthen the timely availability and use of data” [1]
JMIR Public Health Surveill 2016 | vol 2 | iss. 1 | e3 | p.1 methods were conducted for this study, and they all found ≥90% accuracy between records matched by this novel method and traditional matching methods
This study illustrated a novel data-sharing approach that may facilitate timelier and better quality HIV surveillance data for public health action by reducing the effort needed for traditional person-matching reviews without compromising matching accuracy
Summary
The US National HIV/AIDS Strategy has an increased focus on retention and re-engagement in medical care and includes an action step to “strengthen the timely availability and use of data” [1] It calls upon human immunodeficiency virus (HIV) surveillance programs to better measure the continuum of care for persons living with HIV (PLWH) in their jurisdictions and to identify individuals who are in need of public health services aimed at improving linkage, retention, and viral suppression for PLWH. These activities are often described as data to care (D2C), as they utilize HIV surveillance data for public health action [2]. Traditional public health surveillance methods face substantial technological and privacy-related barriers to data sharing
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