DSHS and the National Alliance of State and Territorial AIDS Directors (NASTAD) held a learning series focused on detecting and responding to HIV clusters and outbreaks. These workshops covered topics including ethical considerations for HIV surveillance such as consent and data protection, as well as community engagement and collaboration among persons living with HIV, health departments, providers and other community agencies needed for an effective response.
September 21, 2021 - Public Health Surveillance Basics and Using Surveillance Data to Detect HIV Clusters: Video | Slides
September 28, 2021 - Health Department, Provider, and Community Collaboration to Respond to HIV Clusters: Video | Slides
October 5, 2021 - Addressing Community Concerns: Data Release, HIV Criminal Considerations, and HIV Stigma: Video | Slides
Molecular Sequence Data
How are molecular sequence data generated and collected?
Molecular sequences are generated through drug-resistance testing.
Drug-resistance testing is conducted to identify mutations associated with viral resistance to antiretroviral medications and to help the HIV care provider select an appropriate treatment regimen. This testing is recommended for all persons with diagnosed HIV infection and should be conducted at entry to HIV care.
Drug-resistance testing is typically ordered by providers at entry to HIV care, but it can also be ordered at a later time (for example, if a patient is on treatment but does not have a suppressed viral load).
The final output of drug-resistance testing is a report identifying known mutations that confer drug resistance, which is sent to the care provider. The HIV molecular sequence is generated as a part of the testing process, and laboratories can retrieve this information for surveillance reporting purposes. Current testing methods generate sequences by using a sequencing method called Sanger sequencing. Collection of molecular sequence data is done through multiple ways:
Laboratories report HIV molecular sequence data to HIV surveillance jurisdictions; these data are an integrated component of the National HIV Surveillance System in all jurisdictions.
Health departments report all HIV case information collected by HIV surveillance to CDC (demographics, transmission category, CD4 results, viral load results, HIV molecular sequence) without identifying information (name, street address). See Figure 3-A.
Collection of HIV sequence data is monitored as part of the National HIV Surveillance System; the goal for sequence reporting is =60% of persons with diagnosed HIV infection. Achieving high sequence reporting completeness is essential in order to detect clusters and to capture the greatest extent of molecularly linked cases in a cluster. Jurisdictions should refer to the process and outcome standards listed in the file Evaluation and Data Quality.