Epi Profile - Data Sources and Notes
This profile presents information on people with HIV in Texas diagnosed through December 31, 2018 and reported as of June 20, 2019. The section on people with new HIV diagnoses includes all people who were newly diagnosed regardless of their stage of disease at diagnosis. Statistics on people with new diagnoses are based on the earliest available diagnosis date for that person, regardless of when the information was reported through surveillance. For example, if someone was diagnosed with HIV in 2017, but the report was delayed until 2018, the person would still be shown as being newly diagnosed in 2017.
The primary source of information for this report comes from routine disease surveillance. Texas laws and regulations require that certain health care professionals and laboratories report test results or results of diagnostic evaluation that indicate infection with HIV. These results are maintained in Texas’ Electronic HIV/AIDS Reporting System (eHARS).
A Note on Mode of Transmission
The mode of transmission assigned to each person in eHARS represents the most likely way they acquired HIV based on the risk behaviors documented during disease reporting or investigation. Nearly one-third of the surveillance reports on persons with new diagnoses do not have an identified risk factor. DSHS uses multiple imputation to assign a risk factor when it is missing.
A Note on Gender Identity
HIV and STD surveillance staff are working to improve data collection on transgender persons. Gender identity information is more complete for people who were diagnosed in 2014 or later.
Data on STD/HIV and TB/HIV Comorbidity
A cross-registry match was performed between eHARS and Texas STD and TB registries to identify individuals co-infected with TB or chlamydia, gonorrhea, and syphilis during 2018. A PLWH was co-infected if their co-infection was diagnosed at least 30 days prior to their HIV diagnosis or at any time after their HIV diagnosis.
A Note on Rates
Rates allow the comparison of groups of different sizes. Comparing rates allows us to see which demographic groups and geographic areas carry the greatest burdens of HIV. Rates cannot be calculated for PWID, people who acquired HIV through heterosexual sex, or MSM/PWID because denominators for these groups are unknown. DSHS is actively working on estimates of HIV rates in transgender people. The standard case rate when dealing with HIV is the number of people with HIV per 100,000 members of that population.
The Medical Monitoring Project
The Medical Monitoring Project (MMP) is a special surveillance study designed to learn more about the experiences and needs of PLWH in Texas. Interviews were done with a representative sample of PLWH between June 2017 and April 2018. In addition, patients' medical records were abstracted for documentation of medical care, including prescription of HIV treatment drugs and HIV viral load for the 24 months preceding the interview.
National HIV Behavioral Surveillance
The National HIV Behavior Surveillance project is an ongoing behavioral surveillance system that collects data from MSM, PWID, and people at higher risk for HIV through heterosexual sex. NHBS activities are implemented in one-year cycles so that data are collected from each group every three years. The anonymous interview covers behavioral risk factors for HIV, HIV testing, the receipt of prevention services, and use of prevention strategies (e.g. condoms, PrEP). In addition to these interview data, all NHBS participants are offered an HIV test.