CDC officials yesterday at the 2003 National HIV Prevention Conference in Atlanta outlined a new HIV monitoring system, part of a nationwide effort to track new HIV cases, the Miami Herald reports (Prater, Miami Herald, 7/27). The new system will shift from using AIDS case data submitted by state health departments -- half of which do not submit information because of state privacy laws -- to using anonymous data from 35 sites around the country to get a "nationally representative snapshot" of new HIV infections, according to CDC researchers, the AP/St. Paul Pioneer Press reports. The 35 sites are in areas that represent 93% of the country's HIV population, Dr. Robert Janssen, director of the CDC's Division of HIV/AIDS Prevention, said (Yee, AP/St. Paul Pioneer Press, 7/27). Under the current system, researchers estimate the number of new HIV infections based on the average length of time between infection and the onset of AIDS. However, with antiretroviral therapy delaying the onset of AIDS, there is a "significant gap" in information about which groups are contracting HIV and at what rates, according to the San Francisco Chronicle (Heredia, San Francisco Chronicle, 7/27). Under the new system, which the CDC started testing in 2001 at five pilot sites, people who test HIV-positive at one of the 35 sites take an additional HIV antibody test, which can determine whether a person has been infected with HIV within the last six months. Patients must provide consent for the second blood test, which is confidential (Miami Herald, 7/27). The CDC has allocated about $13 million for the new system.

Concerns
Some advocacy groups have expressed concern that the new testing could impact the privacy of HIV-positive people (AP/St. Paul Pioneer Press, 7/27). While the testing will be confidential, the fact that clinics must secure the patient's approval could be a limitation in the system's accuracy. According to Marlene LaLota, program administrator in the Florida Department of Health's Bureau of HIV/AIDS, the effectiveness of the new system also could be limited by that fact that only state health department labs, which conduct only 20% of all HIV testing nationwide, are participating (Miami Herald, 7/27). However, Janssen said, "This will give us the clearest picture yet of the magnitude of the U.S. HIV epidemic, the true incidence, telling us where it is occurring so we can improve the effectiveness of prevention programs" (San Francisco Chronicle, 7/27). Dr. Ronald Valdiserri, deputy director of the CDC's National Center for HIV, STD and TB Prevention, added, "The new system ... allows us to distinguish a new infection from an old infection. It gets at the question everyone wants answered, which is how many new cases of HIV are occurring" (AP/St. Paul Pioneer Press, 7/27).

Webcasts of selected sessions of the conference will be available online through kaisernetwork.org's HealthCast.

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