California Department of Public HealthCalifornia Department of Public HealthOffice of AIDSOffice of AIDS

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In Private and other Non - Counseling In Private and other Non - Counseling & Testing Settings& Testing Settings

Collecting Testing and Collecting Testing and Treatment History for HIV Treatment History for HIV Incidence SurveillanceIncidence Surveillance

Primary Target Audience

HIV/AIDS Surveillance Coordinators and other health department staff working in HIV surveillance programs in California.

Training Goal Participants will know what Testing and Treatment History (TTH) information is needed for HIV Incidence estimation.

Collecting Testing and Treatment History for Collecting Testing and Treatment History for HIV Incidence SurveillanceHIV Incidence Surveillance

In Private and other Non-Counseling and Testing SettingsIn Private and other Non-Counseling and Testing Settings

Testing and Treatment HistoryTesting and Treatment History(TTH)(TTH)

Used in calculation of HIV incidence Used in calculation of HIV incidence estimates.estimates.

Needed to differentiate between new Needed to differentiate between new testers and repeat testers.testers and repeat testers.

Used to identify patients receiving Used to identify patients receiving ARV meds within six months of first ARV meds within six months of first positive HIV test. positive HIV test.

Testing and Treatment History Testing and Treatment History (TTH) Collection in California(TTH) Collection in California

Counseling and Testing Sites (CTS)

Private and other non-CTS settings

Data entry module LEO/PEMS eHARS

When usually collected

Pre-HIV test Post-HIV test

Implemented 2005 2009

Collection instrument

Supplemental Information Form (SIF) [CDPH 8458 S.]

• Laboratory-documented TTH: HIV/AIDS Case Report Form• Patient Reported TTH: TTH Attachment

Testing and Treatment History Testing and Treatment History (TTH) Collection in California(TTH) Collection in California

Counseling and Testing Sites (CTS)

Private and other non-CTS settings

Data entry module LEO/PEMS eHARS

When usually collected

Pre-HIV test Post-HIV test

Implemented 2005 2009

Collection instrument

Supplemental Information Form (SIF) [CDPH 8458 S.]

• Laboratory-documented TTH: HIV/AIDS Case Report Form• Patient Reported TTH: TTH Attachment

Review of TTH on the HIV/AIDS Case Review of TTH on the HIV/AIDS Case Report FormReport Form

(CDPH 8641 A)(CDPH 8641 A)

Laboratory Data SectionLaboratory Data Section

Treatment/ Services Referrals Treatment/ Services Referrals SectionSection

Documented TTH on the Documented TTH on the HIV/AIDS Case Report Form HIV/AIDS Case Report Form

((NotNot for Patient Reported TTH) for Patient Reported TTH)

Laboratory Data Section

Treatment/Services Referrals Section

Documented TTH on the HIV/AIDS Case Report Form

(Not for Patient Reported TTH)

Collecting Patient-Reported TTHCollecting Patient-Reported TTH

Step-by-step instructionsStep-by-step instructions

Date question answered by patient ___/___/___

Description: Date information is obtained either from the client by interview or from the medical chart by abstraction.

Format: mm/dd/yy

Description: Date the patient first tested positive for HIV. This is a self-reported date. Laboratory documented previous HIV tests should be recorded in the Laboratory Data section of the HIV/AIDS Case Report Form.

Date of first Positive HIV Test reported by patient

(mo/dd/yr) ____/____/_____

Can the date of the first positive HIV test Can the date of the first positive HIV test result be based only on a patient’s result be based only on a patient’s

preliminary positive rapid test result?preliminary positive rapid test result?

No. A positive HIV test refers to a No. A positive HIV test refers to a reactive screening test that is reactive screening test that is confirmed using supplemental confirmed using supplemental testing, either Western Blot or testing, either Western Blot or Immunofluorescent assay (IFA). If Immunofluorescent assay (IFA). If a patient did not return for his or a patient did not return for his or her confirmatory result her confirmatory result disclosure, then this test cannot disclosure, then this test cannot be considered their first positive be considered their first positive HIV test.HIV test.

DescriptionDescription: : Date the patient last tested Date the patient last tested negative for HIV. negative for HIV. This a self-reported dateThis a self-reported date. . Laboratory documented previous tests should be Laboratory documented previous tests should be recorded in the Laboratory Data section of the recorded in the Laboratory Data section of the HIV/AIDS Case Report Form. HIV/AIDS Case Report Form.

Date of last negative HIV test reported by patient

(mo/dd/yr) ____/____/_____

Check if never had a negative HIV test

Date of last negative HIV test reported by patient

(mo/dd/yr) ____/____/____

Check if never had a negative HIV test

Example #1 Example #1

This is the patient’s first HIV test This is the patient’s first HIV test ever.ever.

x

Date of last negative HIV test reported by patient

(mo/dd/yr) ____/____/____

Check if never had a negative HIV test

Example #2Example #2

Patient reported his or her last Patient reported his or her last negative test was March 15, 2007.negative test was March 15, 2007.

03 15 07

Date of last negative HIV test reported by patient

(mo/dd/yr) ____/____/____

Check if never had a negative HIV test

Example #3Example #3

Patient does not remember the Patient does not remember the day of his or her last negative day of his or her last negative test.test.

03 . . 07

Date of last negative HIV test reported by patient

(mo/dd/yr) ____/____/____

Check if never had a negative HIV test

Example #4 Example #4

The patient claims to have previously The patient claims to have previously tested for HIV but did not return for the tested for HIV but did not return for the results.results.

Prior Tests (2 years before 1st positive)Number of HIV tests in 2 years before first positive:

_1_ (first positive) + ___ (# prior negative tests) = ___ Total

Description:

Information can be self-reported.

A pre-printed ‘1’ in the formula just below the question counts as the first confirmatory positive test.

The blank space is used to record the number of HIV tests the client has had in the past two years (not including the first positive).

Prior negative HIV tests may include any kind of test used to detect HIV including anonymous tests and screening tests (e.g., rapid oral fluid).

Example #1Example #1

This HIV positive test is the patient’s first This HIV positive test is the patient’s first HIV test ever.HIV test ever.

0 1

Prior Tests (2 years before 1st positive)Number of HIV tests in 2 years before first positive:

_1_ (first positive) + ___ (# prior negative tests) = ___ Total0 1

Example #2Example #2

Patient tested six months ago.Patient tested six months ago.

0 1

Prior Tests (2 years before 1st positive)Number of HIV tests in 2 years before first positive:

_1_ (first positive) + ___ (# prior negative tests) = ___ Total1 2

Example #3Example #3

Patient tested twice in the past two Patient tested twice in the past two years, three times in 2001, and four years, three times in 2001, and four times in 1998.times in 1998.

0 1

Prior Tests (2 years before 1st positive)Number of HIV tests in 2 years before first positive:

_1_ (first positive) + ___ (# prior negative tests) = ___ Total2 3

Antiretroviral & Prophylaxis Treatment HistoryUsed ARV (e.g., to prevent/treat HIV or Hep

B) in the last six months? □ Yes □ No

First date of ARV use: (mo/dd/yr) ____/____/_____

Last date of ARV use: (mo/dd/yr) ____/____/_____

If yes, list medications: ________________________________________________________________________________________________________________________________________________________________________________________________________

Sending TTHAs to Sending TTHAs to CDPH/OACDPH/OAStep 1 of 2Step 1 of 2

Attach the form to the HIV/AIDS Case Attach the form to the HIV/AIDS Case Report Form. Report Form. – New Cases: Attach to the new HIV/AIDS New Cases: Attach to the new HIV/AIDS

Case Report Form.Case Report Form.– Previously Reported Cases: Treat as an Previously Reported Cases: Treat as an

update; attach to an HIV/AIDS Case Report update; attach to an HIV/AIDS Case Report form with the “update” box checked. form with the “update” box checked.

Sending TTHAs to Sending TTHAs to CDPH/OACDPH/OAStep 2 of 2Step 2 of 2

Shipment should be double enveloped and Shipment should be double enveloped and sent via traceable overnight courier sent via traceable overnight courier – Inner envelope: Seal SIFs and CIFs in the inner Inner envelope: Seal SIFs and CIFs in the inner envelope and mark it confidential.envelope and mark it confidential.

– Outer envelope: Address to:Outer envelope: Address to:

ChiefChief

HIV/AIDS Case Registry SectionHIV/AIDS Case Registry Section

Office of AIDSOffice of AIDS

1616 Capitol Avenue, Suite 616, MS 77001616 Capitol Avenue, Suite 616, MS 7700

Sacramento, CA 95814Sacramento, CA 95814

Sending SIFs to CDPH/OASending SIFs to CDPH/OAStep 3 of 3Step 3 of 3

Notify the HIS program of shipment Notify the HIS program of shipment

Atsuko NonoyomaAtsuko Nonoyoma

HIS Data CoordinatorHIS Data Coordinator

email: Atsuko.Nonoyama@cdph.ca.govemail: Atsuko.Nonoyama@cdph.ca.gov

phone: 916-449-5819phone: 916-449-5819

OA HIS Website OA HIS Website – www.cdph.ca.gov/programs/OAHISwww.cdph.ca.gov/programs/OAHIS– The Forms are located under Local Heath The Forms are located under Local Heath

Departments and ProvidersDepartments and Providers– Download and Print as neededDownload and Print as needed

How do I get more TTHA forms?How do I get more TTHA forms?

Thank You!Thank You!

For more information please visit our For more information please visit our websites: websites:

HIV/AIDS Surveillance in CaliforniaHIV/AIDS Surveillance in Californiawww.cdph.ca.gov/programs/OAHISwww.cdph.ca.gov/programs/OAHIS

HIV Incidence Surveillance in the U.S.HIV Incidence Surveillance in the U.S.www.cdc.gov/hiv/topics/surveillance/incidence.htmwww.cdc.gov/hiv/topics/surveillance/incidence.htm