Improving the Representativeness of Behavioral and Clinical Surveillance for Persons with HIV in the United States: The Rationale for Developing a Population-Based Approach

The need for a new surveillance approach to understand the clinical outcomes and behaviors of people in care for HIV evolved from the new challenges for monitoring clinical outcomes in the HAART era, the impact of the epidemic on an increasing number of areas in the US, and the need for representative data to describe the epidemic and related resource utilization and needs. The Institute of Medicine recommended that the Centers for Disease Control and Prevention and the Heath Resources and Services Administration coordinate efforts to survey a random sample of HIV-infected persons in care, in order to more accurately measure the need for prevention and care services. The Medical Monitoring Project (MMP) was created to meet these needs. This manuscript describes the evolution and design of MMP, a new nationally representative clinical outcomes and behavioral surveillance system, and describes how MMP data will be used locally and nationally to identify care and treatment utilization needs, and to plan for prevention interventions and services

Geographic distribution of US HIV clinical cohorts and Medical Monitoring Project data collection sites, 2007.

<p>Geographic distribution of US HIV clinical cohorts and Medical Monitoring Project data collection sites, 2007.</p

Medical Monitoring Project 3-stage sampling design.

<p>Medical Monitoring Project 3-stage sampling design.</p

Racial/Ethnic Distribution of Adults* Living with HIV/AIDS in the United States, 2003, and in US HIV Cohorts, 2003-2006

*<p>Aged 13 and older in ASD and the US living HIV/AIDS cases, 18 and older in SHAS</p>†<p>Estimated number of persons living with HIV/AIDS at the end of 2003 from 33 areas with confidential name-based HIV infection reporting</p>‡<p>Not available: data on patients with Hispanic ethnicity are not reported in cohort profile <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0000550#pone.0000550-Gange1" target="_blank">[40]</a></p

Medical Monitoring Project Data Domains, 2007*

*<p>Complete interview and chart abstraction instruments are available at: <a href="http://www.cdc.gov/hiv/topics/treatment/MMP/index.htm" target="_blank">http://www.cdc.gov/hiv/topics/treatment/MMP/index.htm</a></p