The Acquired Immunodeficiency Syndrome in New England: An Epidemiological Review of the First Six Years

Between 1981 and 1987 — the six-year period following initial recognition of the acquired immunodeficiency syndrome (AIDS) — 1,475 cases were reported among residents of the six New England states. Of nearly 40,000 cases nationwide, 3.8 percent occurred among New England residents, though the region \u27s population represents 5.5 percent ofthe total United States population. The groups most affected include homosexual or bisexual men (65 percent) and intravenous drug users (20 percent). However, in the two southernmost states — Rhode Island and Connecticut — 32 to 40 percent of all cases have used intravenous drugs. In these states, the male:female ratio of adult cases is 6:1, compared to 12:1 in the remainder of the region. In Massachusetts, the disease incidence rate is equivalent to that of Connecticut (144 cases per 1 million population); however, a greater proportion of cases (69 percent versus 45 percent) are homosexual and bisexual men, and the incidence rate for adult females is lower (49 versus 100 cases/million). Maine, New Hampshire, and Vermont have low cumulative incidence rates (\u3c50 cases/million), and no cases among adult females or associated with blood transfusion. In northern New England, 2 percent of adults with AIDS became infected through heterosexual contact, compared to 10 percent in the southern half of the region. Sources of other data, resulting from serologic testing for human immunodeficiency virus (HIV), confirm the predominance of infection in southern New England. Rates of HIV seropositivity in military recruits, blood donors, and specific high-risk populations are uniformly lower in New England than in high-incidence regions. This review is based on statistics provided by AIDS surveillance programs operated by the Departments of Public Health in the six New England states

Communicating hospital infection data to the public: a study of consumer responses and preferences

There is growing interest in public reporting of health care performance data relating to healthcare-associated infections (HAIs). This study evaluated different approaches for reporting hospital-level comparative data on HAIs and the extent to which such data might influence hospital choice. Eight versions of a report were developed, varying whether data were consistent across indicators, whether data were presented in text or graphs, and whether confidence intervals were included. A report and a questionnaire were mailed to a randomly selected sample of local residents. Findings provide no evidence that consistency of indicators, data presentation, report format, or inclusion of confidence intervals significantly impacted consumers\u27 understanding. More educated consumers reported greater understanding of the reports. Responses suggested that public reporting of comparative data on HAIs could influence hospital choice, but other factors including prior experience, reputation, physicians\u27 recommendations, and insurance coverage are also influential. Most consumers understand information on HAIs when it is presented in a short, simple report, and most correctly select the best or worst hospital. Consumers may be influenced by such data, but other factors are likely to be as or more important