International Journal of Epidemiology, Vol 26, 1352-1358, Copyright © 1997 by International Epidemiological Association
P Pezzotti, C Piovesan, G Rezza, G Moro, G Serpelloni and P Ferraro
BACKGROUND: Surveillance systems based on the reporting of AIDS cases do
not provide a completely up to date picture of the trend of the HIV
epidemic, stressing the need for systems based on the diagnosis of HIV
infection. However, implementation of these systems has been hindered by
low feasibility, poor access to HIV testing, and problems related to
confidentiality. The advantages and disadvantages of the two systems and of
combined use were explored by comparing and integrating information from
AIDS and HIV testing registries in a region of Northern Italy. METHODS:
Linkage of AIDS and HIV testing registries allowed the annual number of
incident and prevalent infections to be calculated. For linked cases,
concordance of exposure category was determined. RESULTS: Up to the end of
1995, 2186 AIDS cases and 5306 HIV-positive individuals were diagnosed.
Linkage identified 1212 individuals reported to both registries. From 1990
to 1995, annual AIDS incidence steadily increased, while incidence of new
HIV diagnoses decreased. The AIDS-to-AIDS-free ratio among those infected
decreased from 1:5.6 in 1989 to 1:4.2 in 1995. The proportion of women and
noninjecting drug users was higher among AIDS-free cases than among AIDS
cases. The concordance of the exposure category was high (K = 0.70; 95% CI:
0.67-0.74), but it varied by exposure category; the highest concordance was
for injecting drug users. CONCLUSIONS: Integrated use of the information
provided by these surveillance systems allowed us to better understand and
foresee the AIDS epidemic dynamics. The data also suggested that the
reliability of information on exposure category may vary among categories.
ARTICLES
Combining HIV and AIDS surveillance: an experience from an Italian region
Laboratory of Epidemiology and Biostatistics, Istituto Superiore di Sanita, Roma, Italy.
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  P. Pezzotti, C. Piovesan, F. Michieletto, F. Zanella, G. Rezza, and G. Gallo Estimating the cumulative number of human immunodeficiency virus diagnoses by cross-linking from four different sources Int. J. Epidemiol., October 1, 2003; 32(5): 778 - 783. [Abstract] [Full Text] [PDF]
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