California Department of Public Health Office of AIDS NOTE: To view the notes section please download and save the file. In Private and other Non - Counseling & Testing Settings Collecting Testing and Treatment History for HIV Incidence Surveillance

Primary Target Audience HIV/AIDS Surveillance Coordinators and other health department staff working in HIV surveillance programs in California. Training GoalParticipants will know what Testing and Treatment History (TTH) information is needed for HIV Incidence estimation. Collecting Testing and Treatment History for HIV Incidence Surveillance In Private and other Non-Counseling and Testing Settings

Testing and Treatment History (TTH) Used in calculation of HIV incidence estimates. Used in calculation of HIV incidence estimates. Needed to differentiate between new testers and repeat testers. Needed to differentiate between new testers and repeat testers. Used to identify patients receiving ARV meds within six months of first positive HIV test. Used to identify patients receiving ARV meds within six months of first positive HIV test.

Testing and Treatment History (TTH) Collection in California Counseling and Testing Sites (CTS) Private and other non-CTS settings Data entry moduleLEO/PEMSeHARS When usually collected Pre-HIV testPost-HIV test Implemented 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 (TTH) Collection in California Counseling and Testing Sites (CTS) Private and other non-CTS settings Data entry moduleLEO/PEMSeHARS When usually collected Pre-HIV testPost-HIV test Implemented 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 Report Form (CDPH 8641 A) Laboratory Data Section Laboratory Data Section Treatment/ Services Referrals Section Treatment/ Services Referrals Section

Documented TTH on the HIV/AIDS Case Report Form (Not 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 TTH

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

Description: Date the patient last tested negative for HIV. This a self-reported date. Laboratory documented previous tests should be recorded in the Laboratory Data section of the 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 This is the patient’s first HIV test ever. x

Date of last negative HIV test reported by patient (mo/dd/yr) ____/____/____  Check if never had a negative HIV test Example #2 Patient reported his or her last negative test was March 15,

Date of last negative HIV test reported by patient (mo/dd/yr) ____/____/____  Check if never had a negative HIV test Example #3 Patient does not remember the day of his or her last negative test

Date of last negative HIV test reported by patient (mo/dd/yr) ____/____/____  Check if never had a negative HIV test Example #4 The patient claims to have previously tested for HIV but did not return for the 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 #1 This HIV positive test is the patient’s first HIV test ever. 01 Prior Tests (2 years before 1st positive) Number of HIV tests in 2 years before first positive: _1_ (first positive) + ___ (# prior negative tests) = ___ Total 01

Example #2 Patient tested six months ago. 01 Prior Tests (2 years before 1st positive) Number of HIV tests in 2 years before first positive: _1_ (first positive) + ___ (# prior negative tests) = ___ Total 12

Example #3 Patient tested twice in the past two years, three times in 2001, and four times in Prior Tests (2 years before 1st positive) Number of HIV tests in 2 years before first positive: _1_ (first positive) + ___ (# prior negative tests) = ___ Total 23

Antiretroviral & Prophylaxis Treatment History Used 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 CDPH/OA Step 1 of 2 Attach the form to the HIV/AIDS Case Report Form. Attach the form to the HIV/AIDS Case Report Form. –New Cases: Attach to the new HIV/AIDS Case Report Form. –Previously Reported Cases: Treat as an update; attach to an HIV/AIDS Case Report form with the “ update ” box checked.

Sending TTHAs to CDPH/OA Step 2 of 2 Shipment should be double enveloped and sent via traceable overnight courier Shipment should be double enveloped and sent via traceable overnight courier – Inner envelope: Seal SIFs and CIFs in the inner envelope and mark it confidential. – Outer envelope: Address to: Chief HIV/AIDS Case Registry Section Office of AIDS 1616 Capitol Avenue, Suite 616, MS 7700 Sacramento, CA 95814

Sending SIFs to CDPH/OA Step 3 of 3 Notify the HIS program of shipment Notify the HIS program of shipment Atsuko Nonoyoma HIS Data Coordinator phone:

OA HIS Website OA HIS Website – –The Forms are located under Local Heath Departments and Providers –Download and Print as needed How do I get more TTHA forms?

Thank You! For more information please visit our websites: HIV/AIDS Surveillance in California HIV Incidence Surveillance in the U.S.