Behavioral and Clinical Surveillance Branch

The Medical Monitoring Project (MMP) is a national population-based surveillance system that collects information on clinical outcomes and behaviors of HIV-diagnosed adults in the United States. Collection of data from interviews with people with HIV provides information on behaviors that may facilitate: HIV transmission; access to, use of, and barriers to HIV-related secondary prevention services; utilization of HIV-related medical services; adherence to drug regimens; and linkage to and engagement in care. Through abstraction of medical records, MMP also provides information on clinical conditions that occur in HIV-infected persons as a result of their disease or the medications they take, receipt of HIV care and support services, and the quality of these services.

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In 2003, CDC created National HIV Behavioral Surveillance (NHBS) to conduct behavioral surveillance among persons at high risk for HIV infection. Surveillance is conducted in rotating, annual cycles in three different populations at increased risk for HIV: men who have sex with men (MSM), persons who inject drugs (PWID), and heterosexually active persons at increased risk for HIV infection (HET). Before each NHBS cycle, formative assessment is conducted to learn more about each local population and to inform operational procedures. Trained interviewers in all NHBS project areas use a standardized, anonymous questionnaire to collect information on HIV-related risk behaviors, HIV testing, and the use of HIV prevention services. HIV testing is offered to all participants. During each cycle, a minimum of 500 eligible persons from each participating project area are interviewed and offered HIV testing.

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The Injection Drug Use Surveillance Project (IDU-SP) is an HIV status-neutral, bio-behavioral surveillance activity conducted in collaboration with syringe services programs (SSPs) among people who inject drugs (PWID) and their peers who may be at high risk for injection drug use.

Participating syringe services programs (SSPs) are selected from the top 25 states with the highest overdose death burden and to ensure diversity based on region, urbanicity, syringe access policy, and affiliation with health departments. At each of the selected SSPs, clients of the program are systematically approached and invited to participate in IDU-SP. Project participants are then asked to recruit others they know who use drugs via injecting and non-injecting routes. The IDU-SP was designed to provide valuable information to each participating SSP and to reach deeper into the networks of persons who use drugs to understand drug use related risks and access to services. Data from this surveillance project will be used to inform planning and evaluation of prevention programs that aim to reduce injection-related adverse health outcomes, to calculate population size estimates of PWID in a community, to address social determinants of health related to injection drug use, and to establish an ongoing surveillance of injection drug use and associated risks. All IDU-SP participants are offered HIV and HCV testing, as well as referrals to care and social services upon completion of the survey.