HIV and Stage 3 (AIDS) Classifications Data through December 2020 Provided for the Ryan White HIV/AIDS Program, for Fiscal Year 2022: Technical Notes

In October 2009, Congress enacted amendments to the Ryan White HIV/AIDS Program (RWHAP) legislation. The RWHAP legislation specifies the use of surveillance data on persons living with diagnosed HIV infection non-stage 3 (AIDS) and infection ever classified as stage 3 (AIDS) to determine formula funding for RWHAP Parts A and B HIV care and services programs. RWHAP authorizes the Centers for Disease Control and Prevention (CDC) to provide HIV infection non-stage 3 (AIDS) and stage 3 (AIDS) classification surveillance data to the Health Resources and Services Administration (HRSA) for use in their funding formula for all jurisdictions.

As of December 2020, CDC was not accepting HIV case data from the Marshall Islands and the Federated States of Micronesia, as their surveillance systems had not yet been certified. However, in the event that another jurisdiction reported cases that were diagnosed in either the Marshall Islands or the Federated States of Micronesia, the cases would be reflected in the data that CDC sends annually to HRSA. These data limitations do not impact the HRSA funding formula for these two jurisdictions due to the HRSA minimum allotment funding standards.

Data re-release agreements between CDC and state/local HIV surveillance programs require certain levels of cell suppression at the state and county level to ensure confidentiality of personally identifiable information.

Data Requirements and Definitions

Case counts in all tables are presented by residence at earliest HIV diagnosis for persons with diagnosed HIV infection non-stage 3 (AIDS) and residence at earliest stage 3 (AIDS) classification for persons with infection ever classified as stage 3 (AIDS). Data are presented by date of report rather than date of diagnosis (e.g., reported stage 3 [AIDS] classifications in the last 5 years). Boundaries for eligible metropolitan areas (EMAs) and transitional grant areas (TGAs) that became eligible prior to FY 2007 are based on the Office of Management and Budget (OMB) metropolitan statistical area (MSA) delineations that were in effect for such areas for FY 1994 (additional information on historical delineations is available at
http://www.census.gov/geographies/reference-files/time-series/demo/metro-micro/historical-delineation-files.html). Boundaries for EMAs, TGAs, and emerging communities (ECs) that became eligible after 2006 are determined by using applicable OMB definitions based on the year of first eligibility.

Reported persons living with diagnosed HIV infection non-stage 3 (AIDS) or infection ever classified as stage 3 (AIDS) are defined as persons reported as “alive” at last update. HIV infection non-stage 3 (AIDS) classification and stage 3 (AIDS) classification data reported from CDC met the CDC surveillance case definitions published in the 2008 and 2014 revised surveillance case definitions for HIV infection among adults, adolescents, and children aged < 18 months and for HIV infection and infection ever classified as stage 3 (AIDS) among children aged 18 months to < 13 years [4, 5].