![]() ![]() The survey included questions on functional requirements, security measures, national policies and guidelines, and barriers for CBS implementation (Supplementary table, ). The protocol for this activity was reviewed in accordance with CDC human research protection procedures and was determined to be nonresearch. CDC country office representatives were asked to complete the survey in partnership with local government officials (ministries of health and implementing partners). Research Electronic Data Capture (REDCap) ( 5, 6), an electronic data management tool hosted at CDC and distributed to each PEPFAR-supported CDC country or regional office (representing 46 countries) during May–July 2019 was used to collect responses. ![]() The survey was revised in 2019 with feedback from stakeholders** to focus on CBS and client-level HIV health information system as they relate to CBS. In 2017, CDC initially assessed clinical surveillance among CDC PEPFAR-supported countries ( 4). Although most surveyed countries reported implementing or planning for implementation of CBS, these barriers need to be addressed to implement effective HIV CBS that can inform the national response to the HIV epidemic. Barriers to CBS implementation included lack of country policies/guidance on mandated reporting of HIV and on CBS, lack of unique identifiers to match and deduplicate patient-level data, and lack of data security standards. The most common characteristic (75% of implementation countries) that facilitated implementation was using a health information system for CBS. All countries with CBS reported capturing information at the point of diagnosis, and 85% captured sentinel event data. Among the 39 (85%) countries that responded, § 20 (51%) have implemented CBS, 15 (38%) were planning implementation, and four (10%) ¶ had no plans for implementation. President’s Emergency Plan for AIDS Relief (PEPFAR)–supported countries with CDC presence † (46) to describe CBS implementation and identify facilitators and barriers. For this assessment, a survey was disseminated during May–July 2019 to all U.S. To date, few standardized assessments have been conducted to describe HIV CBS systems globally ( 3, 4). Surveillance signals such as high viral load, mortality, or recent HIV infection can be used for rapid public health action. ![]() Human immunodeficiency virus (HIV) case-based surveillance (CBS) systematically and continuously collects available demographic and health event data (sentinel events*) about persons with HIV infection from diagnosis and, if available, throughout routine clinical care until death, to characterize HIV epidemics and guide program improvement ( 1, 2). ![]()
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