Provider Reporting & Partner Services
- "Dear Colleague Letter and Partner Services Materials" (PDF, 189 KB, 6pg.)
HIV/AIDS Reporting at a Glance
Five Things to Know About HIV/AIDS Reporting in New York State
What is Reportable?
In 1998, New York State (NYS) expanded existing AIDS case reporting regulations, PHL Article 21 (Chapter 163 of the Laws of 1998). The new law took effect on June 1, 2000 and requires the reporting of persons with HIV as well as AIDS to the New York State Department of Health (NYSDOH). The law also requires that reports contain the names of sexual or needle-sharing partners known to the medical provider or whom the infected person wishes to have notified. A NYS reporting form, the Medical Provider Report Form (PRF) (DOH-4189, revised 8/05), must be completed for persons with the following diagnoses:
- Initial/New HIV diagnosis - First report of HIV antibody positive test results.
- Previously diagnosed HIV infection (non-AIDS) - Infection previously diagnosed (including repeat/confirmatory test) but patient has not met criteria for AIDS. (Applies to a medical provider who is seeing the patient for the first time.)
- Initial/New Diagnosis of AIDS - Including <200 CD4 cells/µL or opportunistic infection (AIDS-defining illness).
- Previously diagnosed AIDS - (Applies to a medical provider who is seeing the patient for the first time.)
How Do Laboratories Report?
In addition to positive HIV antibody results, laboraties are required to report electronically to the NYSDOH all viral load test results, all CD4 count and percent results, and all genetic resistance profiles of HIV-positive persons. These results must include patient name, address, date of birth, sex, race/ethnicity, and the ordering provider name and address. Since laboratory reports do not include partner/contact, risk factor and testing history information, medical providers are required to submit a Medical Provider Report Form (PRF) (DOH-4189, revised 8/05) for all reportable cases.
How Do Providers Report?
Medical providers must complete the NYS Medical Provider HIV/AIDS and Partner/Contact Report Form (PRF) for all reportable cases and submit to the NYSDOH as instructed on the form. Blank forms are available from the NYSDOH by calling (518) 474-4284. In order to protect patient confidentiality, faxing of reports is not permitted.
What Guidance is Available for Notifying Partners of HIV-infected Persons?
NYS Public Health Law Article 21 (Chapter 163 of the Laws of 1998) requires that medical providers talk with HIV-infected individuals about their options for informing sexual and needle-sharing partners that they may have been exposed to HIV. The NYSDOH Partner Services program (formerly known as PNAP) provides assistance to HIV-positive individuals and to medical providers who would like help notifying partners. Call your local Partner Services office or the New York State HIV/AIDS Hotline at 1-800-541-2437 for assistance.
What About HIPAA and Confidentiality?
Under the federal HIPAA Privacy Rule, public health authorities have the right to collect or receive information "for the purpose of preventing or controlling disease" and in the "conduct of public health surveillance..." without further authorization. This execption to HIPAA regulations authorizes medical providers to report HIV/AIDS cases to the NYSDOH Bureau of HIV/AIDS Epidemiology without obtaining patient permission.
Partner Services at a Glance
"Partner Services" is a free Health Department program that helps patients diagnosed with certain sexually transmitted diseases (STDs). These STDs include Chlamydia, gonorrhea, syphillis and HIV. Partner Services gives patiens options about how their sex or needle-sharing partners learn of their exposure to STDs, including HIV. Partner Services is voluntary and confidential.
Partner Services is for patients newly diagnosed with STDs or HIV; the program can also be used by individuals who have been aware of their HIV status (previously known positives).
Basic Steps
- You have a patient who tests positive for an STD/HIV, and will be returning for test results (or confirmatory results if an HIV rapid test was used).
- You contact Partner Services to see when they can meet with the patient, preferably at the time of the scheduled visit, or a time convenient to the patient soon thereafter.
- You inform your patient of the importance and benefits of meeting with a Partner Services Specialist. Studies have shown that 18% of partners found through Partner Services (in 10 states) were identified as new HIV cases.
- The patient meets with a Partner Services Specialist, who explains the program and assists your patient in making a notification plan for each partner, including assessment of domestic violence risk.
- The patient provides information about their partners to help the Partner Services Specialist to locate and notify individuals of their exposure to STD/HIV.
- A Partner Services Specialist contacts partners to set up a meeting to let them know that they have been exposed to an STD/HIV. The patient's anonymity is always maintained. No names, dates or information about the encounters, or the index patient is ever revealed.
- Partners are offered free confidential STD and/or confidential/anonymous HIV testing. Referrals for other prevention services are also offered.
- Partners receive test results. Treatment and referral for medical care, additional STD/HIV screening or other services are provided, if needed.
Internet-based Partner Services
As the use of technology evolves and is increasingly used by people for (often anonymous) sexual encounters, the NYS Department of Health has adapted to address these challenges. Specially trained Internet Partner Services Specialists can investigate and contact individuals by e-mail, website profiles or screen names. These staff can use many different types of partner identifiers to locate these anonymous contacts.
The Partner Services Program provides an immediate link between health care providers, persons diagnosed with HIV, Chlamydia, gonorrhea and/or syphilisand their sexual and/or needle-sharing partners. The Partner Services Program can facilitate partner notification and early testing while maintaining confidentiality of all individuals involved. Partner Services staff work with patients to develop a plan to notify their partners. Based on the patient’s needs, staff can notify potentially exposed partners anonymously, as well as help patients who want to tell their partners on their own.
Local Health Department and NYSDOH Regional Contacts for Partner Services for HIV
| County Contacts | Contact | Phone Number |
|---|---|---|
| Albany County | Valerie Flanders | 518-447-4609 |
| Chautauqua County | Pat Johnson | 716-661-8111 |
| Dutchess County | Andrew Rotans | 845-486-3452 |
| Monroe County | Kim Smith | 585-753-5375 |
| Nassau County | Carolyn McCummings | 516-227-9590 |
| Onondaga County | Sheila Newport-Jenkins | 315-435-8550 |
| Orange County | Marilyn Ejercito | 845-568-5333 |
| Rockland County | Charles Serunkuuma | 845-364-2992 |
| Schenectady County | Phyllis DiLeggi | 518-386-2824 |
| Suffolk County | Jessica Cusano | 631-853-2255 |
| Westchester County | Evonne Nemes | 914-813-5220 |
| Regional Office Contacts | Contact | Phone Number |
|---|---|---|
| Buffalo Regional Office (Allegany, Cattaraugus, Erie, Genesee, Niagara, Orleans, Wyoming) | Paul LaDouceur | 716-855-7066 |
| Capital District Regional Office (Clinton, Columbia, Delaware, Essex, Franklin, Fulton, Green, Hamilton, Montgomery, Otsego, Rensselaer, Saratoga, Schoharie, Warren, Washington) | Kim Mosteller | 518-402-7411 |
| Central New York Regional Office (Broome, Cayuga, Chenango, Cortland, Herkimer, Jefferson, Lewis, Madison, Oneida, Oswego, St. Lawrence, Tioga, Tompkins) | Dana Rinaldo | 315-477-8116 or 1-800-878-3827 |
| Metropolitan Area Regional Office (Putnam, Sullivan, Ulster) | Cheryl Gugliotta | 845-794-2045 or 845-794-5924 |
| New York City CNAP (Bronx, Kings, New York, Richmond, Queens) | 212-693-1419 | |
| Rochester Regional Office (Chemung, Livingston, Ontario, Schuyler, Seneca, Steuben, Wayne, Yates) | Lorraine Urbanski | 585-423-8103 or 1-800-757-5803 |
Partner Services can serve as your proxy in identifying partners, conducting domestic violence screening and the notification plan, and will assist in completing the Partner/Contact Information on the DOH-4189 (Medical Provider HIV/AIDS and Partner/Contact Form (PRF)).
Revised Surveillance Case Definitions for HIV Infection Among Adults, Adolescents, and Children Aged <18 Months and for HIV Infection and AIDS Among Children Aged 18 Months to <13 Years - United States, 2008
MMWR Recommendations and Reports December 5, 2008 / Vol. 57 /No. RR-10
Prepared by Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention:
- Eileen Schneider, MD
- Suzanne Whitmore, DrPH
- M. Kathleen Glynn, DVM
- Kenneth Dominguez, MD
- Andrew Mitsch, MPH
- Matthew T. McKenna, MD
Summary
For adults and adolescents (i.e., persons aged >13 years), the human immunodeficiency virus (HIV) infection classification system and the surveillance case definitions for HIV infection and acquired immunodeficiency syndrome (AIDS) have been revised and combined into a single case definition for HIV infection (1–3). In addition, the HIV infection case definition for children aged <13 years and the AIDS case definition for children aged 18 months to <13 years have been revised (1,3,4). No changes have been made to the HIV infection classification system (4), the 24 AIDS-defining conditions (1,4) for children aged <13 years, or the AIDS case definition for children aged <18 months. These case definitions are intended for public health surveillance only and not as a guide for clinical diagnosis. Public health surveillance data are used primarily for monitoring the HIV epidemic and for planning on a population level, not for making clinical decisions for individual patients. CDC and the Council of State and Territorial Epidemiologists recommend that all states and territories conduct case surveillance of HIV infection and AIDS using the 2008 surveillance case definitions, effective immediately.
| Surveillance case definition for human immunodeficiency virus (HIV) infection among adults and adolescents (aged >13 years) — United States, 2008 | ||
|---|---|---|
| Stage | Laboratory evidence* | Clinical evidence |
| Stage 1 | Laboratory confirmation of HIV infection and CD4+ T-lymphocyte count of >500 cells/µL or CD4+ T-lymphocyte percentage of >29 | None required (but no AIDS-defining condition) |
| Stage 2 | Laboratory confirmation of HIV infection and CD4+ T-lymphocyte count of 200–499 cells/µL or CD4+ T-lymphocyte percentage of 14–28 | None required (but no AIDS-defining condition) |
| Stage 3 (AIDS) | Laboratory confirmation of HIV infection and CD4+ T-lymphocyte count of <200 cells/µL or CD4+ T-lymphocyte percentage of <14† | or documentation of an AIDS-defining condition (with laboratory confirmation of HIV infection)† |
Stage unknown § |
Laboratory confirmation of HIV infection and no information on CD4+ T-lymphocyte count or percentage | and no information on presence of AIDS-defining conditions |
| * The CD4+ T-lymphocyte percentage is the percentage of total lymphocytes. If the CD4+ T-lymphocyte count and percentage do not correspond to the same HIV infection stage, select the more severe stage. † Documentation of an AIDS-defining condition (Appendix A) supersedes a CD4+ T-lymphocyte count of >200 cells/µL and a CD4+ T-lymphocyte percentage of total lymphocytes of >14. Definitive diagnostic methods for these conditions are available in Appendix C of the 1993 revised HIV classification system and the expanded AIDS case definition (CDC. 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults. MMWR 1992;41[No. RR-17]) and from the National Notifiable Diseases Surveillance System (available at http://www.cdc.gov/epo/dphsi/casedef/case_definitions.htm). § Although cases with no information on CD4+ T-lymphocyte count or percentage or on the presence of AIDS-defining conditions can be classified as stage unknown, every effort should be made to report CD4+ T-lymphocyte counts or percentages and the presence of AIDS-defining conditions at the time of diagnosis. Additional CD4+ T-lymphocyte counts or percentages and any identified AIDS-defining conditions can be reported as recommended. (Council of State and Territorial Epidemiologists. Laboratory reporting of clinical test results indicative of HIV infection: new standards for a new era of surveillance and prevention [Position Statement 04-ID-07]; 2004. Available at http://www.cste.org/ps/2004pdf/04-ID-07-final.pdf.) |
||
