Provider Reporting & Partner Services
- Dear Colleague Letter and Partner Services Materials (PDF, 421 KB, 5pg.)
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 3/09), 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, laboratories 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) (DOH-4189 revised 8/05) for all reportable cases and submit to the NYSDOH as instructed on the form. Blank forms are available from the NYSDOH (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 exception to HIPAA regulations authorizes medical providers to report HIV/AIDS cases to the NYSDOH Bureau of HIV/AIDS Epidemiology without obtaining patient permission.
The Partner Services Program provides an immediate link between health care providers, persons diagnosed with HIV, Chlamydia, gonorrhea or syphilis, and 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 STD/HIV
- Partner Services Program contact information (PDF, 122 KB, 1pg.)
Partner Services can serve as a medical provider's 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).
For more information on Partner Services, please visit the Sexually Transmitted Diseases web site.
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
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.)
- Bacterial infections, multiple or recurrent*
- Candidiasis of bronchi, trachea, or lungs
- Candidiasis of esophagus †
- Cervical cancer, invasive §
- Coccidioidomycosis, disseminated or extrapulmonary
- Cryptococcosis, extrapulmonary
- Cryptsporidiosis, chronic intestinal (>1 month's duration)
- Cytomegalovirus disease (other than liver, spleen, or nodes), onset at age >1 month
- Cytomegalovirus retinitis (with loss of vision) †
- Encephalopathy, HIV related
- Herpes simplex: chronic ulcers (>1 month's duration) or bronchitis, pneumonitis, or esophagitis (onset at age >1 month)
- Histoplasmosis, disseminated or extrapulmonary
- Isosporiasis, chronic intestinal (>1 month's duration)
- Kaposi sarcoma †
- Lymphoid interstitial pneumonia or pulmonary lymphoid hyperplasia complex* †
- Lymphoma, Burkitt (or equivalent term)
- Lymphoma, immunoblastic (or equivalent term)
- Lymphoma, primary, of brain
- Mycobacterium avium complex or Mycobacterium kansasii, disseminated or extrapulmonary †
- Mycobacterium tuberculosis of any site, pulmonary †§, disseminated †, or extrapulmonary †
- Mycobacterium, other species or unidentified species, disseminated † or extrapulmonary †
- Pneumocystis jirovecii pneumonia †
- Pneumonia, recurrent †§
- Progressive multifocal leukoencephalopathy
- Salmonella septicemia, recurrent
- Toxoplasmosis of brain, onset at age >1 month †
- Wasting syndrome attributed to HIV
*Only among children aged <13 years. (CDC. 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age. MMWR 1994;43[No. RR-12].)
† Condition that might be diagnosed presumptively.
§ Only among adults and adolescents aged >13 years. (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]
- HIV Clinical Resource
- NYS Department of Health HIV/AIDS Hotline & Website
- 1-800-541-AIDS (2437) (English)
- HIV/AIDS Training for Providers
- NYS HIV/AIDS Laws and Regulations
- HIV/AIDS Statistics in New York State
- Required HIV Related Consent and Authorization Forms
- CDC Medical Monitoring Project (MMP)
- CDC HIV Incidence Surveillance
- NYS Department of Health Partner Services