Reports and Projects

Published Reports

• 10 Years of HIV Reporting
• 25 Years of AIDS in Maryland
• Decline in New HIV Cases in Northwest Baltimore (Northwest Initiative)
• Prevalence Of HIV, Syphilis, Hepatitis B, and Hepatitis C Among Entrants to Maryland Correctional Facilities J Urban Health 2004 81: 25-37; doi:10.1093/jurban/jth085
  Liza Solomon, Colin Flynn, Kelly Muck, and John Vertefeuille
  Links: Abstract
• Managed Care for AIDS Patients: Is Bigger Better?
  JAIDS Journal of Acquired Immune Deficiency Syndromes. 38(3):342-347, March 1, 2005.
  Solomon, Liza DrPH*; Flynn, Colin ScM*; Lavetsky, Georgette MHS +
  Links: Abstract
• The 2006 Maryland Statewide Coordinated Statement of Need (SCSN)
  The SCSN is a needs assessment for HIV services in the state of Maryland.
• The 2006-2008 Title II Comprehensive Plan for HIV Service
  This plan builds on the 2006 SCSN and serves as a blueprint for the implementation of the Title II HIV Services Program.

HIV/AIDS Projects

• Incidence Surveillance
• Behavioral Surveillance
• Antiretroviral Drug Resistance Testing
• Enhanced Perinatal Surveillance

Incidence Surveillance

The standard HIV test tells us that a person is infected with HIV, but does not tell us when they were infected. Some people may go years after infection before getting tested and having their HIV infection diagnosed. There is new testing technology that can tell us whether a new diagnosis of HIV infection was recently infected or has been infected for a long time. This uses a method called STARHS (pronounced "stars"), the Serologic Testing Algorithm for Recent HIV Seroconversion. This method will provide us with population-level estimates of incidence, the number of new HIV infections. Unfortunately, this method does not provide us with reliable results for individuals and therefore cannot be used to guide individual patients' medical care. The Maryland AIDS Administration is rolling this testing out to all HIV testing sites in the state that are collecting blood specimens.

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Information is needed about risk behaviors among groups of persons at high-risk for HIV infection, trends in these behaviors over time, and exposure to and use of HIV prevention services. Behavioral surveillance uses standardized questionnaires and innovative population sampling methods to collect risk behavior information from high-risk populations. The three high-risk groups that information will be collected on are men who have sex with men, injecting drug users, and high-risk heterosexuals. This information can help explain trends in new HIV diagnoses and can be used to evaluate prevention programs and direct future HIV prevention activities.

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Antiretroviral drugs are used to treat HIV infection and prevent AIDS and death. Unfortunately, during treatment HIV can mutate and develop resistance to these life saving medications. Patients who are not responding well to treatment may have tests done to measure the antiretroviral drug resistance of their HIV. The Maryland AIDS Administration has started testing the blood of people newly diagnosed with HIV to measure the amount of drug resistant HIV being transmitted in the community. Starting in 2003, we began to offer antiretroviral drug resistance testing to persons newly diagnosed at publicly funded HIV testing sites throughout the state. The test results are made available to the persons' physician to help guide their treatment. Approximately 10% of the newly diagnosed people tested have shown resistance to one or more of the medications used to treat HIV

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The risk of HIV transmission from mother to child during pregnancy, labor, and delivery (perinatal transmission) has declined dramatically in the United States and in Maryland. Although the number of perinatal transmissions has declined, a small number of transmissions continue to occur. It is important to collect additional information on HIV infected women who deliver babies in order to understand reasons for continued perinatal transmission of HIV. Data collected through Enhanced Perinatal HIV Surveillance in Maryland includes information on prenatal care, HIV counseling and testing, use of HIV medications to reduce the risk of transmission, and rapid testing. This information will identify missed opportunities for preventing perinatal transmission of HIV in Maryland.

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