In 2019, Florida ranked first for new diagnoses and third for new HIV diagnosis rates per 100,000 population in the United States (including the District of Columbia). Among people with HIV (PWH) in Florida, 5.8 percent of diagnoses were early, and 20.7 percent were late. Data shows that many of these cases were classified as stage 0 (5.8%) or stage 3 (20.7%). HIV infections are classified as stage 0 if the first positive HIV test was within 6 months of a negative HIV test and HIV infections are classified as stage 3 (AIDS) by the presence of an AIDS-defining infection or by the lowest CD4 lymphocyte test.
The Florida Department of Health is a current recipient of CDC Medical Monitoring Project (MMP) funding and has been so for the past decade. This provides a working knowledge of MMP as well as an established relationship working with CDC on MMP projects. FDOH plans on leveraging this current understanding and knowledge of the current MMP project successfully implement the surveillance of stage 0 and stage 3 persons. By the end of the first year for the Florida Medical Monitoring Project (MMP) cycle, the FDOH expects to achieve an enhanced capacity to improve surveillance for people with a recent diagnosis at stage 0 or stage 3 and to increase access to HIV care linkage, retention services, and ancillary services for people with a recent diagnosis at stage 0 or stage 3. By the end of the 5-year period, FDOH will use the data obtained through this grant to increase the knowledge among HIV prevention and care programs about individual and systems-level factors that contribute to testing and prevention barriers among people recently diagnosed at stage 0 or stage 3.
FDOH intends to use the data collected from this project to identify actionable, missed opportunities of HIV prevention and treatment interventions in Florida to improve outcomes among persons with early (stage 0) or late (stage 3). Persons who received a diagnosis at stage 0 (early) were able to access HIV testing shortly after infection yet were unable to benefit from biomedical and behavioral interventions to prevent HIV infection. Thus, we want to be able identify persons as soon as possible but we also want to be able to identify those prevention missed opportunities. Persons with stage 3 infection at the time of their diagnosis did not benefit from timely receipt of testing or HIV prevention interventions and were likely unaware of their infection for a substantial length of time. The data from this enhanced surveillance project will help to improve understanding of the individual and systems barriers that contributed to prevention and testing failures and to enhance efforts to improve outcomes in these key groups.