Yes, for shame I don't blog regularly much any more. An apology to you if this is the main way we keep in touch. I graduated from U of A in May with my Master's in Public Health. I have moved back to Phoenix and started a job with the state health department. My official title is: HIV Incidence/Surveillance Epidemiologist for the Arizona Department of Health Services. yay for sounding official! but I understand if you have no idea what that is. In light of recent press in HIV news, I thought I would share with everyone...
...What I do:
Surveillance involves tracking new and current cases of HIV in Arizona (and no, it does not involve cameras, wire-tapping or trench coats...not that kind of surveillance :). Cases are tracked so we can connect people with care services and drug assistance as well as so we know what is going on in the state. Incidence is specifically tracking new infections of HIV. It is useful to know how many new infections occurred recently so we can tell how well prevention methods and education are working. It answers questions like, "Are there any unexpected increases in new infections?" or "What populations should we be targeting prevention efforts to?"
In the 1990's incidence was first estimated by counting the number of new AIDS cases and working backwards to estimate how many new HIV cases occurred. This was done because AIDS reporting was mandatory, but HIV reporting was not. This is problematic, because there is always going to be a lag time between a person being infected with HIV and converting to AIDS. When highly-active anti-retroviral therapy (effective and expensive drugs) came on the scene, this lag time increased substantially. The number of new HIV infections began to be estimated instead by counting the number of new HIV diagnoses, which now must be reported (though isn't...but that's another topic). The problem with using new HIV diagnoses is that people maybe living with HIV for years prior to getting tested, so it is difficult to know how many truly new infections occurred.
A new test was developed, called a STARHS (serologic testing algorithm for recent HIV seroconversions...because you wanted to know that) test, that tests the blood used to diagnose a new HIV case and determines if the infection occurred within the last 5 months or not. 22 states started sending off samples to be tested in 2006 and we are getting our numbers from it now. There was a good article about it in the tribune and more info from the CDC here and here on the results. Basically, the CDC used data and test results from these 22 states and estimated the number of new infections occurring in the nation. The previous methods for estimating new HIV infections apparently underestimated the numbers. So now there is a more accurate way of keeping track of everything.
An important chunk of my job is getting the samples from labs in Arizona to the CDC lab for the STARHS test, summarizing and de-identifying the results for the CDC and figuring out why we didn't actually get what we needed (are certain labs or counties not sending samples? how much time does it take for an investigation?). Now that this article has been released, we will start working on Arizona specific statistics.
I do other things around the office including other stat projects, helping out in the drug assistance program and shake my head at the amount of bureaucracy there is. And, as more of my coworkers have babies and take month long vacations, I am learning what everyone in the office does and plan on taking over soon.
If you're curious about current HIV trends and numbers in Arizona (and who isn't???) ADHS has good summary here. Skip to page 8.
So there you go. There is much more to it all, but hopefully this gives you a basic idea. Questions are welcome here or in person :)
A real life update will be coming at some point. no, really.