EHARS

The Enhanced HIV/AIDS Reporting System (eHARS) is maintained by the Division of HIV/AIDS, STD, and TB Services. EHARS is a browser-based, CDC-developed application that assists health departments with reporting, data management, analysis, and transfer of data to CDC.

Diagnosis of HIV infection

Refers to people diagnosed with HIV infection, regardless of the stage of disease at diagnosis (stage 0, 1, 2, 3 [AIDS], or unknown).

People Living with HIV/AIDS (PLWH)

People currently living with HIV/AIDS, regardless of the stage.

Deaths

Deaths among those with diagnosed HIV/AIDS infection, regardless of the cause of death.

HIV infection, not AIDS

All stages (0, 1, 2) of HIV infection, excluding stage 3 (AIDS).

HIV infection, stage 3 (AIDS)

Refers specifically to people with diagnosed HIV whose infection was classified as stage 3 (AIDS) during a given year (for diagnoses) or whose infection has ever been classified as stage 3 (AIDS). AIDS is the last stage of HIV infection.

Transmission Category

The term for summarizing the multiple risk factors that a person may have by selecting the one most likely to have resulted in HIV transmission. For surveillance purposes, people with more than one reported risk factor are classified in the transmission category listed first in a hierarchy of transmission categories, and therefore counted only once. The exception is men who had sexual contact with other men and injected drugs; this group makes up a separate transmission category.

Hierarchical Categories

• Male-to-male sexual (MSM) contact: men who have had sexual contact with men (i.e. homosexual contact) and men who have had sexual contact with both men and women (i.e. bisexual contact).
• People who inject drugs (PWID): persons who have injected non-prescription drugs.
• Male-to-male sexual contact and people who inject drugs (MSM and PWID): men who have had sexual contact with other men and injected non-prescription drugs.
• Heterosexual contact: persons who have ever had heterosexual contact with someone who had HIV infection or had an MSM or IDU risk factor.
• Perinatal (mother-to-child) exposure: persons infected through perinatal transmission include:
• Exposure in someone who had HIV first diagnosed at age 13 years or older (older perinatal)
• Pediatric receipt of clotting factor blood product for treatment of hemophilia or other chronic coagulation disorder
• Exposure through mother who had HIV infection
• Pediatric receipt of transfusion of blood or blood components, or transplant of organ or tissue
• Child with other risk factor (e.g. sexual abuse by an HIV infected adult, injection drug use)
• Child with No Identified Risk (NIR)
• Child with No Reported Risk (NRR)
• Other: all other transmission categories including:
• Adult receipt of clotting factor blood product for treatment of hemophilia or other chronic coagulation disorder
• Adult receipt of transfusion of blood or blood components, transplant of organ or tissues, or artificial insemination
• Adult with other risk factor (e.g. occupational exposure)
• Adult with No Identified Risk (NIR)
• Adult with No Reported Risk (NRR)

Sex at Birth

Sex designations based on a person's reported sex at birth.

Gender

Refers to a person's internal understanding of their own gender, or gender with which a person identifies.

Gender Categories

• Male: persons assigned "male" sex at birth and current gender identity is not "transgender male-to-female" or "additional gender identity".
• Female: persons assigned "female" sex at birth and current gender identity is not "transgender female-to-male" or "additional gender identity".
• Transgender male-to-female (transgender MTF): persons assigned "male" sex at birth and current gender identity is "transgender male-to-female."
• Transgender female-to-male (transgender FTM): persons assigned "female" sex at birth and current gender identity is "transgender female-to-male."

Records stored and presented in eHARS are based off of data collected through several forms created by the US Department of Health & Human Services (DHSS) and the Centers for Disease Control and Prevention (CDC).

Forms used include the following:

• Adult HIV Confidential Case Report Form: For patients ≥13 years of age at time of diagnosis (link for form)
• Pediatric HIV Confidential Case Report Form: For patients <13 years of age at time of diagnosis (link for form)
• Perinatal HIV Exposure Reporting (PHER) Form: Follows infants to determine infection status (link for form)
• Confidential Lab Reporting Form: Used for laboratory reporting purposes (link for form)

EHARS data is also matched to the following sources to collect as much information as possible:

• New Jersey Birth Certificate
• Death files
• New Jersey Death Certificate
• Social Security Master Death File
• National Death Index
• Hospital Discharge Data (also known as Universal Billing Data)
• Antiretroviral (ARV) Claims Data
• Includes: Medicaid, Senior Gold, AIDS Drug Assistance Program (ADAP), and Pharmaceutical Assistance to the Aged and Disabled (PAAD)
• Hepatitis C Data
• Sexually Transmitted Disease (STD) Data (stopped in 2018)
• Occasionally:
• Cancer Registry
• CareWare
• Other data related to HIV

Completeness of Case Ascertainment: ≥95% of the expected number of cases for a diagnosis year are reported, assessed 12 months after the diagnosis year

Timeliness of Case Ascertainment: ≥90% of the expected number of cases for a diagnosis year are reported within six months following diagnosis, assessed 12 months after the diagnosis year

Timeliness of Laboratory Reporting: ≥85% of all labs with a specimen collection date in the diagnosis year are loaded in the surveillance system within two months of the specimen collection date, assessed at 12 months after the diagnosis year

Data Quality: ≥97% of cases that meet the surveillance case definition for HIV infection for a diagnosis year have no required fields missing and pass all standard data edit checks, assessed 12 months after the diagnosis year

Because of delays in reporting of deaths, prevalence data are only available through the end of the most recent completed year. The exclusion of data from the most recent year allows at least 12 months for deaths to be reported and for these deaths to be factored into calculations of prevalence.

COVID-19 and 2020 Data Collection: 2020 data should be interpreted with caution due to the impact of the COVID-19 pandemic on access to HIV testing, care related services, and changes in testing modality (e.g., self-testing).

Rates per 100,000 population were calculated for (1) the numbers of new diagnoses of HIV infection, (2) the numbers of deaths of persons with diagnosed HIV infection regardless of cause of death, and (3) the numbers of persons living with diagnosed HIV infection through the most recent completed year. The source of all denominator information is the National Center for Health Statistics' bridged-race estimates prepared under a collaborative arrangement with the U.S. Census Bureau and based on the most recent vintage of the American Community Survey 1-Year Estimates.

Caution should be exercised in the interpretation of rates based on small numbers. Suppression has been applied to any numbers with a value less than five.