European Journal of Epidemiology

, Volume 17, Issue 5, pp 479–489

Anonymous reporting of HIV infection: An evaluation of the HIV/AIDS surveillance system in Norway 1983–2000

  • Preben Aavitsland
  • Øivind Nilsen
  • Arve Lystad
Article

Abstract

Several European countries are considering implementing surveillance systems for HIV infection, but questions remain regarding patient confidentiality. The population-based HIV/AIDS surveillance system in Norway integrates anonymous HIV case reports from laboratories and clinicians and named AIDS case reports. This evaluation includes a description of the system, evidence of system attributes, estimation of resources for system operations, and documentation of the system's usefulness. HIV case reports provide a far better picture of the epidemic than AIDS reports. The median delay between positive HIV test and reporting was 30 days (interquartile range 18–49 days). Completeness of demographic and epidemiologic information in the surveillance database ranges from 60 to 100%. Information on pre-AIDS mortality and emigration is incomplete. The system cost euro 25,200 in 1999. Results are published every week and used for planning of health care and prevention. We conclude that the Norwegian surveillance system with anonymous reporting of HIV cases is simple, inexpensive and flexible, and capable of providing a representative and timely overview that guides prevention. The system fulfils its objectives while respecting confidentiality and adhering to ethical principles. A similar system may be considered in other countries.

AIDS Epidemiology Evaluation HIV infection Norway Surveillance 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    HIV/AIDS surveillance in Europe. End-year report 1999: Report no. 62. Paris: European Centre for the Epidemiological Monitoring of AIDS, 2000.Google Scholar
  2. 2.
    Colfax GN, Bindman AB. Health bene.ts and risks of reporting HIV-infected individuals by name. Am J Public Health 1998; 88: 876–879.Google Scholar
  3. 3.
    Gostin LO, Ward JW, Baker AC. National HIV case reporting for the United States. A defining moment in the history of the epidemic. N Engl J Med 1997; 337: 1162–1167.Google Scholar
  4. 4.
    Guidelines for national human immunodefficiency virus case surveillance, including monitoring for human immunodefficiency virus infection and acquired immunodefficiency syndrome. Centers for Disease Control and Prevention. MMWR Morb Mortal Wkly Rep 1999; 48: 1–31.Google Scholar
  5. 5.
    Updated guidelines for evaluating public health surveillance systems. MMWR Morb Mortal Wkly Rep 2001; 50(RR13): 1–35.Google Scholar
  6. 6.
    Helsedirektoratet. System for kartlegging av HTLVIII/ LAV-infeksjon ved hjelp av melding om påvist HTLV-III/LAV-antisto., virus/virusmarkører. Oslo: Helsedirektoratet, 1986.Google Scholar
  7. 7.
    Update on acquired immune de.ciency syndrome (AIDS) – United States. MMWR Morb Mortal Wkly Rep 1982; 31: 507–514.Google Scholar
  8. 8.
    Revision of the case deffinition of acquired immunode-fficiency syndrome for national reporting – United States. MMWR Morb Mortal Wkly Rep 1985; 34: 373–375.Google Scholar
  9. 9.
    Revision of the CDC surveillance case deffinition for acquired immunodefficiency syndrome. Centers for Disease Control. MMWR Morb Mortal Wkly Rep 1987; 36: 1S–15S.Google Scholar
  10. 10.
    Ancelle-Park R. Expanded European AIDS case deffinition. Lancet 1993; 341: 441.Google Scholar
  11. 11.
    1993 revised classiffication system for HIV infection and expanded surveillance case deffinition for AIDS among adolescents and adults. Centers for Disease Control. MMWR Morb Mortal Wkly Rep 1992; 41: 1–19.Google Scholar
  12. 12.
    Aavitsland P, Nilsen Ø, Lystad A. HIV-epidemien blant homoseskuelle menn i Norge [The HIV-epidemic among homosexual men in Norway]. Tidsskr Nor Laegeforen 1996; 116: 3499–3502.Google Scholar
  13. 13.
    Aavitsland P, Nilsen Ø, Lystad A. HIV-epidemien blant sto.misbrukere i Norge [The HIV-epidemic among drug addicts in Norway]. Tidsskr Nor Laegeforen 1996; 116: 3502–3505.Google Scholar
  14. 14.
    Aavitsland P, Nilsen Ø, Hasseltvedt V, Lystad A. HIVepidemien i Norge inntil 1996-hovedvekt på heteroseskuell smitte [The HIV-epidemic in Norway 1996 with an emphasis on heterosexual transmission]. Tidsskr Nor Lægeforen 1996; 116: 3493–3498.Google Scholar
  15. 15.
    Aavitsland P, Nilsen Ø. HIV-infeksjon, gonoréog syfilis fra Thailand til Norge [HIV infection, gonorrhea and syphilis from Thailand to Norway]. Tidsskr Nor Lægeforen 1999; 119: 3915–3918.Google Scholar
  16. 16.
    Smith E, Rix BA, Melbye M. Mandatory anonymous HIV surveillance in Denmark: The first results of a new system. Am J Public Health 1994; 84: 1929–1932.Google Scholar
  17. 17.
    The CASCADE collaboration. Survival after introduction of HAART in people with known duration of HIV-1 infection. Lancet 2000; 355: 1158–1159.Google Scholar
  18. 18.
    Eskild A, Magnus P, Sohlberg C, Jensen F, Kittelsen P. A comparison of the progression rate to acquired immunodefficiency syndrome between intravenous drug users and homosexual men. Scand J Soc Med 1994; 22: 309–314.Google Scholar
  19. 19.
    Woods WJ, Dilley JW, Lihatsh T, Sabatino J, Adler B, Rinaldi J. Name-based reporting of HIV-positive test results as a deterrent to testing. Am J Public Health 1999; 89: 1097–1100.Google Scholar
  20. 20.
    Nakashima AK, Horsley R, Frey RL, Sweeney PA, Weber JT, Fleming PL. Effect of HIV reporting by name on use of HIV testing in publicly funded counseling and testing programs. JAMA 1998; 280: 1421–1426.Google Scholar
  21. 21.
    HIV testing among populations at risk for HIV infection – nine states, November 1995–December 1996. MMWR Morb Mortal Wkly Rep 1998; 47: 1086–1091.Google Scholar
  22. 22.
    Johnson AM. Home grown heterosexually acquired HIV infection. Br Med J 1992; 304: 1125–1126.Google Scholar

Copyright information

© Kluwer Academic Publishers 2001

Authors and Affiliations

  • Preben Aavitsland
    • 1
  • Øivind Nilsen
    • 1
  • Arve Lystad
    • 1
  1. 1.Section for Infectious Disease ControlNational Institute of Public HealthOsloNorway

Personalised recommendations