A Three-stage Cluster-sampling Approach for Clinical Surveillance of Persons in Care for HIV Infection in the United States

• Activity Number: 412
• Type: Contributed
• Date/Time: Thursday, August 12, 2004 : 8:30 AM to 10:20 AM
• Sponsor: Section on Survey Research Methods
• Author(s): Maxine M. Denniston*+ and Mitchell L. Wolfe and Amy J. Drake and Patrick Sullivan and Sandra Berry and Sam Bozzette and Sally Morton and Martin Frankel
• Companies: Centers for Disease Control and Prevention and Centers for Disease Control and Prevention and Centers for Disease Control and Prevention and Centers for Disease Control and Prevention and RAND Corporation and RAND Corporation and RAND Corporation and Baruch College, CUNY
• Keywords: study design ; surveillance ; cluster sampling

Abstract

Historically, the need for national data on morbidity and care of HIV-infected persons has been met by a combination of HIV/AIDS case surveillance and supplemental research projects. Although nationwide AIDS surveillance is a nearly complete census of persons with AIDS, surveillance reports contain limited behavioral risk and clinical data and collect no data on access to/use of treatment, quality of care, impact of treatment, insurance status, comorbidities, immunizations, prophylaxis, or viral resistance. Problems with prior HIV care surveys include estimating service needs in the pre-HAART era, small sample size, designs which did not prioritize the ability to calculate state-level estimates, sampling biases and the high cost of a representative national survey. We propose a three-stage cluster-sampling approach that uses AIDS/HIV surveillance data to construct a frame of HIV care providers for second-stage sampling. This approach would provide a national population-based sample of HIV-infected persons in care while reducing the expense of constructing the provider frame, which was a major cost in a similar prior study. Additionally, the design would allow for state-level estimates.