A Probability Sample for Monitoring the HIV-infected Population in Care in the U.S. and in Selected States

Abstract

Epidemiologic and clinical changes in the HIV epidemic over time have presented a challenge to public health surveillance to monitor behavioral and clinical factors that affect disease progression and HIV transmission. The Medical Monitoring Project (MMP) is a supplemental surveillance project designed to provide representative, population-based data on clinical status, care, outcomes, and behaviors of HIV-infected persons receiving care at the national level. We describe a three-stage probability sampling method that provides both nationally and state-level representative estimates.In stage-I, 20 states, which included 6 separately funded cities/counties, were selected using probability proportional to size (PPS) sampling. PPS sampling was also used in stage-II to select facilities for participation in each of the 26 funded areas. In stage-III, patients were randomly selected from sampled facilities in a manner that maximized the possibility of having overall equal selection probabilities for every patient in the state or city/county. The sampling methods for MMP could be adapted to other research projects at national or sub-national levels to monitor populations of interest or evaluate outcomes and care for a range of specific diseases or conditions.

Assessing the Overall Quality of Health Care in Persons Living with HIV in an Urban Environment

“…To select a representative sample of approximately 400 persons receiving primary HIV medical care in Philadelphia, MMP uses a three-stage sampling process with a probability proportion-to-size sampling design, as has been described elsewhere. [10][11][12][13] Patients were interviewed between July 8, 2009 andMay 28, 2010, and data were collected on all patients for the 365 days prior to the date of the interview or the date of abstraction for those not interviewed.…”

Conjoint Treatment: A Novel Approach to Target the Syndemic Conditions of Trauma, Substance Abuse, and HIV in Women Living with HIV

“…CDC collects data to monitor progress toward achieving the goals and objectives set forth in NHAS, Healthy People 2020, and other federal directives. This surveillance supplemental report complements the 2013 HIV Surveillance Report [6] and presents the results of focused analyses of National HIV Surveillance System (NHSS) [7] and Medical Monitoring Project (MMP) [8][9][10] data to measure progress toward achieving selected objectives of the NHAS and the DHAP Strategic Plan. Data in this report are also used to assess key Department of Health and Human Services core indicators [11,12] and monitor progress toward attainment of HIV-related national objectives in Healthy People 2020 [5].…”

“…For analyses using MMP data (Tables 10 and 11), a 3-stage, probability-proportional-to-size sampling design was used to obtain cross-sectional samples of HIV-infected adults receiving outpatient medical care at HIV care facilities in the United States and Puerto Rico [8][9][10]. Samples included persons who received HIV medical care from January through April of the annual data collection cycles (2009, 2010, 2011, and 2012).…”

“…• Age group: The percentage increased as age increased (e.g., 10.0% of persons aged 13-24 years and 37.1% of persons aged ≥55 years).…”

“…The Medical Monitoring Project (MMP) is a supplemental HIV surveillance system designed to produce nationally representative estimates of behavioral and clinical characteristics of HIV-infected adults receiving HIV medical care in the United States [8][9][10]. MMP uses a 3-stage, probability-proportional-to-size sampling method to obtain cross-sectional samples of HIV-infected adults receiving outpatient medical care at HIV care facilities in the United States and Puerto Rico.…”