Office of AIDS - Medical Monitoring Project (MMP) Description

California Department of Public Health

Both HIV and AIDS surveillance programs function in California to collect a core set of information on the characteristics of persons diagnosed with, living with, and dying from HIV infection and AIDS, including age, sex, race/ethnicity, transmission mode, etc. As the HIV/AIDS epidemic changes due to new treatment options and constant immigration of individuals into California, there is an urgent need for HIV/AIDS surveillance to collect complementary information about clinical outcomes, care utilization, and ongoing risk behaviors.

MMP arose out of the need for a nationally representative, population-based surveillance system to assess clinical outcomes, behaviors, and the quality of HIV care. The Centers for Disease Control and Prevention (CDC) has funded 26 sites, including the state of California, and the Counties of Los Angeles and San Francisco to participate in the project.

The primary objectives of MMP are to obtain data from a probability sample of HIV-infected persons receiving care in California in order to:

describe HIV care and support services being received and the quality of such services;

describe the prevalence and occurrence of co-morbidities related to HIV disease;

determine prevalence of ongoing risk behaviors and access to and use of prevention service among persons living with HIV; and

identify met and unmet needs for HIV care and prevention services in order to inform community and care planning groups, health care providers, and other stakeholders.

A consistent methodology will be used in collecting data on behaviors and clinical outcomes from a probability sample of adults receiving care for HIV infection or AIDS. The methodology involves selection of patients currently receiving care using a three-stage sampling design, in-person interview of eligible patients, and abstraction of their HIV-related medical records.

Sampling stage 1: Because the overall goal is to obtain a national probability sample of adults in care for HIV infection in the United States, all 50 states plus the District of Columbia and Puerto Rico were considered eligible to participate. Systematic sampling was used to select 26 sites to participate in MMP, including California; Chicago, Illinois; Delaware; Florida; Georgia; Houston, Texas; Illinois; Indiana; Los Angeles, California; Maryland; Massachusetts; Michigan; Mississippi; New Jersey; New York City, New York; New York; North Carolina; Oregon; Pennsylvania; Philadelphia, Pennsylvania; Puerto Rico; San Francisco, California; South Carolina; Texas; Virginia; and Washington.

Sampling stage 2: At the second stage of sampling, a number of facilities currently providing medical care for HIV-infected adults in California will be randomly sampled to participate in MMP.

Sampling stage 3: Within each participating facility, patients will be randomly sampled for inclusion in MMP. Patients will be sampled from lists of patients seen during a specified time period. At each selected facility, all patients who meet the following conditions are eligible for inclusion: 1) the patient has a diagnosis of HIV infection, with or without AIDS-defining conditions; 2) the patient is at least 18 years old at the beginning of the time period; and 3) the patient received medical care (defined as any visit to the facility or prescription of medications, including refill authorizations) at the facility. Patient lists stripped of identifying information will be sent to CDC for sampling.

Selected patients will be interviewed first and then their medical records will be abstracted. All data collected will be kept confidential, and no identifiable information will be presented in any reports. Ultimately, this surveillance project will produce population-based data about met and unmet needs for HIV care and prevention services.

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