Behavioral Risk Factor Surveillance System (BRFSS)
The Behavioral Risk Factor Surveillance System (BRFSS) is an annual national random telephone and cellular surveillance survey designed by the Centers for Disease Control and Prevention (CDC). The survey is conducted in all 50 states as well as the District of Columbia and three U.S. territories. BRFSS monitors modifiable risk behaviors and other factors contributing to the leading causes of morbidity and mortality in the population. Data from the BRFSS are useful for planning, initiating, and supporting health promotion and disease prevention programs at the state and federal level, and monitoring progress toward achieving health objectives for the state and nation. New York State’s BRFSS sample is representative of the non-institutionalized civilian adult population, living in households, aged 18 years and older.
Ever been tested for HIV (%): This percent estimate is based on this question: “Have you ever been tested for HIV? Do not count tests you may have had as part of a blood donation. Include testing fluid from your mouth.”
Tested for HIV in the past 12 months (%): Those who have been tested for HIV in the past 12 months are flagged if their last HIV test occurred in the past 12 months prior to the month of interview.
For the age-adjustment method, see “Age Adjustment Using the 2000 Projected U.S. Population” (CDC 2001).
BRFSS Publication Criteria
According to the BRFSS recommendations, a releasable estimate must meet all of the following criteria:
- The total sample size (or denominator; unweighted) should be 50 or more;
- The number of observations (or numerator; unweighted) should be 6 or more;
- Coefficient of variation (COV) should be 30% or less; and
- A half width of a confidence interval (1/2 CI) should be 10% or less.
More information on NYS BRFSS methodology and data reporting found at the NYS Department of Health BRFSS website
Community Health Survey
The New York City Community Health Survey (CHS) is an annual cross-sectional telephone survey conducted by the Bureau of Epidemiology Services at the New York City Department of Health and Mental Hygiene. The CHS provides data on the health of New York City residents. The annual sample includes approximately 8,500 adults ages 18 and older from all five city boroughs. All data collected are based on self-report.
CHS data is used to provide measures of HIV testing and prevention in New York City. CHS participants are asked a) if they have ever been tested for HIV and b) if they have been tested for HIV in the past 12 months. For data regarding condom use, participants are asked whether they used a condom the last time they had sex.
Data suppression and reliability
Sample sizes for some populations are quite small, making some CHS estimates potentially unreliable. The NYC DOHMH guidelines for data reliability incorporate relative standard error, confidence interval width, and sample size to identify potentially unreliable estimates.
Some data are not shown due to estimates being imprecise:
a) relative standard error >= 50% with confidence interval band width >=6, or b) relative standard error <30% and confidence interval half-width >10 or c) estimates equal to 0% or 100% with a denominator <50.
Estimates are suppressed if the denominator is less than 50 (n<50).
For more information on these guidelines for data reliability and suppression visit https://www1.nyc.gov/site/doh/data/data-sets/community-health-survey-public-use-data.page
IDV® Integrated Dataverse from Symphony Health
IDV® (Integrated Dataverse) from Symphony Health contains longitudinal patient data sources that capture adjudicated prescription, medical, and hospital claims across the United States for all payment types, including commercial plans, Medicare Part D, cash, assistance programs, and Medicaid. The IDV ® contains over 10 billion prescription claims linked to over 280 million unique prescription patients with an average of 5 years of prescription drug history. Claims from hospital and physician practices include over 190 million patients with CPT/HCPCS medical procedure history, as well as ICD-9/10 diagnosis history, of which nearly 180 million prescription drug patients are linked to a diagnosis. The overall sample represents over 65,000 pharmacies, 1,500 hospitals, 800 outpatient facilities, and 80,000 physician practices nationally.
New York State uses the IDV® from Symphony Health data to extract PrEP prescription data for all payors with the exception of Medicaid. While IDV® data contains over 90% of prescriptions dispensed nationally, this does not mean that the completeness of the PrEP prescriptions filled is at 90%. This is due to a lower level of completeness of medical claim information in Symphony, which the NYS PrEP algorithm relies on for excluding prescriptions for individuals with other conditions (i.e. HCV, HBV, etc.).
Claims and encounter data are subject to errors and omissions, specifically with regard to the race/ethnicity of individuals.
Medicaid Data Warehouse
Administrative data from medical claims submitted by NYS healthcare providers. HIV-related indicators identified from billing codes reflecting HIV care and prevention services such as HIV testing, ARV prescriptions, and PrEP prescriptions.
An algorithm was developed and applied to Medicaid fee-for-service claims and encounter data submitted by Medicaid managed care plans that are housed in the NYSDOH Medicaid data warehouse. This algorithm included diagnosis and prescription drug coding that was intended to monitor the number of HIV-negative Medicaid recipients who filled prescriptions for Truvada for PrEP and Truvada for PEP, excluding treatment of chronic hepatitis B infection. The algorithm was applied to the Medicaid data warehouse to examine the number of persons enrolled in Medicaid anytime during the analysis period.
Additional context for this analysis of PrEP use and background information on NYS Medicaid data as a source for HIV-related measures.
HIV/AIDS surveillance activities in New York are conducted by the Bureau of HIV/AIDS Epidemiology within the New York State Department of Health, and by the HIV Epidemiology & Field Services Program of the NYC Department of Health and Mental Hygiene. Both release annual detailed reports on the HIV/AIDS epidemiology within NYS and NYC.
Surveillance data includes information on new HIV/AIDS diagnoses (date, test and values, ordering provider), as well as all CD4 and VL laboratory test results following diagnosis that have been reported to the NYS Department of Health. From this information, we can use surveillance data to follow the number of new diagnoses and the number of persons living with HIV/AIDS in New York, as well as trends in linkage to care rates, retention in care rates, and viral load suppression data. Surveillance data can further assist in looking at this data by demographic or high-risk sub-populations. New York State and New York City are also funded by the Centers for Disease Control and Prevention (CDC) to assess incidence data, or estimated new HIV infections, using a method developed by CDC known as stratified extrapolation approach (SEA). Annual incidence estimates are an essential benchmark in tracking progress towards reducing new infections to 750 by the end of 2020.
As required by NYS Public Health Law, we follow the confidentiality standards set forth by both NYS DOH And NYC DOHMH when releasing aggregate data. For NYC surveillance: case counts of 1-5 person(s) with an underlying population denominator of ≤500 persons, or non-zero counts with a denominator ≤100 as per intercensal 2013 estimates are not shown.
Questions related to New York State may be directed to the New York State Department of Health Bureau of HIV/AIDS Epidemiology at 518-474-4284 or email@example.com. Questions related to New York City may be directed to the New York City Department of Health, HIV Epidemiology and Field Services at HIVreport@health.nyc.gov.
The New York State Department of Health (DOH) collects data on live births and deaths recorded in New York State. Through a cooperative agreement, the New York State DOH receives data on live births and deaths recorded in New York City from the New York City Department of Health and Mental Hygiene and on live births and deaths recorded outside of New York State to residents of New York State from other states and Canada. Vital statistics data are used to provide a measure of AIDS mortality. The cause of death reported is based on the underlying cause and is classified according to the International Classification of Diseases.
Questions may be directed to the New York State Vital Records at firstname.lastname@example.org.