HIV/Hepatitis C Epidemiology & Surveillance Program

Page last updated 3/26/2024.

Hiv and Hep C logo

The HIV/Hepatitis C Epidemiology & Surveillance Program (HHESP) is in the Epidemiology and Immunization Services Branch (EISB) of the Public Health Services (PHS) department of the County of San Diego Health and Human Services Agency (HHSA).The HHESP program collects, analyzes, and shares local HIV and Hepatitis C data. Through timely and accurate surveillance, this program achieves its goal of providing a foundation for effective community HIV and Hepatitis C prevention and treatment efforts in San Diego County.

County of San Diego Public Health derives its authority from California Code of Regulations, Title 17, sections 2500 and 2641.5-2653.2, that mandates health care providers to report HIV disease and Hepatitis C, while section 2505 requires laboratories to report tests indicative of HIV and Hepatitis C. 

Reporting

State regulations require reporting of HIV and AIDS cases to the local health department. California's disease reporting regulations specify:

  • What, when, where, and how to report cases, and
  • Descriptions of monetary penalties to be imposed for failure to comply.

Why is Reporting Necessary?

Timely and accurate HIV and AIDS case reports provide the County with a better understanding of our local epidemic. Epidemiologists can:

  • Monitor trends in populations affected by HIV infection.
  • Project future numbers of HIV/AIDS cases.
  • Provide information for those responsible for planning for future health care needs and prevention and educational activities.   

Failure to report in a timely manner may have an impact on current and projected funding needs. Funding formulas using data that represents under-reporting of HIV or AIDS cases may translate into under funded programs and services for those with HIV infection.

Reporting HIV

Ending the HIV epidemic

The State of California implemented HIV reporting regulations (California Code of Regulations, Title 17, Section 2641.5-2653.2) July 1, 2002, amended by legislation April 17, 2006. The original regulations required health care providers and laboratories to report cases using a non-name code. The April 17, 2006 legislation requires HIV cases, like AIDS cases, to be reported by name. As with many other communicable diseases, this is a dual reporting process in which both health care providers and laboratories report.

Who Reports HIV?

Health care providers and laboratory directors, or their designees, are required to report all patients with a test indicative of HIV to the local health department.

  • In San Diego County, all HIV disease reports are processed by the HIV/Hepatitis C Epidemiology & Surveillance Program, in the Epidemiology and Immunization Services Branch of the Public Health Services department.
  • When a laboratory has a test indicative of HIV infection, they report a limited amount of information to the Epidemiology Unit and send the results to the provider. The provider then forwards a completed case report form to the Epidemiology Unit.

What is Reported?

Reports of HIV cases to the Epidemiology Unit shall include:

  • Name, address, phone number,
  • Racial/ethnic group,
  • Gender,
  • Date of birth,
  • Mode of transmission information,
  • Laboratory accession number,
  • Test reported,
  • Date of test, and
  • Name, address and phone number of the person or facility making the report.

The Epidemiology Program is required by law to protect the privacy of any individual reported with HIV.

When is HIV Reported?

Providers report an HIV case when a patient has a test result indicative of HIV infection and once again if the individuals the AIDS case definition. Tests indicative of HIV infection include:

  • Confirmed positive HIV antibody test,
  • Any viral load test,
  • Positive P24 antigen test,
  • Positive viral isolation test,
  • Positive Nucleic Acid Testing (NAT), and/or
  • CD4+T-cell test (clinical laboratories may withhold report if they can demonstrate that the CD4+T-cell test is unrelated to a diagnosed case of HIV infection).

Always report a case, even if you think the patient may have been reported by another provider. This helps ensure complete case capture, which is critical for local prevention and treatment funding.

How to Report HIV?

HIV case reports should be sent to:

Health and Human Services Agency, Epidemiology Program
Attention: Samantha Tweeten, PhD, MPH
3255 Camino del Rio South, MS P491
San Diego, CA 92108

Providers also have the option of reporting cases by phone at (619) 692-8505.

Is Training Available?

Yes, free training is available. The HIV/Hepatitis C Epidemiology & Surveillance Program can provide a free one-hour training, conducted on-site.

  • To schedule training, or for more information, call 619-692-8505 or e-mail.

Reporting AIDS

The State of California has implemented AIDS reporting regulations (California Code of Regulations, Title 17, Section 2500) since 1983.

Who Reports AIDS?

AIDS is a condition listed in California's disease reporting regulations. Health care providers knowing of, or in attendance on, a case or suspected case of a disease/condition in Section 2500 (including AIDS) is required to make a report.

  • When a health care provider is not in attendance on a case, any individual having knowledge of a person with one of the reportable diseases or conditions is required to notify the local health department.

What is Reported?

Reports of AIDS cases to the Epidemiology Program shall include, but are not limited to:

  • Name, address, phone number,
  • Racial/ethnic group,
  • Gender,
  • Date of birth,
  • Mode of transmission information,
  • Diagnosis and date of diagnosis, and
  • Name, address and phone number of the person or facility making the report.

The Epidemiology Program is required by law to protect the privacy of any individual reported with HIV.

When is HIV Reported?

When an individual is diagnosed with one or more of the AIDS defining conditions listed below, their HIV care providers are required to report the case to the Epidemiology Program within 7 days of the diagnosis.  

  • CD4+ T-lymphocyte count <200 mL/mm 3  
  • Candidiasis of the bronchi, trachea, or lungs
  • Candidiasis, esophageal                      
  • Cervical cancer, invasive                     
  • Coccidioidomycosis, disseminated or extrapulmonary
  • Cryptococcosis, extra-pulmonary 
  • Cryptosporidiosis, chronic intestinal
  • Cytomegalovirus disease
  • Cytomegalovirus retinitis
  • Encephalopathy, HIV-related    
  • Herpes simplex: chronic ulcers; or  bronchitis, pneumonitis or esophagitis
  • Histoplasmosis, disseminated or extrapulmonary
  • Isosporiasis, chronic intestinal
  • Kaposi's Sarcoma
  • Lymphoma, Burkitt's
  • Lymphoma, immunoblastic
  • Lymphoma, primary in the brain
  • Mycobacterium avium  complex or M. kansasii, disseminated or extrapulmonary
  • Mycobacterium tuberculosis , any site
  • Pneumocystis carinii  pneumonia
  • Pneumonia, recurrent
  • Progressive multifocal Leukoencephalopathy
  • Salmonella septicemia, recurrent
  • Toxoplasmosis of the brain
  • Wasting syndrome due to HIV

Diagnosis of AIDS in Children

  • Diagnosis of AIDS in children less than 13 years of age includes all of the above list, except pulmonary tuberculosis and CD4 count cut-offs. 
  • Recurrent bacterial infections (at least two episodes within a two-year period) and lymphoid interstitial pneumonia/pulmonary lymphoid hyperplasia (LIP/PLH) are AIDS defining conditions for HIV infected children. 

The original case definition of AIDS was established by the Centers for Disease Control and Prevention (CDC) in 1981. Additional conditions and diseases were added in 1985, 1987, 1999 and 2014. All case definitions and revisions are published in the CDC's Morbidity and Mortality Weekly Report (MMWR) publication.

How to Report AIDS?

Providers can submit a confidential case report form to:

Health and Human Services Agency, Epidemiology Program
Attention: Samantha Tweeten, PhD, MPH
3255 Camino del Rio South, MS P491
San Diego, CA 92108

Providers also have the option of reporting cases by phone at (619) 692-8505.

Disease Reporting and HIPAA

The Health Insurance Portability and Accountability Act (HIPAA) of 1996 included legislative deadlines for the creation of federal regulations regarding the privacy of health information.

  • Acting on those deadlines, the secretary of the Department of Health and Human Services issued the proposed Privacy Rule in 1999.
  • The final Privacy Rule became effective April 14, 2003.
  • The final Privacy Rule does allow HIV and AIDS reporting as part of permitted disclosures for public health activities (45 CFR § 164.512); no consent or authorization is required. This is supported by California Civil Code §56.10(c)(18).

The CDC’s HIPAA Privacy Rule and Public Health addresses common questions regarding HIPAA and public health reporting. Additional resources below:

For more information, contact the Epidemiology Unit at (619) 692-8499 or send us an e-mail.