How This Rating Was Determined
The rating reflects the extent to which state CD4 and viral load reporting requirements were in place, as determined by a policy assessment conducted by CDC (10,11), and whether complete CD4 and viral load data were reported to CDC (1,10,11).
CDC researches state laws, regulations, and policies that could influence risk behavior or alter the environment in which HIV prevention services are accessed and delivered (17). To assess CD4 and viral load reporting requirements, staff reviewed laws, regulations, and directives in the 50 states and the District of Columbia using WestlawNext© (an online legal research system), literature reviews, and web searches. Relevant laws, regulations, and directives were coded using the following parameters:
- CD4 reporting: Required laboratories to report all values (not just those below a specified threshold)
- HIV viral load: Required laboratories to report all results (detectable and undetectable)
States were assessed as having complete reporting of laboratory results to CDC if, in addition to having state laws requiring the reporting of all levels of CD4 and viral load, the following criteria were met: 1) laboratories that perform HIV-related testing had reported a minimum of 95% of HIV-related test results to the state or local health department, and 2) by December 2014, the state had reported to CDC at least 95% of all CD4 and viral load test results received during January 2012–September 2014 (1).