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The Florida Department of Health works to protect, promote, and improve the health of all people in Florida through integrated state, county, and community efforts.

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Routine Interstate Duplicate Review Process


The CDC's Routine Interstate Duplicate Review (RIDR) Process

Florida sends a computer created identifier using components of a person's name, gender and date of birth to the CDC along with other demographic, clinical and behavioral information. The CDC studies the information from all of the states, detects cases that may be duplicates and sends the information to the respective states to investigate. States then work together to resolve potential duplicates by discussing case information. Outcomes can include no match (they are different people) or match. Matches are duplicates, and the states must decide which state should retain the case based on where the case was first diagnosed. The state that retains the case will include it in their analysis of HIV/AIDS surveillance data.

  • Florida's HIV/AIDS Surveillance and RIDR Process
  • Where do the deduplicated cases go?
  • Frequently Asked Questions

A strong reporting infrastructure within the 67 counties is the cornerstone of HIV surveillance in Florida. The state is divided into 17 areas, each led by a county health department (CHD) that works with program staff to coordinate surveillance activities for their area.

Florida's HIV/AIDS surveillance relies on electronic laboratory reporting. Currently, any person in charge of a laboratory that receives an HIV test order or processes an HIV test is required to report positive results to their local CHD within three business days. (Laboratories must also report all viral loads, p24 antigen, viral cultures, CD4 absolute count and percent of total lymphocytes.) Health care providers who initiate an order resulting in a positive HIV test or who diagnose HIV in a patient must report the diagnosis to their local CHD. Health care providers must also report all HIV-exposed newborns or infants less than 18 months born to woman with HIV by the next business day.

Program staff also locate cases by reviewing medical records and contacting local organizations, private providers and hospital infection control staff. Cases of HIV-related conditions, from HIV infection in asymptomatic people to HIV/AIDS-related mortality (as found through death certificate reviews), are identified as well.

Florida data are entered in the Enhanced HIV/AIDS Reporting System (eHARS) and sent to the CDC monthly. CDC maintains the national dataset—an unduplicated count of all HIV/AIDS cases in the U.S. RIDR is the process that ensures the national dataset is made up of unduplicated cases. All states participate in RIDR.

RIDR eliminates duplicate HIV Cases

The table below is based on the year the case was reported to DOH, not the year the patient was diagnosed.  For example, of the 5,211 cases reported in Florida in 2010, 4,369 of those cases were diagnosed in Florida in 2010 or earlier. The HIV cases in this table reflect year of report but could have been diagnosed anytime (that year or before), not just 2010. Therefore, these numbers will always be different.

2010-2014 HIV Infections Reported in Florida

Check out our FAQ on RIDR for more information on the process.

The following are examples of how HIV cases can be duplicated.

An individual from Ohio was diagnosed with HIV five years ago. The person moved to Florida last year, found a doctor in their new town and went in for a check-up. The new doctor ordered routine lab tests, including CD4 and viral load, to see how the person was doing. These lab results were reported electronically to the Department of Health. Follow-up by surveillance staff shows current residence of diagnosis as Florida, with a past HIV history in Ohio, per client. The case is entered into the database and counted as a Florida case because of the residence of diagnosis. The patient is later identified during a deduplication process, and it is verified that the patient has an earlier diagnosis in Ohio. The residence at diagnosis is then changed to Ohio in Florida’s database, and the case will no longer be counted as a Florida case.
An individual lives in Alabama but visits family in Florida. While here, the individual attends a community event where free HIV testing is offered. The person uses their family member’s Florida address at the event. The individual tests positive, and the results are reported to the Department of Health. This is the person’s first time testing positive for HIV, therefore they are counted as a newly reported and newly diagnosed case in Florida. Even if the person goes back to Alabama to receive care and treatment for HIV, the case will remain a Florida case because the residence at diagnosis given by the patient to the testing site and/or provider was Florida.
An individual lives in a small town in southern Georgia. The individual travels into Florida to see an HIV specialist who provides outstanding care. The individual’s routine CD4 and viral load lab tests are reported electronically to the Department of Health. Follow-up by surveillance shows the individual resides in Georgia. The case will not be entered into the Florida database because the residence of diagnosis and current residence are in Georgia.