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How Florida dropped its HIV numbers — without actually dropping its HIV numbers

Did Florida cook the books on HIV statistics in 2014?

That’s what it looked like when Florida took the top spot in the US for reported HIV cases — and then released reevaluated numbers that cut the number of cases by 24 percent.

That seemed suspicious, especially since it happened on the heels of the state’s surgeon general losing his job and passed the ignominious honor of being the state with the most new HIV cases to California.

It’s what prompted the Tampa Bay Times to take a second look at how the data is calculated. And spurred 11 members of Congress to write a letter to Gov. Rick Scott calling for a federal investigation of how HIV data is collected.

But the state department of health says it was just a routine adjustment.

In a process known as deduplication 1,534 cases were taken off the books, according to an analysis by the Tampa Bay Times.

Here’s how it works: The Florida Department of Health issues publicly-available monthly statistics to the Centers for Disease Control and Prevention. The CDC responds with a criteria for revising that data so that it’s more accurate.

Deduplication is exactly what it sounds like: the same HIV-infected person is reported multiple times for a couple of reasons like changes in the way a name is reported across multiple forms, or the same person being documented across different states. Those repeat records are removed, a pretty routine clean-up process.

What’s not so routine is that whopper 24 percent drop experienced in 2014. The revision dropped the number of new statewide HIV cases to from 6,147 cases to 4,613.

According to the DOH, Florida cases dropped 8 percent in 2013 and 16 percent in 2012. The unusually high reduction in 2014 was the result of a new nationwide protocol issued by the CDC, which expanded the criteria for identifying duplicates.

The exact parameters of the newly expanded protocol process are unknown, but the CDC noted that it accounted for “approximately 1% fewer cases in the national data set,” wrote Kathleen LaPorte, a spokesperson for the CDC.

When asked how Florida’s revision compares to revisions in other states, the DOH wrote this: “The process is the same for all states, and some lose more than others depending on the level of immigration of persons with HIV disease to other states.” (a.k.a avoiding the question)

The DOH or the CDC did not comment further on this and declined repeated requests for a phone interview.

Experts told the Tampa Bay Times that an adjustment this large is unusual.

This change came at a time when Florida’s Surgeon General Dr. John Armstrong, was blasted for the state’s spike in HIV cases, costing him his job as the state’s top health official.

Even with the adjusted data, Florida’s rates of new HIV cases are still climbing annually, likely the result of cuts of more than 2,000 staff positions and reductions in state spending on health care by almost 26 percent since 2010.

There’s one important thing to remember: even if this big drop is a legit data correction, which it seems to be, the number of reported cases of HIV in Florida continues climbing as it declines in most of the rest of the country and that’s a problem, especially in Miami-Dade, which tops the state in new HIV cases. And without data that people think they can trust, health care providers and policy makers are going to struggle to figure out what to do.