HAB Performance Measures Group 2 -
HIV Risk Counseling

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Percentage of clients with HIV infection who received HIV risk counseling [ 1 ] within the measurement year.

Number of HIV-infected clients, as part of their primary care, who received HIV risk counseling

Number of HIV-infected clients who had a medical visit with a provider with prescribing privileges [ 2 ] at least once in the measurement year

None

1. Is the client HIV-infected? (Y/N)
   1. If yes, did the client receive HIV risk counseling at least once during the measurement year with appropriate feedback to the provider?(Y/N)

• Electronic Medical Record/Electronic Health Record
• CAREWare, Lab Tracker, or other electronic data base
• Medical record data abstraction by grantee of a sample of records

None available at this time.

• Incidence of new HIV infection
• Incidence of STD cases in clinic population
• Rates of substance abuse counseling and referrals

Reducing transmission of human immunodeficiency virus (HIV) in the United States requires new strategies, including emphasis on prevention of transmission by HIV-infected persons. Through ongoing attention to prevention, risky sexual and needle sharing behaviors among persons with HIV infection can be reduced and transmission of HIV infection prevented. Medical care providers can substantially affect HIV transmission by screening their HIV-infected patients for risk behaviors; communicating prevention messages; discussing sexual and drug-use behavior; positively reinforcing changes to safer behavior; referring patients for services such as substance abuse treatment; facilitating partner notification, counseling, and testing; and identifying and treating other sexually transmitted diseases. [ 3 ]

Measure reflects important aspect of care that impacts HIV-related morbidity and focuses on treatment decisions that affect a sizable population. Measure has a strong evidence base supporting the use.

"HIV-infected patients should be screened for behaviors associated with HIV transmission by using a straightforward, nonjudgmental approach. This should be done at the initial visit and subsequent routine visits or periodically, as the clinician feels necessary, but at a minimum of yearly. Any indication of risky behavior should prompt a more thorough assessment of HIV transmission risks." [ 4 ] (7/18/03)

[1] HIV risk counseling includes assessment of risk, counseling and as necessary, referrals. Counseling occurs in the context of comprehensive medical care and can be provided by any member of the multidisciplinary primary care team.

[2] A "provider with prescribing privileges" is a health care professional who is certified in their jurisdiction to prescribe ARV therapy.

[3] Centers for Disease Control and Prevention. Incorporating HIV prevention into the medical care of persons living with HIV: recommendations of CDC, the Health Resources and Services Administration, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. MMWR 2003;52 (No. RR-12)
( http://www.cdc.gov/mmwr/PDF/rr/rr5212.pdf or
http://aidsinfo.nih.gov/ContentFiles/HIVPreventionInMedCare_TB.pdf )

[4] Ibid.