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The HIV/AIDS Program: HAB Performance Measures Group 2

 

HIV Risk Counseling

 

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Performance Measure
 
Numerator
 
Denominator
 
Patient Exclusions
 
Data Element
 
Data Sources
 
National Goals, Targets or Benchmarks for Comparison
 
Outcome Measures for Consideration
 
Basis for Selection and Placement in Group 2
 
US Public Health Service Guidelines
 
References/Notes
 
Performance Measure: HIV Risk Counseling- OPR-Related Measure: Yes  

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

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Numerator  

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

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Denominator  

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

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Patient Exclusions  

None

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Data Elements  
  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)
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Data Sources  
  • 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
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National Goals, Targets, or Benchmarks for Comparison 

None available at this time.

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Outcome Measures for Consideration 
  • Incidence of new HIV infection
  • Incidence of STD cases in clinic population
  • Rates of substance abuse counseling and referrals
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Basis for Selection and Placement in Group 2 

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.
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US Public Health Service Guidelines 

"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)

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References/Notes 

[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.

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