| Title |
Sexually Transmitted Infection (STI) Testing for People with HIV
|
Sexually Transmitted Infection (STI) Testing for People with HIV
|
| CMS eCQM ID |
CMS1188v1
|
CMS1188v2
|
| CBE ID* |
3755e
|
3755e
|
| MIPS Quality ID |
205
|
205
|
| Measure Steward |
Health Resources & Services Administration
|
Health Resources & Services Administration
|
| Description |
Percentage of patients 13 years of age and older with a diagnosis of HIV who had tests for syphilis, gonorrhea, and chlamydia performed within the measurement period
|
Percentage of patients 13 years of age and older with a diagnosis of HIV who had tests for syphilis, gonorrhea, and chlamydia performed within the measurement period
|
| Measure Scoring |
Proportion measure
|
Proportion measure
|
| Measure Type |
Process
|
Process
|
| Stratification |
None
|
None
|
| Risk Adjustment |
None
|
None
|
| Rationale |
The rates of syphilis, gonorrhea, and chlamydia cases per 100,000 in the United States have steadily risen over the last decade and increased 11.2%, 5.9%, and 2.8%, respectively, from 2018 to 2019 (DHHS, 2021). People with HIV are at an increased risk of bacterial sexually transmitted... infections (STIs), including chlamydia, gonorrhea, and syphilis (CDC, 2004). However, early detection and treatment of bacterial STIs in people with HIV can lead to a reduction in HIV transmission (CDC, 2004). Despite guidelines for at least annual screening among sexually active persons with HIV, only an estimated 55% received a syphilis test in the past year, 23% received a gonorrhea test in the past year, and 24% received a chlamydia test in the past year based on a nationally-representative survey of adults with HIV receiving medical care in the United States (Flagg et al., 2015). This measure will help providers focus their attention and quality improvement efforts towards testing and treating sexually transmitted infections in patients with HIV, thus reducing the complications to long-term syphilis infection and reducing STI incidence (Patel et al., 2012).
Show more >
The rates of syphilis, gonorrhea, and chlamydia cases per 100,000 in the United States have steadily risen over the last decade and increased 11.2%, 5.9%, and 2.8%, respectively, from 2018 to 2019 (DHHS, 2021). People with HIV are at an increased risk of bacterial sexually transmitted infections (STIs), including chlamydia, gonorrhea, and syphilis (CDC, 2004). However, early detection and treatment of bacterial STIs in people with HIV can lead to a reduction in HIV transmission (CDC, 2004). Despite guidelines for at least annual screening among sexually active persons with HIV, only an estimated 55% received a syphilis test in the past year, 23% received a gonorrhea test in the past year, and 24% received a chlamydia test in the past year based on a nationally-representative survey of adults with HIV receiving medical care in the United States (Flagg et al., 2015). This measure will help providers focus their attention and quality improvement efforts towards testing and treating sexually transmitted infections in patients with HIV, thus reducing the complications to long-term syphilis infection and reducing STI incidence (Patel et al., 2012).
Show less |
The rates of syphilis, gonorrhea, and chlamydia cases per 100,000 in the United States have steadily risen over the last decade and increased 11.2 percent, 5.9 percent, and 2.8 percent, respectively, from 2018 to 2019 (DHHS, 2021). People with HIV are at an increased risk of bacterial... sexually transmitted infections (STIs), including chlamydia, gonorrhea, and syphilis (Centers for Disease Control and Prevention [CDC], 2004). However, early detection and treatment of bacterial STIs in people with HIV can lead to a reduction in HIV transmission (CDC, 2004). Despite guidelines for at least annual screening among sexually active persons with HIV, only an estimated 55 percent received a syphilis test in the past year, 23 percent received a gonorrhea test in the past year, and 24 percent received a chlamydia test in the past year based on a nationally-representative survey of adults with HIV receiving medical care in the United States (Flagg et al., 2015). This measure will help providers focus their attention and quality improvement efforts towards testing and treating sexually transmitted infections in patients with HIV, thus reducing the complications to long-term syphilis infection and reducing STI incidence (Patel et al., 2012).
Show more >
The rates of syphilis, gonorrhea, and chlamydia cases per 100,000 in the United States have steadily risen over the last decade and increased 11.2 percent, 5.9 percent, and 2.8 percent, respectively, from 2018 to 2019 (DHHS, 2021). People with HIV are at an increased risk of bacterial sexually transmitted infections (STIs), including chlamydia, gonorrhea, and syphilis (Centers for Disease Control and Prevention [CDC], 2004). However, early detection and treatment of bacterial STIs in people with HIV can lead to a reduction in HIV transmission (CDC, 2004). Despite guidelines for at least annual screening among sexually active persons with HIV, only an estimated 55 percent received a syphilis test in the past year, 23 percent received a gonorrhea test in the past year, and 24 percent received a chlamydia test in the past year based on a nationally-representative survey of adults with HIV receiving medical care in the United States (Flagg et al., 2015). This measure will help providers focus their attention and quality improvement efforts towards testing and treating sexually transmitted infections in patients with HIV, thus reducing the complications to long-term syphilis infection and reducing STI incidence (Patel et al., 2012).
Show less |
| Clinical Recommendation Statement |
"Routine serologic screening for syphilis is recommended at least annually for all persons with HIV infection who are sexually active, with more frequent screening (i.e., every 3-6 months) for those who have multiple or anonymous partners" (Panel on Opportunistic Infections in Adults and... Adolescents with HIV, 2022, p. Y-3). "Patients undergoing screening or treatment for syphilis also should be evaluated for other sexually transmitted diseases such as chlamydia and gonorrhea at anatomic sites of exposure in men and for chlamydia, gonorrhea, and trichomonas in women" (Panel on Opportunistic Infections in Adults and Adolescents with HIV, 2022, p. Y-3). "The USPSTF recommends screening for syphilis in persons who are at increased risk for infection. When deciding which persons to screen for syphilis, clinicians should consider the prevalence of infection in the communities they serve, as well as other sociodemographic and behavioral factors that may be associated with increased risk of syphilis infection. For example, prevalence of syphilis is higher in men, men who have sex with men, persons with HIV infection, young adults, and persons with a history of incarceration, sex work, or military service…. Optimal screening frequency for persons who are at increased risk for syphilis infection is not well established. Men who have sex with men or persons with HIV infection may benefit from screening at least annually or more frequently (e.g., every 3 to 6 months) if they continue to be at high risk" (USPSTF, 2022, p. 1244-1246). "At the initial HIV care visit, providers should screen all sexually active persons for syphilis, gonorrhea, and chlamydia, and perform screening for these infections at least annually during the course of HIV care. Specific testing includes syphilis serology and [a nucleic acid amplification test] NAAT for N. gonorrhoeae and C. trachomatis at the anatomic site of exposure" (Workowski et al., 2021, p. 26).
Show more >
"Routine serologic screening for syphilis is recommended at least annually for all persons with HIV infection who are sexually active, with more frequent screening (i.e., every 3-6 months) for those who have multiple or anonymous partners" (Panel on Opportunistic Infections in Adults and Adolescents with HIV, 2022, p. Y-3). "Patients undergoing screening or treatment for syphilis also should be evaluated for other sexually transmitted diseases such as chlamydia and gonorrhea at anatomic sites of exposure in men and for chlamydia, gonorrhea, and trichomonas in women" (Panel on Opportunistic Infections in Adults and Adolescents with HIV, 2022, p. Y-3). "The USPSTF recommends screening for syphilis in persons who are at increased risk for infection. When deciding which persons to screen for syphilis, clinicians should consider the prevalence of infection in the communities they serve, as well as other sociodemographic and behavioral factors that may be associated with increased risk of syphilis infection. For example, prevalence of syphilis is higher in men, men who have sex with men, persons with HIV infection, young adults, and persons with a history of incarceration, sex work, or military service…. Optimal screening frequency for persons who are at increased risk for syphilis infection is not well established. Men who have sex with men or persons with HIV infection may benefit from screening at least annually or more frequently (e.g., every 3 to 6 months) if they continue to be at high risk" (USPSTF, 2022, p. 1244-1246). "At the initial HIV care visit, providers should screen all sexually active persons for syphilis, gonorrhea, and chlamydia, and perform screening for these infections at least annually during the course of HIV care. Specific testing includes syphilis serology and [a nucleic acid amplification test] NAAT for N. gonorrhoeae and C. trachomatis at the anatomic site of exposure" (Workowski et al., 2021, p. 26).
Show less |
"Routine serologic screening for syphilis is recommended at least annually for all persons with HIV infection who are sexually active, with more frequent screening (i.e., every 3-6 months) for those who have multiple or anonymous partners" (Panel on Opportunistic Infections in Adults and... Adolescents with HIV, 2022, p. Y-3). "Patients undergoing screening or treatment for syphilis also should be evaluated for other sexually transmitted diseases such as chlamydia and gonorrhea at anatomic sites of exposure in men and for chlamydia, gonorrhea, and trichomonas in women" (Panel on Opportunistic Infections in Adults and Adolescents with HIV, 2022, p. Y-3). "The [United States Preventive Services Task Force (USPSTF)] recommends screening for syphilis in persons who are at increased risk for infection. When deciding which persons to screen for syphilis, clinicians should consider the prevalence of infection in the communities they serve, as well as other sociodemographic and behavioral factors that may be associated with increased risk of syphilis infection. For example, prevalence of syphilis is higher in men, men who have sex with men, persons with HIV infection, young adults, and persons with a history of incarceration, sex work, or military service…. Optimal screening frequency for persons who are at increased risk for syphilis infection is not well established. Men who have sex with men or persons with HIV infection may benefit from screening at least annually or more frequently (e.g., every 3 to 6 months) if they continue to be at high risk" (USPSTF, 2022, p. 1244-1246). "At the initial HIV care visit, providers should screen all sexually active persons for syphilis, gonorrhea, and chlamydia, and perform screening for these infections at least annually during the course of HIV care. Specific testing includes syphilis serology and [a nucleic acid amplification test] NAAT for N. gonorrhoeae and C. trachomatis at the anatomic site of exposure" (Workowski et al., 2021, p. 26).
Show more >
"Routine serologic screening for syphilis is recommended at least annually for all persons with HIV infection who are sexually active, with more frequent screening (i.e., every 3-6 months) for those who have multiple or anonymous partners" (Panel on Opportunistic Infections in Adults and Adolescents with HIV, 2022, p. Y-3). "Patients undergoing screening or treatment for syphilis also should be evaluated for other sexually transmitted diseases such as chlamydia and gonorrhea at anatomic sites of exposure in men and for chlamydia, gonorrhea, and trichomonas in women" (Panel on Opportunistic Infections in Adults and Adolescents with HIV, 2022, p. Y-3). "The [United States Preventive Services Task Force (USPSTF)] recommends screening for syphilis in persons who are at increased risk for infection. When deciding which persons to screen for syphilis, clinicians should consider the prevalence of infection in the communities they serve, as well as other sociodemographic and behavioral factors that may be associated with increased risk of syphilis infection. For example, prevalence of syphilis is higher in men, men who have sex with men, persons with HIV infection, young adults, and persons with a history of incarceration, sex work, or military service…. Optimal screening frequency for persons who are at increased risk for syphilis infection is not well established. Men who have sex with men or persons with HIV infection may benefit from screening at least annually or more frequently (e.g., every 3 to 6 months) if they continue to be at high risk" (USPSTF, 2022, p. 1244-1246). "At the initial HIV care visit, providers should screen all sexually active persons for syphilis, gonorrhea, and chlamydia, and perform screening for these infections at least annually during the course of HIV care. Specific testing includes syphilis serology and [a nucleic acid amplification test] NAAT for N. gonorrhoeae and C. trachomatis at the anatomic site of exposure" (Workowski et al., 2021, p. 26).
Show less |
| Improvement Notation |
Higher score equals better quality
|
Higher score equals better quality
|
| Definition |
None
|
None
|
| Guidance |
This eCQM is a patient-based measure. This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM.
|
This eCQM is a patient-based measure. This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM.
|
| Initial Population |
All patients 13 years of age and older at the start of the measurement period with a diagnosis of HIV before the end of the measurement period with an eligible encounter during the measurement period
|
All patients 13 years of age and older at the start of the measurement period with an eligible encounter during the measurement period with a diagnosis of HIV before the end of the measurement period
|
| Denominator |
Equals Initial Population
|
Equals Initial Population
|
| Denominator Exclusions |
None
|
None
|
| Numerator |
Patients who were tested for each of the following at least once during the measurement period: syphilis, gonorrhea, and chlamydia
|
Patients who were tested for each of the following at least once during the measurement period: chlamydia, gonorrhea, and syphilis
|
| Numerator Exclusions |
Not Applicable
|
Not Applicable
|
| Denominator Exceptions |
None
|
None
|
| Telehealth Eligible |
Yes
|
Yes
|
| Next Version |
|
No Version Available
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| Previous Version |
No Version Available
|
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