HIV Screening

Percentage of patients 15-65 years of age who have been tested for HIV within that age range

Limited proprietary coding is contained in the measure specifications for convenience. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets. Quality Insights, Inc. disclaims all liability for use or accuracy of any Current Procedural Terminology (CPT[R]) or other coding contained in the specifications.

CPT(R) contained in the Measure specifications is copyright 2007-2017 American Medical Association. LOINC(R) copyright 2004-2017 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2017 International Health Terminology Standards Development Organisation. All Rights Reserved.

These performance measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications.

THE MEASURES AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND.

Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].

None

None

None

Human immunodeficiency virus (HIV) is a communicable infection that leads to a progressive disease with a long asymptomatic period. Approximately 50,000 persons in the United States are newly infected with HIV each year (Prejean 2011). Without treatment, most persons develop acquired immunodeficiency syndrome (AIDS) within 10 years of HIV infection. Antiretroviral therapy (ART) delays this progression and increases the length of survival, but it is most effective when initiated during the asymptomatic phase. It is estimated that on average an HIV-infected person aged 25 years who receives high quality health care will live an additional 39 years (Lohse 2007). DHHS Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents recommends antiretroviral therapy for all HIV-infected individuals to reduce the risk of disease progression (regardless of CD4 cell count at diagnosis) (Panel on Antiretroviral Guidelines for Adults and Adolescents, 2017).

CDC estimates that almost 16% of the 1.1 million adults and adolescents living with HIV infection in the United States are unaware of their infection (Centers for Disease Control and Prevention 2013). Among persons diagnosed with HIV in 2011, one quarter were diagnosed with Stage 3 HIV (AIDS) at the time of HIV diagnosis (Centers for Disease Control and Prevention 2010). Median CD4 count at diagnosis is less than 350 cells/mm3 (Althoff 2010). HIV screening identifies infected persons who were previously unaware of their infection, which enables them to seek medical and social services that can improve their health and the quality and length of their lives. Additionally, using ART with high levels of medication adherence has been shown to substantially reduce risk for HIV transmission (Panel on Antiretroviral Guidelines for Adults and Adolescents, 2017).

Based on the National Health Interview Survey, fewer than half of persons 18 and older reported ever having been tested for HIV as of 2010 (Centers for Disease Control and Prevention 2014).

The US Preventive Services Task Force recommends that clinicians screen for HIV infection in adolescents and adults aged 15 to 65 years. Younger adolescents and older adults who are at increased risk should also be screened (A Recommendation) (Moyer 2013). 

Since 2006, the CDC has recommended routine opt-out HIV screening (i.e. patient is notified that testing will be performed unless the patient declines) in healthcare facilities of adolescents and adults 13-64 years of age and HIV diagnostic testing of adolescents and adults with clinical signs or symptoms consistent with HIV infection (Centers for Disease Control and Prevention 2006).

Higher score indicates better quality

Althoff KN, Gange SJ, Klein MB, Brooks JT, Hogg RS, Bosch RJ, et al. Late presentation for human immunodeficiency virus care in the United States and Canada. Clin Infect Dis. 2010;50:1512-20.

Centers for Disease Control and Prevention. Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings. MMWR 2006;55(No. RR-14).

Centers for Disease Control and Prevention. Monitoring selected national HIV prevention and care objectives by using HIV surveillance data-United States and 6 U.S. dependent areas-2011. HIV Surveillance Supplemental Report 2013;18(No. 5). http://www.cdc.gov/hiv/topics/surveillance/resources/reports/. Published October 2013. Accessed April 7, 2014.

Lohse N, Hansen AB, Pedersen G, et al. Survival of persons with and without HIV infection in Denmark, 1995-2005. Ann Intern Med 2007;146:87-95.

Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Department of Health and Human Services 2017. Available at https://aidsinfo.nih.gov/contentfiles/lvguidelines/adultandadolescentgl.pdf. Accessed 2/19/2018.

Moyer VA, on behalf of the U.S. Preventive Services Task Force. Screening for HIV: U.S. Preventive Services Task Force Recommendation Statement. Annals Internal Medicine 2013. Published at www.annals.org (accessed July 1, 2013).

Prejean J, Song R, Hernandez A, et al. Estimated HIV incidence in the United States, 2006-2009. PlosOne 2011. 2011;6(8):e17502.

None

This measure evaluates the proportion of patients with an HIV test between their 15th and 66th birthdays. In order to satisfy the measure, the reporting provider must have documentation of the administration of the laboratory test present in the patient's medical record. On occasion, providers will view HIV screening results that were performed elsewhere and therefore the results are not present in the EHR in structured format. To allow such tests to be applied to this measure, they should be entered into the EHR as a laboratory test in a manner consistent with the EHR in use. If the specific Human Immunodeficiency Virus (HIV) Laboratory Test LOINC code of the test is not known, the entry should use the more generic code LOINC panel code [75622-1] which is present in the HIV test value set titled, "HIV Test Documentation Reviewed."

TBD

Patients 15 to 65 years of age who had an outpatient visit during the measurement period

Equals Initial Population

Patients diagnosed with HIV prior to the start of the measurement period

Patients with documentation of an HIV test between age 15-65 before the end of the measurement period

Not Applicable

None

For every patient evaluated by this measure also identify payer, race, ethnicity and sex

NA