Performance Measure: Late HIV Diagnosis

National Quality Forum #: None

Description: Percentage of patients with a diagnosis of Stage 3 HIV (AIDS) within 3 months of diagnosis of HIV¹

Numerator: Number of patients with a diagnosis of Stage 3 HIV infection (AIDS) within 3 months of diagnosis of HIV infection in the 12-month measurement period

Denominator: Number of patients with an HIV diagnosis in the 12-month measurement period

Patient Exclusions: None

Data Elements:

1. Does the patient receive an initial diagnosis of HIV in the measurement year? (Y/N)
   
   1. Did the patient receive a diagnosis of Stage 3 HIV (AIDS) within 3 months of his/her initial diagnosis of HIV? (Y/N)

National goals, target, or benchmarks for comparison

The HIV Quality Measures (HIVQM) Module is a tool within the Ryan White HIV/AIDS Services Report portal. It allows recipients to enter aggregate data specific to HRSA HAB Performance Measures. The HIVQM Module allows recipients to conduct point-in-time benchmarking across Ryan White HIV/AIDS Programs that use the module.

Department of Health and Human Services Clinical Practice Guidelines

Adult guidelines

"Diagnosis of HIV is delayed more often in nonwhite individuals, those who inject drugs, those who live in rural communities, and older adults, and many individuals in these groups develop AIDS-defining illnesses within 1 year of diagnosis.23-25 Therefore, to ensure that the current treatment guidelines have maximum impact, routine HIV screening per current CDC recommendations is essential. The U.S. Preventative Services Task Force recommends HIV testing for persons aged 15 to 65 years and for all pregnant individuals. HIV testing should also be performed for younger and older persons when indicated. This recommendation has been designated a Grade A recommendation by the U.S. Preventative Services Task Force, meaning that third-party payers should cover this service without cost to patients.26 It is critical that everyone who receives an HIV diagnosis be educated about HIV disease and linked to care for full evaluation, follow-up, and management as soon as possible. In order for both individuals with HIV and their sexual partners to fully benefit from early diagnosis, clinicians should initiate ART as soon as possible and provide support to enhance retention in care and ART adherence (see Adherence to the Continuum of Care)."²

Use in other federal programs

U.S. Department of Health and Human Services HIV measures: Secretary Sebelius Approves Indicators for Monitoring HHS-Funded HIV Services

References/notes

¹ The HIV/AIDS Bureau did not develop this measure. The Centers for Disease Control and Prevention originally developed this measure. More information is available at: National Quality Forum Measure #1999.

² Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents with HIV (PDF - 5 MB). Department of Health and Human Services. Available online. Accessed August 2022. E-2.