National Quality Forum #: None
Description: Percentage of clients who receive ADAP, regardless of age, with a diagnosis of HIV with a HIV viral load less than 200 copies/mL at last HIV viral load test in the measurement year
Numerator: Number of clients from the denominator with a HIV viral load less than 200 copies/mL at last HIV viral load test in the measurement year
Denominator: Number of clients, regardless of age, with a diagnosis of HIV with at least one ADAP service1 in the measurement year
Exclusions: None
Data Elements: Does the client, regardless of age, have a diagnosis of HIV? (Y/N)
- If yes, did the client have at least one medical visit during the measurement year? (Y/N)
- If yes, did the client have a HIV viral load test with a result <200 copies/mL at the last test? (Y/N)
Data Sources: Recipient's ADAP data system
National goals, targets, or benchmarks for comparison
This HIV/AIDS Bureau measure aligns with the following national indicators:
- Healthy People 2030 Objective HIV-05: Increase viral suppression. Most recent data 63.1 percent (2017); target 95 percent.
- National HIV/AIDS Strategy (2022-2025) Indicator 6: Increase viral suppression. Baseline result 77.8 percent (2017); target increase to 95 percent by 2025.
- Ending the HIV Epidemic in the U.S. initiative Indicator 5: Viral suppression. Most recent data 65.5 percent (2019); target increase to 95 percent by 2025.
The Ryan White HIV/AIDS Program AIDS Drug Assistance Program (ADAP) Annual Client-Level Data Report (ADR) includes client-level data for all clients enrolled in the ADAP. Learn more about the ADR report and publication by visiting https://hab.hrsa.gov/data.
The Ryan White HIV/AIDS Program (RWHAP) Compass Dashboard displays aggregate-level RSR data and provides users an opportunity to interact with and visualize the reach, impact, and outcomes of the RWHAP. The RWHAP Compass Dashboard also visualizes information about RWHAP services received and characteristics of those clients accessing ADAP services.
In addition, the HIV Quality Measures (HIVQM) Module is a tool within the RSR portal that allows recipients to enter aggregate data specific to the 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
"These guidelines and the AIDS Clinical Trials Group (ACTG) now define virologic failure as a confirmed viral load >200 copies/mL – a threshold that eliminates most cases of apparent viremia caused by viral load blips or assay variability (see Virologic Failure and Suboptimal Immunologic Response).
Individuals who are adherent to their antiretroviral (ARV) regimens and do not harbor resistance mutations to the component drugs can generally achieve suppression 8 to 24 weeks after ARV therapy initiation; rarely, in some patients it may take longer."2
Pediatric guidelines
"Based on accumulated experience with currently available assays, the current definition of virologic suppression is a plasma viral load below the detection limit of the assay used (generally <20 copies/mL to 75 copies/mL)."3
Use in other federal programs
- This measure is a Merit-based Incentive Payment System (MIPS) quality measure. MIPS is one of two quality payment program tracks administered by the Centers for Medicare and Medicaid Services. Learn more about the quality payment program by visiting https://qpp.cms.gov/.
- U.S. Department of Health and Human Services HIV measures: Secretary Sebelius approves indicators for monitoring HHS-funded HIV services.
- This measure is linked to an exact or similar indicator(s) within Healthy People 2030, the National HIV/AIDS Strategy (2022-2025), and the Ending the HIV Epidemic in the U.S. initiative.
References/notes
1 ADAP service includes health insurance assistance (including premium payment and medication copays) and full-pay medication assistance.
2 Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents with HIV (PDF - 4 MB). Department of Health and Human Services. Available online. Accessed August 2023. C-6 through C-7.
3 Panel on Antiretroviral Therapy and Medical Management of HIV-Infected Children. Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection (PDF - 5 MB). Department of Health and Human Services. Available online. Accessed August 2023. D-5.