Performance Measure: Syphilis Screening

National Quality Forum #: None

Description: Percentage of patients with a diagnosis of HIV who had a serologic test for syphilis performed within the measurement year

Numerator: Number of patients with a diagnosis of HIV who had a serologic test for syphilis performed at least once during the measurement year

Denominator: Number of patients with a diagnosis of HIV who meet both criteria:

  • Were ≥18 years old in the measurement year1 or who were <18 years old with a history of sexual activity
  • Had a medical visit with a provider with prescribing privileges2 at least once in the measurement year

Patient Exclusions: Patients who were <18 years old and denied a history of sexual history

Data Elements:

  1. Does the patient have a diagnosis of HIV? (Y/N)
    1. If yes, is the patient ≥18 years or reports having a history of sexual activity? (Y/N)
      1. If yes, was the patient screened for syphilis during the measurement year?

***Consider analyzing data for disparities among youth, men who have sex with men, and uninsured patients.

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

"Routine serologic screening for syphilis is recommended at least annually for all persons with HIV who are sexually active, with more frequent screening (i.e., every 3 – 6 months) for those who have multiple or anonymous partners."3

"Bacterial and viral sexually transmitted diseases (STDs) in HIV-infected men and women receiving outpatient care have been increasingly noted, indicating ongoing risky behaviors and opportunities for HIV transmission. Further, despite declining syphilis prevalence in the general U.S. population, sustained outbreaks of syphilis among MSM, many of whom are HIV infected, continue to occur in some areas; rates of gonorrhea and chlamydial infection have also risen for this population. Rising STD rates among MSM indicate increased potential for HIV transmission, both because these rates suggest ongoing risky behavior and because STDs have a synergistic effect on HIV infectivity and susceptibility."4

"On the basis of available evidence, quarterly screening for gonorrhea, chlamydia, and syphilis for certain sexually active MSM can improve case finding, which can reduce the duration of infection at the population level, reduce ongoing transmission and, ultimately, prevalence among this population. Preventive screening for common STIs is indicated for all MSM."5

Use in other federal programs

This measure is linked to an exact or similar indicator(s) within Healthy People 2030, the National HIV/AIDS Strategy (2022-2025), and the Sexually Transmitted Infections National Strategic Plan for the United States (2021-2025).


1 Onset of sexual activity is not reliably reported or recorded. The lower age bracket of 18 years is selected for performance measurement purposes only and should not be interpreted as a recommendation about the age at which screening should begin to occur.

2 A "provider with prescribing privileges" is a health care professional certified in his/her jurisdiction to prescribe medications.

3 Panel on Opportunistic Infections in Adults and Adolescents with HIV. Guidelines for the prevention and treatment of opportunistic infections in adults and adolescents with HIV: Recommendations from the Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America (PDF - 5 MB). Department of Health and Human Services. Available online. Accessed August 2023. Y-3.

4 Centers for Disease Control and Prevention (CDC); Health Resources and Services Administration; National Institutes of Health; HIV Medicine Association of the Infectious Diseases Society of America. "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 Infectious Diseases Society of America." MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports. 2003;52(RR-12): 1-24. Available online. Accessed January 2022.

5 Workowski, KA, Bachmann, LH, Chan, PA, Johnston CM, Muzny, CA, Park, I, Reno, H, Zenilman, JA, & Bolan, GA. "Sexually Transmitted Infections Treatment Guidelines, 2021." MMWR Recomm Rep. 2021; 70(No. RR-4): 17. Available online. Accessed January 2022.

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