1. Home
  2. Grants
  3. Performance Measure Portfolio
  4. HIV/AIDS Bureau Systems-Level Performance Measures
  5. Performance Measure: HIV Test Results for People with HIV

Performance Measure: HIV Test Results for People with HIV

National Quality Forum #: None

Description: Percentage of individuals who test positive1 for HIV and are given their HIV antibody test results in the measurement year

Numerator: Number of individuals who are tested in the system/network who test positive1 for HIV and are given their HIV antibody test results in the measurement year

Denominator: Number of individuals who are tested in the system/network and who test positive1 for HIV in the measurement year

Patient Exclusions:

  1. Patients who test negative for HIV antibodies
  2. Patients who receive an indeterminate HIV antibody test result
  3. Patients who are already aware of a positive confirmatory test (i.e., confirmatory test at first medical care visit)
  4. Patients who are less than 13 years of age

Data Elements:

For each agency:

  1. Was the patient tested for HIV infection during the measurement year? (Y/N)
    1. If yes, did the patient have a positive confirmatory test1? (Y/N)
      1. If yes, was the patient given his/her confirmatory test result in the measurement year? (Y/N)

For the system:

  1. How many patients were tested for HIV infection within the system/network in the measurement year?
    1. How many patients had positive confirmatory tests1?
      1. Of those patients, how many received the confirmatory test results?

Data Sources:

  • Data reports required by HRSA/HAB, such as the Ryan White Data Report (RDR) and Ryan White HIV/AIDS Program Services Report (RSR), may provide useful data regarding the number of patients identified receiving HIV antibody testing at the system
  • Electronic databases, such as CAREWare, Lab Tracker, PEMS, Electronic Medical Record/Electronic Health Record
  • Surveillance data systems

National goals, targets, or benchmarks for comparison

This HIV/AIDS Bureau measure aligns with the following national indicators:

  • Healthy People 2030
    • Objective HIV-02: Increase knowledge of HIV status. Most recent data 85.8% (2017); target 95%.
    • Objective HIV-03: Reduce the number of new HIV infections. Most recent data 37,000 persons (2017); target 3,000 persons.
  • National HIV/AIDS Strategy (2022-2025)
    • Indicator 1: Increase knowledge of status. Baseline result 85.8% (2017); target by 2025, increase to 95%.
    • Indicator 3: Reduce new HIV diagnoses. Baseline result 38,351 (2017); target by 2025, reduce diagnoses by 90% from baseline. By 2030, reduce diagnoses by 90% from baseline.
  • Ending the HIV Epidemic in the U.S. initiative
    • Indicator 2: Knowledge of status. Most recent result 86.7% (2019); target increase knowledge of status by 95% by 2025.
    • Indicator 3: Most recent data 36,337 people were diagnosed with HIV (2019); target to decrease confirmed HIV diagnoses to 25% by 2025 and 8% by 2030.

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.

Outcome measures for consideration

  • Percent of patients entering outpatient/ambulatory medical care with an AIDS diagnosis in the measurement year
  • Percent of HIV+ patients linked to outpatient/ambulatory medical care in the measurement year

Basis for selection

"The U.S. Preventive Services Task Force recommended that clinicians screen for HIV all adults and adolescents at increased risk for HIV, on the basis that when HIV is diagnosed early, appropriately timed interventions, particularly HAART, can lead to improved health outcomes, including slower clinical progression and reduced mortality…Timely access to diagnostic HIV test results also improves health outcomes. Diagnostic testing in health care settings continues to be the mechanism by which nearly half of new HIV infections are identified…Persons with a diagnosis of HIV infection need a thorough evaluation of their clinical status and immune function to determine their need for antiretroviral treatment or other therapy. HIV-infected persons should receive or be referred for clinical care promptly, consistent with HSPHS guidelines for management of HIV-infected persons."2

The Ryan White HIV/AIDS Treatment Extension Act of 2009 (P.L. 111-87) further emphasized the importance of identifying individuals with HIV/AIDS who do not know their HIV status, making them aware of their status, and referring them into treatment and care.3

Department of Health and Human Services Clinical Practice Guidelines

"Diagnostic HIV testing and opt-out health screening [should] be a part of routine clinical care in all health-care settings while also preserving the patient’s option to decline HIV testing and ensuring a provider-patient relationship conducive to optimal clinical and preventive care…The central goal of HIV screening in a health-care setting is to maximize the number of persons who are aware of their HIV infection and receive care and prevention services. Definitive mechanisms should be established to inform patients of their test results…HIV-positive test results should be communicated confidentially through personal contact by a clinician, nurse, mid-level practitioner, counselor or other skilled staff…Active efforts are essential to ensure that HIV-infected patients receive their positive tests results and linkages to clinical care, counseling, support, and prevention services."2

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 Ending the HIV Epidemic in the U.S. initiative.

References/notes

1 "Test positive" includes only a confirmatory HIV test, regardless of the test used.

2 Centers for Disease Control and Prevention. Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings. MMWR 2006:55 MMWR Recommendations and Reports: Past Volume (2006) (No. RR-14):1-17 Accessed January 2022.

3 "Ryan White HIV/AIDS Treatment Extension Act of 2009". (P.L. 111-87), 42 USC TITLE XXVI—HIV HEALTH CARE SERVICES PROGRAM

Date Last Reviewed: