HAB HIV Core Clinical Performance Measures for 

Adult/Adolescent Clients: Group 1

HAB HIV Core Clinical Performance Measures for 

Adult/Adolescent Clients: Group 1 

Performance Measure: ARV Therapy for Pregnant 

Women 

OPR-Related Measure: Yes 

www.hrsa.gov/performancereview/measures.htm 

Percentage of pregnant women with HIV infection who are prescribed antiretroviral therapy 

Numerator: Number of HIV-infected pregnant women who were prescribed antiretroviral therapy 

during the 2nd and 3rd trimester 

Denominator: Number of HIV-infected pregnant women who had a medical visit with a provider with 

prescribing privileges1

, i.e. MD, PA, NP at least once in the measurement year 

Patient 

Exclusions: 

1. Patients whose pregnancy is terminated 

2. Pregnant patients who are in the 1st trimester and newly enrolled in care during last 

three months of the measurement year 

Data Element: 

1. Is the client HIV-infected? (Y/N) 

a. If yes, is the client female? (Y/N) 

i. If yes, was she pregnant during the reporting period? (Y/N) 

1. If yes, was she on antiretroviral therapy during this 

reporting period? (Y/N) 

Data Sources: 

• Ryan White Program Data Report, Section 5, Item 53 may provide data useful in 

establishing a baseline for this performance measure 

• Electronic Medical Record/Electronic Health Record 

• CAREWare, Lab Tracker, or other electronic data base 

• Medical record data abstraction by grantee of a sample of records 

National Goals, 

Targets, or 

Benchmarks 

for 

Comparison: 

None available at this time. 

Outcome 

Measures for 

Consideration:

° Rate of perinatal transmission in the measurement year 

° Number of events of perinatal transmission in the measurement year 

Basis for Selection and Placement in Group 1: 

Treatment recommendations for pregnant women infected with HIV-1 have been based on the belief that 

therapies of known benefit to women should not be withheld during pregnancy unless there are known 

adverse effects on the mother, fetus, or infant and unless these adverse effects outweigh the benefit to the 

woman. Antiretroviral therapy can reduce perinatal HIV-1 transmission by nearly 70%.2 

Measure reflects important aspect of care that significantly impacts survival, mortality and hinders 

transmission. Data collection is currently feasible and measure has a strong evidence base supporting the use. 

US Public Health Service Guidelines:

Health-care providers considering the use of antiretroviral agents for HIV-1 infected women during 

pregnancy must take into account two separate but related issues: 

July 2008 
HAB HIV Core Clinical Performance Measures for 

Adult/Adolescent Clients: Group 1

• Antiretroviral treatment of maternal HIV-1 infection, and 

• Antiretroviral chemoprophylaxis to reduce the risk for perinatal HIV-1 transmission 

The benefits of antiretroviral therapy for a pregnant woman must be weighed against the risk of adverse 

events to the woman, fetus, and newborn. Although ZDV chemoprophylaxis alone has substantially reduced 

the risk for perinatal transmission, antiretroviral monotherapy is now considered suboptimal for treatment of 

HIV-1 infection, and combination drug regimens are considered the standard of care for therapy. Initial 

evaluation of an infected pregnant woman should include an assessment of HIV-1 disease status and 

recommendations regarding antiretroviral treatment or alteration of her current antiretroviral regimen. 

This assessment should include the following: 

• Evaluation of the degree of existing immunodeficiency determined by CD4 T-cell count, 

• Risk for disease progression as determined by the level of plasma RNA, 

• History of prior or current antiretroviral therapy, 

• Gestational age, and 

• Supportive care needs. 

Decisions regarding initiation of therapy should be the same for women who are not currently receiving 

antiretroviral therapy and for women who are not pregnant, with the additional consideration of the potential 

impact of such therapy on the fetus and infant. 

Further, use of ZDV alone should not be denied to a woman who wishes to minimize exposure of the fetus to 

other antiretroviral drugs and therefore, after counseling, chooses to receive only ZDV during pregnancy to 

reduce the risk for perinatal transmission.1

References/Notes:

1

A “provider with prescribing privileges” is a health care professional who is certified in their jurisdiction to 

prescribe ARV therapy. 

2

Recommendations for Use of Antiretroviral Drugs in Pregnant HIV-1-Infected Women for Maternal Health 

and Interventions to Reduce Perinatal HIV-1 Transmission in the United States 

(http://aidsinfo.nih.gov/ContentFiles/PerinatalGL.pdf) 

July 2008