HAB HIV Core Clinical Performance Measures: 

Adult/Adolescent Clients Group 2

Performance Measure: Syphilis Screening OPR-Related Measure: Yes 

www.hrsa.gov/performancereview/measures.

htm 

Percentage of adult clients with HIV infection who had a test for syphilis performed within the measurement 

year 

Numerator: Number of HIV-infected clients who had a serologic test for syphilis performed at least 

once during the measurement year 

Denominator: 

Number of HIV-infected clients who: 

• were >18 years old in the measurement year1 or had a history of sexual activity < 18 

years, and 

• had a medical visit with a provider with prescribing privileges2 at least once in the 

measurement year 

Patient 

Exclusions: 1. Patients who were < 18 years old and denied a history of sexual activity 

Data Element: 

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

a. If yes, is the client > 18 years or reports having a history of sexual 

activity? (Y/N) 

1. If yes, was the client screened for syphilis during the 

measurement year? 

Data Sources: 

• Ryan White Program Data Report , Section 5, Items 42 and 48 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 

• HIVQUAL reports on this measure for grantee under review 

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

National Goals, 

Targets, or 

Benchmarks 

for 

Comparison 

IHI Goal: 90%3 

National HIVQUAL Data:4

2003 2004 2005 2006 

Top 10% 99.0% 100% 100% 100% 

Top 25% 90.4% 92.2% 95.7% 95.6% 

Mean* 73.7% 78.5% 82.1% 80.0% 

*from HAB data base

Outcome 

Measures for 

Consideration 

o Incidence of neurosyphilis in the clinic population 

Basis for Selection and Placement in Group 2: 

HIV-1 infection appears to alter the diagnosis, natural history, management, and outcome of T. pallidum 

infection. 

Measure reflects important aspect of care that impacts HIV-related morbidity and focuses on treatment 

decisions that affect a sizable population. Measure has a strong evidence base supporting the use. 

August 1, 2008 Page 17 
HAB HIV Core Clinical Performance Measures: 

Adult/Adolescent Clients Group 2

US Public Health Guidelines: 

“HIV-infected patients should be screened for behaviors associated with HIV transmission by using a 

straightforward, nonjudgmental approach. This should be done at the initial visit and subsequent routine visits 

or periodically, as the clinician feels necessary, but at a minimum of yearly. Any indication of risky behavior 

should prompt a more thorough assessment of HIV transmission risks. Screening for STDs should be 

repeated periodically (i.e., at least annually) if the patient is sexually active or if earlier screening revealed 

STDs. Screening should be done more frequently (e.g., at 3–6-month intervals) for asymptomatic persons at 

higher risk.5

 (7/18/03) 

References/Notes:

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 who is certified in their jurisdiction to 

prescribe ARV therapy. 

3

IHI Measure reads, “Percent of Patients with Annual Syphilis Screen” 

(http://www.ihi.org/IHI/Topics/HIVAIDS/HIVDiseaseGeneral/Measures/PercentofPatientswithAnnualSyphil

isScreen.htm) 4

(http://www.hivguidelines.org/public_html/center/quality-of-care/hivqual-project/hivqual-workshop/03-04-

natl-score-top10-25.pdf) 5

Centers for Disease Control and Prevention. 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 the Infectious Diseases Society of America. 

MMWR 2003;52 (No. RR-12) (http://aidsinfo.nih.gov/ContentFiles/HIVPreventionInMedCare_TB.pdf or 

http://aidsinfo.nih.gov/ContentFiles/HIVPreventionInMedCare_TB.pdf)

August 1, 2008 Page 18