HIV Screening for Pregnant Women

Part 1: Introduction

Part 2: Characteristics for Success: HIV Screening for Pregnant Women

Part 3: Implementation of Quality Measure: HIV Screening for Pregnant Women

Part 4: Improvement Strategies: HIV Screening for Pregnant Women

Part 5: Holding the Gains and Spreading Improvement

Part 6: Supporting Information

Part 6: Supporting Information 

To gain insight into how one QI team approached this measure, review a case study highlighting Big Valley's Quality Improvement Program and its approach to improving HIV Screening for Pregnant Women.

1. Mother-to-Child (Perinatal) HIV Transmission and Prevention (PDF - 5 pages)
2. Cooper ER, Charurat M, Mofenson L, Hanson IC, Pitt J, Diaz C, Hayani K, Handelsman E, Smeriglio V, Hoff R, Blattner W; Women and Infants' Transmission Study Group. Combination antiretroviral strategies for the treatment of pregnant HIV-1-infected women and prevention of perinatal HIV-1 transmission. J Acquir Immune Defic Syndr 2002;29(5):484-94.
3. Connor EM, Sperling RS, Gelber R, Kiselev P, Scott G, O'Sullivan MJ, VanDyke R, Bey M, Shearer W, Jacobson RL, et al. Reduction of maternal-infant transmission of human immunodeficiency virus type 1 with zidovudine treatment. Pediatric AIDS Clinical Trials Group Protocol 076 Study Group. N Engl J Med 1994;331(18):1173-80.
4. Lindegren ML, Byers RH, Thomas P, et al. Trends in perinatal transmission of HIV/AIDS in the United States. JAMA 1999;282:531-38.
5. McKenna M, Hu X. Recent trends in the incidence and morbidity associated with perinatal human immunodeficiency virus infection in the United States. American Journal of Obstetrics and Gynecology. 2007;197(3 Suppl 1):S10-S16.
6. Cooper ER, Charurat M, Mofenson L, Hanson IC, Pitt J, Diaz C, Hayani K, Handelsman E, Smeriglio V, Hoff R, Blattner W; Women and Infants' Transmission Study Group. Combination antiretroviral strategies for the treatment of pregnant HIV-1-infected women and prevention of perinatal HIV-1 transmission. J Acquir Immune Defic Syndr 2002;29(5):484-94.
7. U.S. Preventive Services Task Force: Screening for HIV
8. Kaiser State Health Facts
9. ACOG/AAP Statement of Policy: JOINT STATEMENT ON HUMAN IMMUNODEFICIENCY VIRUS SCREENING Reaffirmed by the ACOG Executive Board, July 2006
10. HRSA Core Clinical Measures
11. Advancing HIV Prevention Program from the CDC – Strategy 4: Further Decrease Mother-to-Child HIV Transmission
12. Healthy People 2010: Progress Review Focus Area 13 - HIV
13. CDC HIV Testing Among Pregnant Women --- United States and Canada, 1998--2001
14. CDC. HIV testing among pregnant women―United States and Canada, 1998–2001. MMWR 2002;51:1013–1016.
15. Anderson JE, Ebrahim S, Sansom S. Women's knowledge about treatment to prevent mother-to-child human immunodeficiency virus transmission. Obstetrics and Gynecology 2004;103:165–168.
16. Anderson JE, Chandra A, Mosher WD. HIV Testing in the United States, 2002. Hyattsville, MD: National Center for Health Statistics; 2005:1–32. Advance Data from Vital and Health Statistics, No. 363.
17. Gorsky RD, Farnham PG, Straus WL. Preventing perinatal transmission of HIV―costs and effectiveness of a recommended intervention. Public Health Reports 1996;111:335–341.
18. Reference: Lansky A, Jones JL, Frey RL, Lindegren ML. Trends in HIV testing among pregnant women: United States, 1994-1999. Am J Public Health 2001;91:1291-3
19. Indian Health Service: Quality of IHS Health Care
20. CDC. HIV/AIDS Surveillance Report, 2004. Vol. 16. Atlanta: US Department of Health and Human Services, CDC; 2005:1-46.
21. Institute of Medicine. Breakthrough Series College Aim Statement Checklist Boston: Institute for Healthcare Improvement. February 2004
22. Indian Health Services Clinical Reporting System National GPRA & PART Report Performance Measurement List & Definitions Version, 9.0, August 2009
23. Adapted from pre-work manual used in HRSA sponsored Health Disparities Collaborative
24. Indian Health Service: Quality of IHS Health Care
25. Timmermans S, Mauck A (2005). The promises and pitfalls of evidence-based medicine. Health Aff (Millwood) 24 (1): 18–28. doi:10.1377/hlthaff.24.1.18. PMID 15647212
26. National Guideline Clearinghouse: Guideline Archive
27. Adapted from HRSA Clinical Quality Performance Measures (2009)
28. Langley G., Nolan K., Nolan T., Norman C., Provost L. The Improvement Guide: A Practical Approach to Enhancing Organizational Performance. San Francisco. Jossey-Bass, 1996.

1. The Web site at CDC presents Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings  
2. American Academy of Pediatrics and American College of Obstetricians and Gynecologists. Guidelines for Perinatal Care, Fifth Edition; Elk Grove Village, IL, AAP/ACOG 2002.
3. AHRQ provides a summary on Physician Performance Measures
4. The Joint Commission - presents relevant information on Performance Measurement in Pregnancy-related conditions at their Web site.
5. A Guide to Effective Care in Pregnancy and Childbirth (Oxford University Press, 2000) Murray Enkin, Marc J.N.C. Keirse, James Neilson, Caroline Crowther, Lelia Duley, Ellen Hodnett and Justus Hofmeyr.
6. HRSA HIV/AIDS Bureau offers information on performance measures on their Web site.
7. National and State Maternal and Child Health (MCH)
8. American College of Obstetricians and Gynecologists. Routine HIV Screening Recommended for All Women, Regardless of Individual Risk Factors, August 1, 2008.
9. Physician Consortium for Performance Improvement. Prenatal Care Physician Performance Measurement Set. September 2007.
10. NQF-Endorsed™ National Voluntary Consensus Standards for Physician-Focused Ambulatory Care APPENDIX A – NCQA Measure Technical Specifications, April, 2008 V.7
11. Physician Consortium for Performance Improvement® Prenatal Care Physician Performance Measurement Set September 2007 Prenatal Care Work Group
12. Centers for Disease Control - One Test Two Lives One Test. - Two Lives provides a variety of resources for providers—as well as materials for their patients—to help encourage universal prenatal testing for HIV.
13. HIV/AIDS Bureau - Women's HIV/AIDS Care Guide 2005 - Table of Contents
    Publications: A Guide to the Clinical Care of Women with HIV/AIDS, 2005 edition ... See also A Guide to Primary Care for People with HIV/AIDS, 2004 edition....also Edited by Jean Anderson, MD
14. Target Center - Technical Assistance for the Ryan White Community
15. Women, Children & HIV: Resources for prevention and treatment
16. National Perinatal HIV Consultation and Referral Service (Perinatal Hotline) - 1-888-448-8765