Office of HIV/AIDS GDPH 2018 HIV Test Template...

GEORGIA DEPARTMENT OF PUBLIC HEALTH

Office of HIV/AIDS

GDPH 2018 HIV Test Template Training

Audience: Georgia Staff Conducting HIV Testing / Presenters: Lisa Martin, MA, MPA and Jamila Ealey, MPH / Date: November 8, 2018


Agenda

• Attendance

• Introductions

• What’s New

• Template Review

• Projected Timeline

• Q & A


What’s New?An Overview of Changes in CDC Required Variables

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New 2018 National HIV Prevention Program Monitoring and Evaluation Testing Requirements

2018 CDC NHM&E Requirements

• HIV Testing /HIV Partner Services

• New Data Collection Template PS18-1802 variables

Data collection process

Reporting process

• Data Quality Assurance Measures

• Effectiveness of Prevention Strategies

• Accountability of funds

• Progress towards performance measures/objectives


New 2018 National HIV Prevention Testing Requirements

2018 CDC NHM&E Requirements• Removed Data Variables

Additional specification of gender identity

Self-reported test result

Test technology

Behavioral risk profile



2018 CDC NHM&E Requirements• New Required Data VariablesAdditional variables for:

All persons tested

Persons testing HIV-negative

Persons testing HIV-positive



2018 CDC NHM&E Requirements• New Required Data Variables for ALL Persons TestedRisk behavior in past 5 years/priority population

PrEP awareness

HIV testing history

STI Screening



2018 CDC NHM&E Requirements• New Required Data Variables for Persons Testing NEGATIVEAt-Risk assessment

PrEP eligibility screening assessment

Support Service needs

Behavioral and Social Service needs



2018 CDC NHM&E Requirements• New Required Data Variables for Persons Testing POSITIVEPrevious HIV testing history

Pregnancy screening /Perinatal HIV services

Essential Support Service needs

Behavioral and Social Service needs

Enhanced Integration of Partner Services*

eHARS State Number


New 2018 National HIV Prevention Program Monitoring and Evaluation Testing Requirements

• PS18-1802 reporting is a requirement for all funded sites conducting HIV testing

• HIV Data Team will work closely with agencies to help facilitate data and process transitions

• Identified resources to aid in streamlining passive referrals

• Testing data reports will be more readily available

• Collaborations with Surveillance and STD programs to reduce data burden where possible


The 2018 HIV Testing Data Collection Template


GDPH HIV Testing Template Overview

• Required for all OHA funded and supported testing sites

• Comprised of 3 Parts and 10 Sections

• Sections 1-6 for ALL persons

• Sections 7 & 8 for persons testing NEGATIVE

• Sections 9 & 10 for persons testing POSITIVE• Section for Health

Department Use Only


Part 1, Section 1: Agency and Client Information

Session Date: the date onwhich the session was delivered to the client. Written - MM/DD/YYYY

Program Announcement:indicates the funding source under which this HIV testing event is associated.Only choose one – PS18-1802

Agency Name: an identification used to uniquely identify an agency. Site ID: A unique alpha-numeric identification code used to distinguish the locations where an agency delivers the HIV prevention service.Both assigned by OHA

Site Type: The setting of the location in which the HIV test was provided. Each site fits one site type from the code list that best represents the setting and/or primary type of services offered at this site of service delivery.


Site Type Codes List (page 2)


Part 1, Section 1: Agency and Client Information

Client ID: locally generated, unique key used to distinguish an individual client. Should be agency specific (i.e., medical record #) but cannot contain patient identifiers (i.e., DOB, last three letters of first name).

Year of Birth: calendar yearin which the client was born. Written - YYYY

Client County: county, parish, or municipality where the client is currently residing at the time of service delivery. Use the county FIPS code, unless outside Georgia. If FIPS code is not known please write in county name.

Client Ethnicity: client’s self report of whether or not he/she is of Hispanic origin.

Client Race: client’s self-reported classification of biological heritage with which he/she identifies. Can be more than one, check all that apply.

Sex at Birth: client’s self report of sex at birth. Select only one option.

Gender Identity: client’s current self-reported sexual identity. Select only one option.HIV Test History: client’s self-

report of having had at least one prior HIV test before these data were collected.


Part 1, Section 2: PrEP Awareness and Use

Pre-exposure prophylaxis (PrEP) is the antiretroviral medication taken by persons who are not infected with HIV, but are at substantial risk for infection, to reduce their risk for becoming infected.

• Ever Heard of PrEP: client's awareness of HIV Pre-exposure prophylaxis (PrEP), the medication taken daily to reduce the risk for acquiring HIV infection. Select One.

• Currently Taking PrEP: an indication if the client is currently on Pre-exposure prophylaxis (PrEP) medicine. Select One.

• Used PrEP in Last 12 Months: an indication of if the client/patient has used PrEP anytime in the last 12 months. Select One.


Part 1, Section 3: Priority Populations

The client self-report of having done any of the following in the past 5 years:

1. Sex with a male. Select One.

2. Sex with a female. Select One.

3. Sex with a transgender person. Select One.

4. Injected drugs or substances not prescribed by a medical care provider. Select One.

Sex includes oral, anal, or vaginal


Part 1, Section 4: Final Test Information

HIV Test Result – FINAL Determination: The determined outcome of the current HIV test or the final test in a sequence or series of tests.

Note: It is no longer necessary to document the multiple test events in a sequence or series of tests. The new HIV Test Form only requires the current HIV test or the final test used to determine/confirm the clients HIV status.



HIV Test Election: an indication of whether the test is linked to a name or is anonymous. All OHA funded and supported HIV tests are Confidential.

Test Type: refers to the basis for determining the outcome of the current HIV test. SELECT ONE.

• Point-of-Care rapid tests are used to screen for HIV antibodies, and typically have results within minutes. Most POC tests require a simple finger prick (blood test) or mouth swab (oral fluid).

• Laboratory-based tests are conducted on blood plasma or serum specimens by laboratory facilities to diagnose HIV-1 or HIV-2 infection.



CLIA-Waved Point-of-care Rapid Test Results (Select One)Preliminary positive: One or more of the same point-of-care rapid tests were reactive and none are non-reactive and no supplemental testing was done at your agency.Positive: Two or more different (orthogonal) point-of-care rapid tests are reactive and none are non-reactive and no laboratory-based supplemental testing was done.Negative: One or more point-of-care rapid tests are non-reactive and none are reactive and no supplemental testing was done.Discordant: One or more point-of-care rapid tests are reactive and one or more are non-reactive and no laboratory-based supplemental testing was done.Invalid: A CLIA-waved POC rapid test result cannot be confirmed due toconditions related to errors in the testing technology, specimen collection, or transport.



Laboratory-based Test Results (Select One)HIV-1 Positive: Positive for HIV type 1 infection. HIV-1 Positive, possible acute: Positive for HIV type 1 infection and is possibly an acute HIV infection. The term “acute” refers to the interval between the appearance of detectable HIV RNA and the first detection of anti-HIV antibodies. HIV-2 Positive: Positive for HIV type 2 infection. HIV Positive, undifferentiated: Positive for HIV infection. HIV antibodies could not be differentiated. HIV-1 Negative, HIV-2 inconclusive: Negative for HIV type 1 infection and HIV type 2 antibodies were not confirmed. HIV-1 Negative: Negative for HIV type 1 infection. HIV Negative: Negative for HIV infection. Inconclusive, further testing needed: HIV antibodies were not confirmed; further testing is needed.


Part 1, Section 5: Additional Tests

Note: Complete the STI screening questions only if an HIV test was conducted. If a client presents for STD testing only and no HIV test was administered, you do not need to provide responses to this set of questions. This information is to be reported only if an HIV test is conducted.

Tests for STIs: the client was tested for syphilis, gonorrhea, chlamydial infection, or Hepatitis C in conjunction with this HIV test.If the response is no, skip the rest to Section 6.


Part 1, Section 6: Essential Support Services

Essential support services are services or interventions aimed at reducing risk for transmitting or acquiring HIV infection by modifying a factor (e.g., housing, transportation, employment assistance, and education) or combination of factors that can contribute to risk (e.g., healthcare benefits, behavioral health, and other medical and social services).



Evidence-based Risk Reduction Intervention: information-based program designed to decrease the risk of contracting or transmitting HIV by providing information on HIV and STI risk reduction via culturally- and developmentally-appropriate individual or group sessions. For examples, refer to https://effectiveinterventions.cdc.gov

Behavioral Health Services: programs that help clients enroll in public or private programs promoting emotional health and prevention of mental illnesses and substance abuse disorders.

Social Services: a range of public services provided by the government, private, and non-profit organizations to enable, empower, and promote client welfare.

https://effectiveinterventions.cdc.gov/



Screen Determine Need Provide/Refer

SCREEN

Tester: “Are you in need of health benefits navigation and enrollment”

NEED DETERMINED

Client: “Yes.”

REFER

Tester: “Here is our Georgia CAPUS Resource Hub brochure and web address where you can find information about HIV, health benefits, behavioral health services, and social services in your area!”

PROVIDE*


Georgia CAPUS Resource Hub

www.gacapus.com

http://www.gacapus.com/


Part 2, Section 7: Risk Assessment

At Risk for HIV Infection: an indication of whether the client/patient is at risk for HIV infection based on an agency or jurisdiction’s risk assessment.

OHA defines “at risk” as having unprotected vaginal/anal sex, or sharing needles with someone of unknown or known HIV positive status.


Part 2, Section 8: PrEP Eligibility and Referral

PrEP Eligibility refers to a person’s status with regard to whether or not he or she meets appropriate criteria for using pre-exposure prophylaxis (PrEP); specifically, whether or not he or she is HIV-negative and at substantial risk for HIV, as defined by CDC in its guidelines for PrEP (https://www.cdc.gov/hiv/pdf/risk/prep/cdc-hiv-prep-guidelines-2017.pdf) and/or Georgia OHA’s PrEP Protocol and Screening Tool.

https://www.cdc.gov/hiv/pdf/risk/prep/cdc-hiv-prep-guidelines-2017.pdf



Referral to PrEP provider is a process involving the provision of information on who the

providers are, what documents referred person should take with them, how to get to the providers’ agency, and what to expect from the referral process. A person can be referred to a PrEP provider internally (to another unit or person within the same agency) or externally (e.g. a CBO may screen and identify eligible persons, and then refer them to a healthcare provider that offers PrEP services).



Screened for PrEP Eligibility: refers to whether an assessment was conducted to determine if he or she meets the appropriate criteria for using pre-exposure prophylaxis (PrEP). Use Form HIV 553: PrEP Screening Tool to conduct this assessment.

Eligible for PrEP Referral: an indication of whether the client/patient met the appropriate criteria for receiving a referral for PrEP. SELECT ONEDetermined by the three eligibility criteria listed in “Section D. PrEP Eligibility” of Form HIV 553: PrEPScreening Tool.



Referred to a PrEP Provider: an indication of whether the client/patient was given a referral to a PrEP provider. Option #2 in “Section E. PrEP Screening Outcomes” of Form HIV 553: PrEP Screening Tool.

Assistance with Linkage to a PrEP Provider: an indication of whether the client/patient was provided navigation or linkage services to assist with linkage to a PrEP provider.Option #3 in “Section E. PrEP Screening Outcomes” of Form HIV 553: PrEP Screening Tool.


Part 3, Section 9: Positive Test Result

Attended HIV Medical Care Appointment: indicate if the client/patient has seen a medical care provider for HIV treatment after this HIV test.

Ever Had a Positive HIV Test: indicate if HIV surveillance system or the client reports a previous positive HIV test or evidence of a previous positive test is found on review of other data sources.

“Date” Variables: calendar month, day, and year of client’s attended HIV medical care appointment after this positive test OR earliest know HIV positive test. Written – MM/DD/YYYY

Note: Enter 01/01/1800 if date is unknown. If the month and year are known, but the day is

unknown, enter the 15th of the month.



Behavioral Risk-reduction Counseling: an HIV prevention service directly aimed at reducing risk for transmitting or acquiring HIV infection.

Housing Status in Past 12 Months: client's self-report of the most unstable housing status in the past 12 months.

Contact Information for Partner Services: indicate if the client/patient's contact information was provided to the health department for partner services.Contact information includes name, address, phone number, and email address, as well as social media account names and handles.



Pregnancy and Screening1. Obtain the self-reported pregnancy status of a female

client with a preliminary or confirmed positive HIV test.

2. Obtain the self-reported status of the HIV-positive pregnant client's receipt of regular health care during pregnancy.

3. Screen the HIV-positive pregnant client for perinatal HIV service coordination needs by asking if she has both an obstetrician-gynecologist AND an HIV primary care provider.

4. The need for perinatal HIV service coordination is confirmed if the HIV-positive pregnant client does NOT have BOTH an obstetrician-gynecologist AND an HIV primary care provider.

5. Provide a referral to all HIV-positive pregnant clients in need of EITHER an obstetrician-gynecologist OR an HIV primary care provider.



*Screen Determine Need Provide/Refer*

(Simple Dialogue between Tester and Client)

Navigation Services for Linkage: refer to assisting clients with locating the right resources so they can be linked to HIV medical care.

Linkage Services: actually link the client to HIV medical care and may or may not be a service provided by your agency.

Medication Adherence Support: CDC-supported interventions that improve medication adherence and/or viral load among HIV patients who have been prescribed antiretroviral treatment.


Health Department Use Only

Notes and Definitions (eHARS)Encourage completion by those districts with access to

eHARS*

eHARS State Number: A unique state number assigned to each patient throughout the course of HIV infection assigned by the state in which they are reported.

• Note: Georgia OHA does NOT have eHARSCity/County Numbers DO NOT FILL THIS IN; LEAVE BLANK



Notes and Definitions (eHARS)

New or Previous Diagnosis: The indication of if the client/patient's HIV infection is a new diagnosis or if their infection was previously diagnosed.• New diagnosis, verified: HIV surveillance system did not

have a prior report AND there is no indication of a previous diagnosis by either client self-report or review of other data sources.

• New diagnosis, not verified: HIV surveillance system was NOT checked and the new diagnosis is based only on client self-report or review of other data sources.

• Previous diagnosis: Previously reported to the HIV surveillance system OR the client reports a previous positive HIV test OR evidence of a previous positive test is found on review of other data sources.

• Unable to determine: HIV surveillance system NOT checked AND no other data sources were reviewed AND there is no information from the client about previous HIV test results.



Notes and Definitions (SENDSS)

Partner Services Case Number: A unique case ID number assigned to each patient when initiating an interview record within SENDSS for STD partner notification services

• Note: The person associated with the case number should have record of a positive HIV test event



Notes and Definitions (SENDSS)

Interviewed for Partner Services: Indicates whether or not a client was interviewed for the purpose of HIV Partner Services by health department specialists or non-health department providers trained and authorized to conduct Partner Services interviews on behalf of the health department.


Local Use Fields

*All Local Use Fields are optional EXCEPT for Local Use Field 1, which is reserved for Worker ID. Other Local Use Fields should be used to document HIV Testing activities associated with National HIV Awareness Days (NHAD). *


Local Use Fields (NHADs)


Things to Remember

1. Sections 1-6 are to be completed for ALL persons.

2. Sections 7 & 8 are to be completed for persons testing NEGATIVE for HIV.

3. Sections 9, 10, and HD Use Only are to be complete for persons testing POSITIVE for HIV.

4. Form ID stickers are to be placed at the top of all completed pages of the test form.


Projected Timeline

• Test Template Training Available November 8th – 30th

• Security & Confidentiality Training November 14th

• Confirmation of Training December 3rd – 7th

• Official Roll-Out December 10th


Questions & Answers


Contact for Further Questions

Lisa Martin, MA, MPA

HIV Assistant Data Manager

[email protected]

Jamila Ealey, MPH

HIV Deputy Director

[email protected]

HIV Prevention Regional Coordinators

mailto:[email protected]

mailto:[email protected]

Office of HIV/AIDS GDPH 2018 HIV Test Template...

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