PS20-2010 and PS20-2004 Indicators Reporting Tables

The Performance Measures Project: Improving Performance Measurement and Monitoring by CDC Programs

Att 1_PS20-2010_PS20-2004 Indicators Reporting Tables 5-13-2021_DHAP_DSTDP_Final.xlsx

OMB: 0920-1282

Document [xlsx]
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Overview

DHAP_Testing_HC
DHAP_Testing_Corrections
DHAP_Testing_Venues
DHAP_Self-Test
DHAP_PrEP
DHAP_SSP
DHAP_Juris_spec
DSTDP_Extragen_Testing
DSTDP_Testing_HC
DSTDP_PrEP
DSTDP_Capacity


Sheet 1: DHAP_Testing_HC

Routine Testing in Prioritized Health Care Settings














Aggregate Data Tables for Diagnose Indicators 1A1.1A, 1A1.1B, and 1A1.1C: Percentage of persons tested for and diagnosed with HIV (new and previous positives) in health care facilities identified as a priority for routine opt-out screening.














Contextual Question (provide response in the PS20-2010 EPMP where indicated): Please briefly explain the 1) criteria used to select the PS20-2010-funded health care facilities that have been prioritized for routine opt-out screening and 2) how HIV screening is conducted in each facility.














The following data table should be completed for each EHE county and each of the 7 EHE states:














Table 1A1.A Routine Opt-Out HIV Testing in Prioritized Health Care Facilities: Enter the name of each prioritized health care facility in column A and select the facility type from the drop-down options in column B. In columns C through H, enter the requested aggregate data in cells labelled “DDE” (direct data entry). Please note that in Column D you will need to enter the total number of persons whose HIV test were directly funded or indirectly funded (e.g., EMR enhancements, testing staff, etc.) by PS20-2010. You may add additional rows as needed.

Table 1A1.B. Persons Tested and Positivity in Health Care Facilities Conducting Routine Opt-Out HIV Testing
Prioritized Health Care Facility Name Facility Type Number of Persons Served1
Number of HIV-positive Persons4 Previously Diagnosed HIV-positive Persons Newly Diagnosed HIV-positive Persons Confirmed in Surveillance5 Newly Diagnosed HIV-positive Persons Identified by Self-Report6


Total Number of Persons Served1 Number of Persons Tested2,3 Number of HIV-Positive Persons4 Previously Diagnosed Persons Newly Diagnosed HIV-positive Persons Confirmed in Surveillance5 Newly Diagnosed HIV-positive Persons Identified by Self-Report6


DDE DDE DDE DDE DDE DDE


N N % N % N % N % N %
% Calculated % Calculated % Calculated % Calculated % Calculated

Age Group


DDE DDE DDE DDE DDE DDE

<15 Years










% Calculated % Calculated % Calculated % Calculated % Calculated

15-19 Years












DDE DDE DDE DDE DDE DDE

20-29 Years










% Calculated % Calculated % Calculated % Calculated % Calculated

30-65 Years












DDE DDE DDE DDE DDE DDE

≥ 66 Years










% Calculated % Calculated % Calculated % Calculated % Calculated

Unknown












DDE DDE DDE DDE DDE DDE

Gender
% Calculated % Calculated % Calculated % Calculated % Calculated

Male










1 Includes persons, regardless of age, who attended at least one medical appointment at the health care facility during the reporting period.








Female










2 Includes tests that are supported in any way by PS20-2010-funded resources (e.g., funding, test kits, personnel, training and technical assistance, laboratory support, electronic medical record enhancements).

Transgender7










3 Includes persons who had a positive or negative test result.

Unknown










4 Includes newly and previously diagnosed infections and those with unknown prior history

Race and Hispanic Origin8
5 Includes newly identified HIV diagnosis that have been confirmed in surveillance. For persons included in this column, the HIV surveillance system is checked and 1) no prior report of HIV diagnosis is found and 2) there is no indication of a previous diagnosis by either client self-report (if the client was asked) or review of other data sources (if other data sources were checked).

Hispanic or Latino










6 Includes persons for whom a new diagnosis of HIV is determined by self-report or provider report.

Not Hispanic or Latino American Indian or Alaska Native alone










CDC Calculations for Percentages: Percentage of persons tested (Column D%)=(D#/C#)*100; Percentage of HIV-Positive Persons (Column E%)=(E#/D#)*100; Percentage of Previous HIV-Positives (Column F%)=(F#/D#)*100; New Positivity—Confirmed in Surveillance (Column G%)=(G#/D#)*100; New Positivity—Self Report (Column H%)=(H#/D#)*100.

Asian alone




















Black or African American alone




















Native Hawaiian or Pacific Islander alone




















White alone




















Two or more races




















Unknown




















Population Groups










MSM/IDU




















MSM




















PWID




















Heterosexual males




















Heterosexual females




















Other




















Unknown




















Total




















1 Includes persons who received one or more services at the health care facility during the reporting period.










2 Includes tests that are supported in any way by PS20-2010-funded resources (e.g., funding, test kits, personnel, training and technical assistance, laboratory support, electronic medical record enhancements).










3 Includes persons who had a positive or negative test result.





















4 Includes newly and previously diagnosed infections and those with unknown prior history





















5 Includes newly identified HIV diagnosis that have been confirmed in surveillance. For persons included in this column, the HIV surveillance system is checked and 1) no prior report of HIV diagnosis is found and 2) there is no indication of a previous diagnosis by either client self-report (if the client was asked) or review of other data sources (if other data sources were checked).










6 Includes self-report and provider report of new HIV diagnosis.





















7 Transgender includes all persons whose gender identity or expression is different from their sex assigned at birth. Transgender persons may self-identify as transgender female or transgender woman, transgender male or transgender man, or other gender non-binary person.










8Race and ethnicity are to be collected at the local level in accordance with OMB standards (https://www.govinfo.gov/content/pkg/FR-1997-10-30/pdf/97-28653.pdf) and reported to CDC in the aggregate using these categories. Hispanic or Latino persons can be of any race.










CDC Calculations for Percentages: Percentage of persons tested (Column B%)=(B#/A#)*100; Percentage of HIV-Positive Persons (Column C%)=(C#/B#)*100; Percentage of Previous HIV-Positives (Column D%)=(D#/B#)*100; New Positivity—Confirmed in Surveillance (Column E%)=(E#/B#)*100; New Positivity—Self Report (Column F%)=(F#/B#)*100.

Sheet 2: DHAP_Testing_Corrections

Routine Testing in Prioritized Jails and Correctional Facilities













Aggregate Data Tables for Diagnose Indicators 1A2.1A, 1A2.1B, 1A2.1C: Percentage of persons incarcerated in jails and correctional facilities who are tested for and diagnosed with HIV (new and previous positives).














Contextual Question (provide response in the PS20-2010 EPMP where indicated): Please briefly explain the 1) criteria used to select the prioritized PS20-2010-funded jails and correctional facilities and 2) how HIV screening is conducted in each facility.














The following data table should be completed for each EHE county and each of the 7 EHE states:





















Table 1A2.A Routine Opt-Out HIV Testing in Prioritized Jails and Correctional Facilities: Enter the name of each prioritized jail or correctional facility in column A and select when HIV screening is conducted from the drop-down options in column B. In columns C through G, enter the requested aggregate data in cells labelled “DDE” (direct data entry). Please note that in Column D you will need to enter the total number of persons whose HIV test were directly funded or indirectly funded (e.g., EMR enhancements, testing staff, etc.) by PS20-2010. You may add additional rows as needed.

Table 1A2.B. Persons Tested and Positivity in Jails and Correctional Facilities Conducting Routine Opt-Out HIV Testing
Prioritized Jail or Correctional Facility Name HIV Screening Conducted Number of Persons Incarcerated1 Number of Incarcerated Persons Tested2,3 Number of HIV-positive Persons4 Previously Diagnosed HIV-positive Persons Newly Diagnosed HIV-positive Persons Confirmed in Surveillance5 Newly Diagnosed HIV-positive Persons Identified by Self-Report6


Total Number of Persons Detained or Incarcerated1 Number of Persons Tested2,3 Number of HIV-Positive Persons4 Previously Diagnosed HIV-positive Persons Newly Diagnosed HIV-positive Persons Confirmed in Surveillance5 Newly Diagnosed HIV-positive Persons Identified by Self-Report6


DDE DDE DDE DDE DDE DDE


N N % N % N % N % N %
% Calculated % Calculated % Calculated % Calculated % Calculated

Age Group


DDE DDE DDE DDE DDE DDE

<15 Years










% Calculated % Calculated % Calculated % Calculated % Calculated

15-19 Years












DDE DDE DDE DDE DDE DDE

20-29 Years










% Calculated % Calculated % Calculated % Calculated % Calculated

30-65 Years












DDE DDE DDE DDE DDE DDE

≥ 66 Years










% Calculated % Calculated % Calculated % Calculated % Calculated

Unknown












DDE DDE DDE DDE DDE DDE

Gender
% Calculated % Calculated % Calculated % Calculated % Calculated

Male










[1] Includes persons detained or incarcerated at the prioritized jail or correctional facility during the reporting period.

Female










2 Includes tests that are supported in any way by PS20-2010-funded resources (e.g., funding, test kits, personnel, training and technical assistance, laboratory support, electronic medical record enhancements).

Transgender7










3 Includes persons who received at least one HIV test during their detainment or incarceration. Testing can occur at intake, release, or any time during detainment or incarceration. If HIV testing occurs more than once during detainment or incarceration, then report results from most recent HIV test.

Unknown










4 Includes newly and previously diagnosed infections and those with unknown prior history.

Race and Hispanic Origin8
5 Includes newly identified HIV diagnosis that have been confirmed in surveillance. For persons included in this column, the HIV surveillance system is checked and 1) no prior report of HIV diagnosis is found and 2) there is no indication of a previous diagnosis by either client self-report (if the client was asked) or review of other data sources (if other data sources were checked).

Hispanic or Latino










6 Includes self-report and provider report of new HIV diagnosis.

Not Hispanic or Latino American Indian or Alaska Native alone










CDC Calculations for Percentages: Percentage of persons tested (Column D%)=(D#/C#)*100; Percentage of HIV-Positive Persons (Column E%)=(E#/D#)*100; Percentage of Previous HIV-Positives (Column F%)=(F#/D#)*100; New Positivity—Confirmed in Surveillance (Column G%)=(G#/D#)*100; New Positivity—Self Report (Column H%)=(H#/D#)*100.

Asian alone




















Black or African American alone




















Native Hawaiian or Pacific Islander alone




















White alone




















Two or more races




















Unknown




















Population Groups










MSM/IDU




















MSM




















PWID




















Heterosexual males




















Heterosexual females




















Other




















Unknown




















Total




















1 Includes persons detained or incarcerated at the prioritized jail or correctional facility during the reporting period.





















2 Includes tests that are supported in any way by PS20-2010-funded resources (e.g., funding, test kits, personnel, training and technical assistance, laboratory support, electronic medical record enhancements).










3 Includes persons who had a positive or negative test result.










4 Includes newly and previously diagnosed infections and those with unknown prior history










5 Includes newly identified HIV diagnosis that have been confirmed in surveillance. For persons included in this column, the HIV surveillance system is checked and 1) no prior report of HIV diagnosis is found and 2) there is no indication of a previous diagnosis by either client self-report (if the client was asked) or review of other data sources (if other data sources were checked).










6 Includes self-report and provider report of new HIV diagnosis.










7 Transgender’ includes all persons whose gender identity or expression is different from their sex assigned at birth. Transgender persons may self-identify as transgender female or transgender woman, transgender male or transgender man, or other gender non-binary person.










8Race and ethnicity are to be collected at the local level in accordance with OMB standards (https://www.govinfo.gov/content/pkg/FR-1997-10-30/pdf/97-28653.pdf) and reported to CDC in the aggregate using these categories. Hispanic or Latino persons can be of any race.










CDC Calculations for Percentages: Percentage of persons tested (Column B%)=(B#/A#)*100; Percentage of HIV-Positive Persons (Column C%)=(C#/B#)*100; Percentage of Previous HIV-Positives (Column D%)=(D#/B#)*100; New Positivity—Confirmed in Surveillance (Column E%)=(E#/B#)*100; New Positivity—Self Report (Column F%)=(F#/B#)*100.

Sheet 3: DHAP_Testing_Venues

Testing in Non-Traditional Venues:





















Aggregate Data Tables for Diagnose Indicators 1B1.1A, 1B1.1B, and 1B1.1C: Percentage of HIV-positive tests (new and previous positives) in non-traditional venues identified as a priority for EHE testing services.















Contextual Question 1B1 (provide response in the PS20-2010 EPMP where indicated): Please list and briefly describe the non-traditional testing venues where PS20-2010- funded testing is conducted.















The following data table should be completed for each EHE county and each of the 7 EHE states:





















Table 1B1.A Testing in Non-Traditional Venues: Enter the name of each non-traditional venue category in column A and select setting type (health care or non-healthcare) from the drop-down options in column B. In columns C through F, enter the requested aggregate data in cells labelled “DDE” (direct data entry). You may add additional rows as needed.


Table 1B1.B HIV Testing and Positive Tests in Non-Traditional Venues
Non-Traditional Venue Category1 Setting Type Number of Tests Number of HIV-positive Tests2 Previously Diagnosed HIV-positive Persons Newly Diagnosed HIV-positive Persons Confirmed in Surveillance3 Newly Diagnosed HIV-positive Persons Identified by Self-Report4



Number of HIV Tests Number of HIV-positive Tests1 Number of Previously Diagnosed HIV-positive Persons Newly Diagnosed HIV-positive Persons Confirmed in Surveillance2 Newly Diagnosed HIV-positive Persons Identified by Self-Report3 Test Result Unknown


DDE DDE DDE DDE DDE



N N % N % N % N % N %
% Calculated % Calculated % Calculated % Calculated


Age Group


DDE DDE DDE DDE DDE


<15 Years










% Calculated % Calculated % Calculated % Calculated


15-19 Years












DDE DDE DDE DDE DDE


20-29 Years










% Calculated % Calculated % Calculated % Calculated


30-65 Years












DDE DDE DDE DDE DDE


≥ 66 Years










% Calculated % Calculated % Calculated % Calculated


Unknown












DDE DDE DDE DDE DDE


Test Setting
% Calculated % Calculated % Calculated % Calculated


Health Care Setting










1 Aggregate counts for each non-traditional venue category (e.g., retail, pharmacy, mobile, etc.) should be reported in this column. For example, a recipient conducting HIV testing in 6 different non-traditional pharmacy venues (e.g., CVS, Walgreens, Rite AID, etc.) and 7 different retail venues (e.g., Ross, Marshalls, Dollar General etc.) would report aggregate counts for two non-traditional venue categories—pharmacy and retail. Recipients will not need to report individual aggregate counts for each of the 13 venues noted in the example.


Non-Heath Care Setting










2 Includes newly and previously diagnosed infections and those with unknown prior history








Unknown










3 Includes newly identified HIV diagnosis that have been confirmed in surveillance. For persons included in this column, the HIV surveillance system is checked and 1) no prior report of HIV diagnosis is found and 2) there is no indication of a previous diagnosis by either client self-report (if the client was asked) or review of other data sources (if other data sources were checked).


Testing History
4 Includes self-report and provider report of new HIV diagnosis.








First-Time Tester










CDC Calculations for Percentages: Percentage of HIV-Positive Persons (Column D%)=(D#/C#)*100; Percentage of Previous HIV-Positives (Column E%)=(E#/C#)*100; New Positivity—Confirmed in Surveillance (Column F%)=(F#/C#)*100; New Positivity—Self Report (Column H%)=(G#/C#)*100.


Repeat Tester










*Drop down options: healthcare setting, non-healthcare setting.








Unknown




















Gender










Male




















Female




















Transgender4




















Unknown




















Race and Hispanic Origin5










Hispanic or Latino




















Not Hispanic or Latino American Indian or Alaska Native alone




















Asian alone




















Black or African American alone




















Native Hawaiian or Pacific Islander alone




















White alone




















Two or more races




















Unknown




















Population Groups










MSM/IDU




















MSM




















PWID




















Heterosexual males




















Heterosexual females




















Other




















Unknown




















Total




















1 Includes newly and previously diagnosed infections and those with unknown prior history





















2 Includes newly identified HIV diagnosis that have been confirmed in surveillance. For persons included in this column, the HIV surveillance system is checked and 1) no prior report of HIV diagnosis is found and 2) there is no indication of a previous diagnosis by either client self-report (if the client was asked) or review of other data sources (if other data sources were checked).










3 Includes self-report and provider report of new HIV diagnosis.










4 Transgender’ includes all persons whose gender identity or expression is different from their sex assigned at birth. Transgender persons may self-identify as transgender female or transgender woman, transgender male or transgender man, or other gender non-binary person.










5Race and ethnicity are to be collected at the local level in accordance with OMB standards (https://www.govinfo.gov/content/pkg/FR-1997-10-30/pdf/97-28653.pdf) and reported to CDC in the aggregate using these categories. Hispanic or Latino persons can be of any race.













CDC Calculations for Percentages: Percentage of HIV-Positive Persons (Column B%)=(B#/A#)*100; Percentage of Previous HIV-Positives (Column C%)=(C#/A#)*100; New Positivity—Confirmed in Surveillance (Column D%)=(D#/A#)*100; New Positivity—Self Report (Column E%)=(E#/A#)*100; Percentage of Test with Unknown Result (Column F%)=(F#/A#)*100.

Sheet 4: DHAP_Self-Test

HIV Self-Test











Aggregate Data Tables for Diagnose indicators 1B2.1 and 1C4.1: Number of HIV self-test kits distributed in health care settings and non-health care settings and number of persons who received at least one HIV self-test kit.
Contextual Question (provide response in the PS20-2010 EPMP where indicated): Please briefly describe how HIV self-test kits funded by PS20-2010 are distributed to or ordered by testers. Please indicate if, and how test results are provided to the health department.
The following data table should be completed for each EHE county and each of the 7 EHE states:
Table 1C4. HIV Self-Tests and Positive Tests

Number of HIV Self-Test Kits Distributed Number of Persons Receiving ≥ 1 HIV Self-Test Kit Newly Diagnosed HIV-positive Persons Confirmed in Surveillance1 Newly Diagnosed HIV-positive Persons Identified by Self-Report2 Previously Diagnosed HIV Infection Test Result Unknown

N N %
N %
N %
N % N %
Age Group
<15 Years










15-19 Years










20-29 Years










30-65 Years










≥ 66 Years










Unknown










Test Setting
Health Care Setting










Non-Heath Care Setting










Unknown










Testing History
First-Time Tester










Repeat Tester










Unknown










Gender 
Male










Female










Transgender3 










Unknown










Race and Hispanic Origin4
Hispanic or Latino










Not Hispanic or Latino American Indian or Alaska Native alone










Asian alone










Black or African American alone










Native Hawaiian or Pacific Islander alone










White alone










Two or more races










Unknown










Population Groups
MSM/IDU










MSM










PWID










Heterosexual males










Heterosexual females










Other










Unknown










Total










1 Includes newly identified HIV diagnosis that have been confirmed in surveillance. For persons included in this column, the HIV surveillance system is checked and 1) no prior report of HIV diagnosis is found and 2) there is no indication of a previous diagnosis by either client self-report (if the client was asked) or review of other data sources (if other data sources were checked).
2 Includes self-report and provider report of new HIV diagnosis.











3 Transgender’ includes all persons whose gender identity or expression is different from their sex assigned at birth. Transgender persons may self-identify as transgender female or transgender woman, transgender male or transgender man, or other gender non-binary person.
4Race and ethnicity are to be collected at the local level in accordance with OMB standards (https://www.govinfo.gov/content/pkg/FR-1997-10-30/pdf/97-28653.pdf) and reported to CDC in the aggregate using these categories. Hispanic or Latino persons can be of any race.
CDC Calculations for Percentages: Percentage of Persons Receiving at least 1 HIV Self-Test Kit (Column B%)=(B#/A#)*100; New Positivity—Confirmed in Surveillance (Column C%)=(C#/B#)*100; New Positivity—Self Report (Column D%)=(D#/B#)*100; Percentage of Previous HIV-Positives (Column E%)=(E#/B#)*100; Percentage of Test with Unknown Result (Column F%)=(F#/B#)*100

Sheet 5: DHAP_PrEP

Provision of PrEP Services:











Data should include all PrEP services funded by PS20-2010 regardless of the funding source for the HIV test. PrEP data will be reported as a cascade and will be calculated as specified in the numerator and denominator for each indicator (see Prevent Table in the PS20-2010 EPMP).

Aggregate Data Tables for Prevent Indicator 3A1.3: Number and percentage of HIV-negative persons who are linked to a PrEP provider

Note: PrEP cascade is reported as follows:











The following data table should be completed for each EHE county and each of the 7 EHE states:











Table 3A1. PrEP in STD Clinics

HIV-Negative Persons1 Screened for PrEP Need2,3 Eligible for PrEP Referral4,5 Referred to PrEP Provider6,7 Linked to a PrEP Provider8,9 Prescribed PrEP10,11

N N % N % N % N % N %
Age Group
<15 Years










15-19 Years










20-29 Years










30-65 Years










≥ 66 Years










Unknown










Test Setting
STD Clinic










Other Health Care Setting










Non-Heath Care Setting










Unknown










Gender
Male










Female










Transgender12










Unknown










Race and Hispanic Origin13
Hispanic or Latino










Not Hispanic or Latino American Indian or Alaska Native alone










Asian alone










Black or African American alone










Native Hawaiian or Pacific Islander alone










White alone










Two or more races










Unknown










Population Groups
MSM/IDU










MSM










PWID










Heterosexual males










Heterosexual females










Other










Unknown










Total










1 Includes HIV-negative persons who received HIV testing or PrEP services (e.g., screening, referral, linkage, prescription) that were in any way supported by PS20-2010 funds. Denominator for Column B

2,3 Screening for PrEP eligibility is the process of conducting an initial assessment regarding a person’s eligibility (e.g., behavioral risk screening) for pre-exposure prophylaxis (PrEP) and determining whether a more thorough evaluation is warranted. A person is screened if an initial assessment of eligibility for PrEP services is completed. For further discussion on PrEP screening, see Centers for Disease Control and Prevention: US Public Health Service: Preexposure prophylaxis for the prevention of HIV infection in the United States—2017 Update: a clinical practice guideline. https://www.cdc.gov/hiv/pdf/risk/prep/cdc-hiv-prep-guidelines-2017.pdf3Denominator is Column A (number of HIV-negative persons). All persons reflected in Column B should also be reflected in Column A.

4 Eligible for PrEP Referral refers to a person’s status with regard to whether or not he or she meets appropriate criteria for using PrEP; specifically, whether or not he or she is HIV-negative and at risk for HIV, as defined locally or by CDC guidelines for Prep

5Denominator is Column B (number of persons screened for PrEP). Persons reported as eligible for PrEP referral are those who have sexual or drug risk behaviors. These individuals should also be reflected in the counts reported for columns A-B.

6 Referral to a 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 provider’s agency, and what to expect from the referral process.

7 Denominator is Column C (number of persons eligible for PrEP). Persons who are referred to a PrEP provider should also be reflected in the counts reported for columns A-C.

8 Linkage to PrEP provider is the process through which a person at risk for becoming infected with HIV is helped to access a healthcare provider who offers evaluation and management for PrEP. Linked to a PrEP provider refers to the outcome of the referral or linkage of a PrEP eligible person to a PrEP provider, as indicated by the person’s attendance at the first appointment and verified through reviews of medical records or other data systems or self-report by the client.

9 Denominator is Column D (number of persons referred). Persons who are linked to a PrEP provider should also be reflected in the counts reported for columns A-D.

10 Prescribed PrEP refers to a person who has been adequately evaluated and received a prescription for PrEP. Prescription information may come from clinical records, pharmacy data, or self-report by client.

11 Denominator is Column E (number of persons linked to PrEP). Persons who are prescribed PrEP should also be reflected in the counts reported for columns A-E.

12 ‘Transgender’ includes all persons whose gender identity or expression is different from their sex assigned at birth. Transgender persons may self-identify as transgender female or transgender woman, transgender male or transgender man, or other gender non-binary person.

13Race and ethnicity are to be collected at the local level in accordance with OMB standards (https://www.govinfo.gov/content/pkg/FR-1997-10-30/pdf/97-28653.pdf) and reported to CDC in the aggregate using these categories. Hispanic or Latino persons can be of any race.

CDC Calculations for Percentages: Percentage of Persons Screened for PrEP (Column B)=(B#/A#))*100; Percentage of Persons Eligible for PrEP (Column C)=(C#/B#))*100; Percentage of Persons Referred for PrEP (Column D)=(D#/C#))*100; Percentage of Persons Linked to a PrEP Provider (Column E)=(E#/D#))*100; Percentage of Persons Prescribed PrEP (Column F)=(F#/E#)*100.


Sheet 6: DHAP_SSP

Linkage to SSP:








Syringe Services Program (SSP) Locations and Service Provision:





Aggregate Data Tables for Diagnose Indicators 1A5.1, 1B4.3: Percentage of persons who inject drugs (PWID) tested for HIV in an STD clinic or non-health care setting who are linked to a syringe services program (SSP).


Aggregate Data Tables for Prevent indicators 3B1.1: Number of SSPs operating in the jurisdiction

The following data table should be completed for each EHE county and each of the 7 EHE states:


The following data table should be completed for each EHE county and each of the 7 EHE states:

Table 1A5.1A PWID Tested for HIV and Linked to SSP


Table 3B1.A SSPs in the jurisdiction


Total Number of PWID Screened for HIV Referred to SSP1 Linked to SSP2


Total Number of SSPs Operating in the Jurisdiction Number of Fixed Site SSP Locations Number of Mobile/Outreach SSP Locations


N N % N %


N N % N %

Age Group







DDE DDE Calculated DDE Calculated

<15 Years







CDC Calculations for Percentages: Percentage of Fixed Location SSP (Column B)=(B#/A#))*100; Percentage of Mobile/Outreach Location SSP (Column C)=(C#/A#)*100.

15-19 Years














20-29 Years














30-65 Years







Aggregate Data Tables for Treat indicators 3B1.2: Number of encounters that received at least one standard SSP service
≥ 66 Years







Contextual Question (provide response in the PS20-2010 EPMP where indicated): Please list and briefly describe the services provided by each of the SSPs operating in your jurisdiction. If the SSP provides outreach services, please briefly describe the method(s) used to conduct outreach (e.g. mobile vans, delivery services, etc.).
Unknown







Aggregate Data Collection (DDE= direct data entry):





Test Setting


Table 3B1.B Provision of Standard SSP Services in the jurisdiction
STD Clinic







Total Number of SSP Encounters SSP Encounters with 1 or more Standard Services Provided1
Other Health Care Setting








Non-heath Care Setting







Number of SSP Encounters with 1 or more Standard Services Provided1 Number of Encounters at Fixed Site SSP Locations Number of Encounters via Mobile/Outreach SSP Locations
Gender


N N N % N %
Male







DDE DDE DDE Calculated DDE Calculated
Female







1 Sterile needles, syringes, injection equipment; condoms; syringe disposal; HIV testing; linkage to HIV care ≤30 days of diagnosis; HCV testing; linkage to HCV care; linkage to a PrEP provider; Naloxone distribution, linkage to mediation-assistance treatment; infectious disease prevention, detection, care, and treatment; substance use disorder care and treatment; essential support services.
Transgender3







CDC Calculations for Percentages: Percentage of Encounters at Fixed Location SSP (Column B)=(B#/A#))*100; Percentage of Encounters at Mobile/Outreach Location SSP (Column C)=(C#/A#)*100.
Unknown














Race and Hispanic Origin4









Hispanic or Latino







Aggregate Data Tables for Treat indicators 3B3.1





Not Hispanic or Latino American Indian or Alaska Native alone







Table 3B3.1 SSPs providing or actively referring to key SSP services
Asian alone







Black or African American alone







Total Number of SSPs Operating in the Jurisdiction Provide/Actively Refer to Infectious Disease Prevention, Detection, Care, and Treatment Provide/Actively Refer to Substance Use Disorder Care and Treatment Provide/Actively Refer to Essential Support Services
Native Hawaiian or Pacific Islander alone







N N % N % N %
White alone







Calculated DDE Calculated DDE Calculated DDE Calculated
Two or more races







CDC Calculations for Percentages: Percentage of SSP Providing/Referring to Infectious Disease, Prevention, Detection, Care, and Treatment (Column B)=(B#/A#))*100; Percentage of SSP Providing/Referring to Substance Use Care and Treatment(Column C)=(C#/A#)*100; Percentage of SSP Providing/Referring to Essential Support Services (Column D)=(D#/A#)*100 .
Unknown














Population Groups














MSM














Heterosexual males














Heterosexual females














Other














Unknown














Total














1 Persons who are linked to an SSP are those who attend an appointment at the SSP where they are seen by a provider. Linkage to an SSP may be determined by provider report, record review, or client self-report.









2Active referrals to SSP may include, but are not limited to, activities such as making appointments for the client, providing transportation, using a case manager or peer navigator to help with access to services, providing the organization to which the client is referred with information collected about the client, etc.









3‘Transgender’ includes all persons whose gender identity or expression is different from their sex assigned at birth. Transgender persons may self-identify as transgender female or transgender woman, transgender male or transgender man, or other gender non-binary person.









4Race and ethnicity are to be collected at the local level in accordance with OMB standards (https://www.govinfo.gov/content/pkg/FR-1997-10-30/pdf/97-28653.pdf) and reported to CDC in the aggregate using these categories. Hispanic or Latino persons can be of any race.









CDC Calculations for Percentages: Percentage of PWID Referred to SSP (Column B)=(B#/A#))*100; Percentage of PWID Linked to SSP (Column C)=(C#/B#)*100.










Sheet 7: DHAP_Juris_spec

Integrated HIV Screening

TelePrEP

Navigator Assistance for HIV/STD Screenings/PrEP/SSP

Social Marketing Campaigns






Aggregate Data Table for Integrated Screening Indicator J1: Percentage of HIV screenings conducted that are integrated with other screenings (i.e., viral hepatitis/TB/STD).

Aggregate Data Table for TelePrEP Indicator J2: Percentage of persons who received TelePrEP services

Aggregate Data Table for Navigator Assistance Indicator J3: Percentage of persons who were linked to HIV/STD screenings/PrEP/SSP with the assistance of navigators

Aggregate Data Table for Social Marketing Indicator J4: Percentage of impressions from social marketing campaign(s) advertising conducted in HIV/STD screenings/PrEP/SSP (e.g., print; digital/internet-based; radio; television; out-of-home advertising) targeting specified priority groups (e.g., MSM, youth, MSM of color, Hispanics/Latinos, Blacks/African Americans, and Transgender persons)
Contextual Question (provide response in the APR and EOY): Please briefly describe where and how integrated screening funded under PS20-2010 is conducted.







Contextual Question J4 (provide response in the APR and EOY): Please list and briefly describe the PS20-2010-funded social marketing campaign that was conducted
The following data table should be completed for each EHE county and each of the 7 EHE states

The following data table should be completed for each EHE county and each of the 7 EHE states

The following data table should be completed for each EHE county and each of the 7 EHE states

The following data table should be completed for each EHE county and each of the 7 EHE states:
(DDE= direct data entry):

(DDE= direct data entry):

(DDE= direct data entry):

(DDE= direct data entry):
Table J1: Percentage of HIV screenings conducted that are integrated with other screenings (i.e., viral hepatitis/TB/STD).

Table J2: Percentage of persons who received TelePrEP services

Table J3: Percentage of persons who were linked to HIV/STD screenings/PrEP/SSP with the assistance of navigators

Table J4: Percentage of impressions from social marketing campaign(s) advertising conducted in HIV/STD screenings/PrEP/SSP

Number of HIV Tests Number of HIV tests integrated with viral hepatitis tests1 Number of HIV tests integrated with TB tests2 Number of HIV tests integrated with STD tests3


Persons who received PrEP Services1 Persons who received TelePrEP Services2


Number of persons who received navigator assistance for HIV/STD screenings Number of persons screened for HIV/STD Number of persons who received navigator assistance for PrEP Number of persons who were linked to PrEP Provider1 Number of persons who received navigator assistance for SSP services Number of persons who were linked to SSP services2

Social Marketing Campaign Name Advertising Type 2
Priority Group 3
Number of overall impressions4 Number of unique impressions Number of persons in the priority group Number of overall impressions specific to priority group Number of unique impressions specific to priority group






Age Group N N % N % N %

Age Group N N %

Age Group N N % N N % N N %


N N N N % N %
<15 Years DDE DDE DDE DDE

<15 Years DDE DDE

<15 Years DDE DDE DDE DDE DDE DDE




DDE DDE DDE DDE DDE
% Calculated % Calculated % Calculated

% Calculated

% Calculated
% Calculated % Calculated


% Calculated % Calculated
15-19 Years DDE DDE DDE DDE

15-19 Years DDE DDE

15-19 Years DDE DDE DDE DDE DDE DDE




DDE DDE
DDE DDE
% Calculated % Calculated % Calculated

% Calculated

% Calculated
% Calculated % Calculated



DDE % Calculated % Calculated
20-29 Years DDE DDE DDE DDE

20-29 Years DDE DDE

20-29 Years DDE DDE DDE DDE DDE DDE




DDE DDE
DDE DDE
% Calculated % Calculated % Calculated

% Calculated

% Calculated % Calculated % Calculated



DDE % Calculated % Calculated
30-65 Years DDE DDE DDE DDE

30-65 Years DDE DDE

30-65 Years DDE DDE DDE DDE DDE DDE




DDE DDE
DDE DDE
% Calculated % Calculated % Calculated

% Calculated

% Calculated % Calculated % Calculated



DDE % Calculated % Calculated
≥ 66 Years DDE DDE DDE DDE

≥ 66 Years DDE DDE

≥ 66 Years DDE DDE DDE DDE DDE DDE




DDE DDE
DDE DDE
% Calculated % Calculated % Calculated

% Calculated

% Calculated % Calculated % Calculated



DDE % Calculated % Calculated
Unknown DDE DDE DDE DDE

Unknown DDE DDE

Unknown DDE DDE DDE DDE DDE DDE

1 Out-of-home (OOH) advertising is also known as outdoor advertising or outdoor media and is generally advertising experienced outside of the home. These include billboards, transit ads on buses or trains, wallscapes, and posters that may be seen while “on the go” or in the community. This may also include “place-based” advertising, such as those in medical centers, airports, stores, or other buildings or facilities.
% Calculated % Calculated % Calculated

% Calculated

% Calculated % Calculated % Calculated

2 Includes print advertising; digital/internet-based advertising; radio advertising; television; out-of-home
Test Setting

Test Setting



Test Setting

3 Includes MSM; youth; MSM of color; Hispanics/Latinos; Blacks/African Americans; Transgender persons; other group(s) (specified by recipient).
STD Clinic DDE DDE DDE DDE

STD Clinic DDE DDE

STD Clinic DDE DDE DDE DDE DDE DDE

4 In this column report the total number of impressions for advertising activities targeted to the specific demographic group of interest in the campaign. Counts reported in this column may reflect repeated exposures to messaging/advertising.
% Calculated % Calculated % Calculated

% Calculated

% Calculated % Calculated % Calculated

Calculation: Overall impressions specific to population group (Column G%) =(G#/F)*100; Unique impressions specific to population group (Column H%) =(H#/F)*100.
Other Health Care Setting DDE DDE DDE DDE

Other Health Care Setting DDE DDE

Other Health Care Setting DDE DDE DDE DDE DDE DDE









% Calculated % Calculated % Calculated

% Calculated

% Calculated % Calculated % Calculated









Non-heath Care Setting DDE DDE DDE DDE

Non-Heath Care Setting DDE DDE

Non-heath Care Setting DDE DDE DDE DDE DDE DDE









% Calculated % Calculated % Calculated

% Calculated

% Calculated % Calculated % Calculated









Gender

Gender



Gender















Male DDE DDE DDE DDE

Male DDE DDE

Male DDE DDE DDE DDE DDE DDE









% Calculated % Calculated % Calculated

% Calculated

% Calculated % Calculated % Calculated









Female DDE DDE DDE DDE

Female DDE DDE

Female DDE DDE DDE DDE DDE DDE









% Calculated % Calculated % Calculated

% Calculated

% Calculated % Calculated % Calculated









Transgender4 DDE DDE DDE DDE

Transgender3 DDE DDE

Transgender3 DDE DDE DDE DDE DDE DDE









% Calculated % Calculated % Calculated

% Calculated

% Calculated % Calculated % Calculated









Unknown DDE DDE DDE DDE

Unknown DDE DDE

Unknown DDE DDE DDE DDE DDE DDE









% Calculated % Calculated % Calculated

% Calculated

% Calculated % Calculated % Calculated









Race and Hispanic Origin5

Race and Hispanic Origin4



Race and Hispanic Origin4















Hispanic or Latino DDE DDE DDE DDE

Hispanic or Latino DDE DDE

Hispanic or Latino DDE DDE DDE DDE DDE DDE









% Calculated % Calculated % Calculated

% Calculated

% Calculated % Calculated % Calculated









Not Hispanic or Latino American Indian or Alaska Native alone DDE DDE DDE DDE

Not Hispanic or Latino American Indian or Alaska Native alone DDE DDE

Not Hispanic or Latino American Indian or Alaska Native alone DDE DDE DDE DDE DDE DDE









% Calculated % Calculated % Calculated

% Calculated

% Calculated % Calculated % Calculated









Asian alone DDE DDE DDE DDE

Asian alone DDE DDE

Asian alone DDE DDE DDE DDE DDE DDE









% Calculated % Calculated % Calculated

% Calculated

% Calculated % Calculated % Calculated









Black or African American alone DDE DDE DDE DDE

Black or African American alone DDE DDE

Black or African American alone DDE DDE DDE DDE DDE DDE









% Calculated % Calculated % Calculated

% Calculated

% Calculated % Calculated % Calculated









Native Hawaiian or Pacific Islander alone DDE DDE DDE DDE

Native Hawaiian or Pacific Islander alone DDE DDE

Native Hawaiian or Pacific Islander alone DDE DDE DDE DDE DDE DDE









% Calculated % Calculated % Calculated

% Calculated

% Calculated % Calculated % Calculated









White alone DDE DDE DDE DDE

White alone DDE DDE

White alone DDE DDE DDE DDE DDE DDE









% Calculated % Calculated % Calculated

% Calculated

% Calculated % Calculated % Calculated









Two or more races DDE DDE DDE DDE

Two or more races DDE DDE

Two or more races DDE DDE DDE DDE DDE DDE









% Calculated % Calculated % Calculated

% Calculated

% Calculated % Calculated % Calculated









Unknown DDE DDE DDE DDE

Unknown DDE DDE

Unknown DDE DDE DDE DDE DDE DDE









% Calculated % Calculated % Calculated

% Calculated

% Calculated % Calculated % Calculated









Population Groups

Population Groups

Population Groups









MSM/IDU DDE DDE DDE DDE

MSM/IDU DDE DDE

MSM/IDU DDE DDE DDE DDE DDE DDE









% Calculated % Calculated % Calculated

% Calculated

% Calculated % Calculated % Calculated









MSM DDE DDE DDE DDE

MSM DDE DDE

MSM DDE DDE DDE DDE DDE DDE









% Calculated % Calculated % Calculated

% Calculated

% Calculated % Calculated
% Calculated









PWID DDE DDE DDE DDE

PWID DDE DDE

PWID DDE DDE DDE DDE DDE DDE









% Calculated % Calculated % Calculated

% Calculated

% Calculated % Calculated
% Calculated









Heterosexual males DDE DDE DDE DDE

Heterosexual males DDE DDE

Heterosexual males DDE DDE DDE DDE DDE DDE









% Calculated % Calculated % Calculated

% Calculated

% Calculated % Calculated % Calculated









Heterosexual females DDE DDE DDE DDE

Heterosexual females DDE DDE

Heterosexual females DDE DDE DDE DDE DDE DDE









% Calculated % Calculated % Calculated

% Calculated

% Calculated % Calculated % Calculated









Other DDE DDE DDE DDE

Other DDE DDE

Other DDE DDE DDE DDE DDE DDE









% Calculated % Calculated % Calculated

% Calculated

% Calculated % Calculated % Calculated









Unknown DDE DDE DDE DDE

Unknown DDE DDE

Unknown DDE DDE DDE DDE DDE DDE









% Calculated % Calculated % Calculated

% Calculated

% Calculated % Calculated % Calculated









Total





Total



Total















% Calculated % Calculated % Calculated

% Calculated

% Calculated % Calculated % Calculated









1 Includes HIV tests conducted along with Hepatitis C tests






1 An outcome of the referral or linkage of a PrEP eligible person to a PrEP provider, indicated by attendance at the first appointment and verified through reviews of medical records or other data systems or self-report by the client.



















2 Includes HIV tests conducted along with Tuberculosis tests






2 An outcome of the referral or linkage of a PrEP eligible person to a PrEP provider, indicated by attendance at the first telehealth appointment and verified through reviews of medical records or other data systems or self-report by the client. Denominator is Column A (number of persons who received PrEP services).

1 An outcome of the referral or linkage of a PrEP eligible person by navigators to a PrEP provider, indicated by attendance at the first appointment and verified through reviews of medical records or other data systems or self-report by the client.









3 Includes HIV tests conducted along with tests for other sexually transmitted diseases (syphilis, gonorrhea, and chlamydia)

3 Transgender’ includes all persons whose gender identity or expression is different from their sex assigned at birth. Transgender persons may self-identify as transgender female or transgender woman, transgender male or transgender man, or other gender non-binary person.

2 An encounter at an SSP to receive SSP services including Sterile needles, syringes, injection equipment; condoms; syringe disposal; HIV testing; linkage to HIV care ≤30 days of diagnosis; HCV testing; linkage to HCV care; linkage to a PrEP provider; Naloxone distribution, linkage to mediation-assistance treatment; infectious disease prevention, detection, care, and treatment; substance use disorder care and treatment; essential support services









4 Transgender’ includes all persons whose gender identity or expression is different from their sex assigned at birth. Transgender persons may self-identify as transgender female or transgender woman, transgender male or transgender man, or other gender non-binary person.

4Race and ethnicity are to be collected at the local level in accordance with OMB standards (https://www.govinfo.gov/content/pkg/FR-1997-10-30/pdf/97-28653.pdf) and reported to CDC in the aggregate using these categories. Hispanic or Latino persons can be of any race.

3 ‘Transgender’ includes all persons whose gender identity or expression is different from their sex assigned at birth. Transgender persons may self-identify as transgender female or transgender woman, transgender male or transgender man, or other gender non-binary person.









5Race and ethnicity are to be collected at the local level in accordance with OMB standards (https://www.govinfo.gov/content/pkg/FR-1997-10-30/pdf/97-28653.pdf) and reported to CDC in the aggregate using these categories. Hispanic or Latino persons can be of any race.

CDC Calculation: Percentage of HIV-Viral Hepatitis Integrated Tests (Column C%) =(C#/B)*100; HIV-TB Integrated Tests (Column D%)=(D#/B)*100; Percentage of HIV-STD Integrated Tests (Column E%)=(E#/B)*100

4Race and ethnicity are to be collected at the local level in accordance with OMB standards (https://www.govinfo.gov/content/pkg/FR-1997-10-30/pdf/97-28653.pdf) and reported to CDC in the aggregate using these categories. Hispanic or Latino persons can be of any race.










CDC Calculation: Percentage of HIV-Viral Hepatitis Integrated Tests (Column C%) =(C#/B)*100; HIV-TB Integrated Tests (Column D%)=(D#/B)*100; Percentage of HIV-STD Integrated Tests (Column E%)=(E#/B)*100








CDC Calculation: Percentage of Persons who were screened for HIV/STD (Column B%) = (B#/A)*100; Percentage of persons who were linked to PrEP (Column D%)=(D#/C)*100; Percentage of persons who were linked to SSP services (Column F%)=Column F#/E)*100










Sheet 8: DSTDP_Extragen_Testing

Extragential Testing in STD Clinics




Aggregate Data Tables for Performance Measure: STD-1: Percentage of persons tested for rectal GC/CT who are positive for rectal GC/CT




Gray = auto-calculated cell; does not represent a reporting burden




TableXXX. Extragenital testing and testing in STD Clinics

Number of persons tested for rectal GC/CT Number of persons testing positive for rectal GC/CT

N % N %
Age Group
<15 Years



15-19 Years



20-29 Years



30-65 Years



≥ 66 Years



Unknown



Gender
Male



Female



Transgender



Unknown



Race and Hispanic Origin1
Hispanic or Latino



Not Hispanic or Latino American Indian or Alaska Native alone



Asian alone



Black or African American alone



Native Hawaiian or Pacific Islander alone



White alone



Two or more races



Unknown



Population Groups
MSM/IDU



MSM



PWID



Heterosexual males



Heterosexual females



Other



Unknown



Total





1Race and ethnicity are to be collected at the local level in accordance with OMB standards (https://www.govinfo.gov/content/pkg/FR-1997-10-30/pdf/97-28653.pdf) and reported to CDC in the aggregate using these categories. Hispanic or Latino persons can be of any race.

Sheet 9: DSTDP_Testing_HC

Routine Testing in Prioritized Health Care Settings: STD Clinic











Aggregate Data Tables for Diagnose Indicators 1A1.1A, 1A1.1B, and 1A1.1C: Percentage of persons tested for and diagnosed with HIV (new and previous positives) in health care facilities identified as a priority for routine opt-out screening.











Gray = auto-calculated cell; does not represent a reporting burden











Table 1A1.B. Persons Tested and Positivity in STD Clinics

Total Number of Persons Served1 Number of Persons Tested2,3 Number of HIV-Positive Persons4 Previously Diagnosed Persons Newly Diagnosed HIV-positive Persons Confirmed in Surveillance5 Newly Diagnosed HIV-positive Persons Identified by Self-Report6

N N % N % N % N % N %
Age Group
<15 Years










15-19 Years










20-29 Years










30-65 Years










≥ 66 Years










Unknown










Gender
Male










Female










Transgender7










Unknown










Race and Hispanic Origin8
Hispanic or Latino










Not Hispanic or Latino American Indian or Alaska Native alone










Asian alone










Black or African American alone










Native Hawaiian or Pacific Islander alone










White alone










Two or more races










Unknown










Population Groups
MSM/IDU










MSM










PWID










Heterosexual males










Heterosexual females










Other










Unknown










Total










1 Includes persons who received one or more services at the health care facility during the reporting period.
2 Includes tests that are supported in any way by PS20-2010-funded resources (e.g., funding, test kits, personnel, training and technical assistance, laboratory support, electronic medical record enhancements).
3 Includes persons who had a positive or negative test result.











4 Includes newly and previously diagnosed infections and those with unknown prior history











5 Includes newly identified HIV diagnosis that have been confirmed in surveillance. For persons included in this column, the HIV surveillance system is checked and 1) no prior report of HIV diagnosis is found and 2) there is no indication of a previous diagnosis by either client self-report (if the client was asked) or review of other data sources (if other data sources were checked).
6 Includes self-report and provider report of new HIV diagnosis.











7 Transgender includes all persons whose gender identity or expression is different from their sex assigned at birth. Transgender persons may self-identify as transgender female or transgender woman, transgender male or transgender man, or other gender non-binary person.
8Race and ethnicity are to be collected at the local level in accordance with OMB standards (https://www.govinfo.gov/content/pkg/FR-1997-10-30/pdf/97-28653.pdf) and reported to CDC in the aggregate using these categories. Hispanic or Latino persons can be of any race.
CDC Calculations for Percentages: Percentage of persons tested (Column B%)=(B#/A#)*100; Percentage of HIV-Positive Persons (Column C%)=(C#/B#)*100; Percentage of Previous HIV-Positives (Column D%)=(D#/B#)*100; New Positivity—Confirmed in Surveillance (Column E%)=(E#/B#)*100; New Positivity—Self Report (Column F%)=(F#/B#)*100.

Sheet 10: DSTDP_PrEP

Provision of PrEP Services: STD Clinics












Aggregate Data Tables for Prevent Indicator 3A1.3: Number and percentage of HIV-negative persons who are linked to a PrEP provider and for Performance Measure STD-2: Percent of persons eligible for PrEP who receive PrEP at the STD clinic

The following data table should be completed for each reporting STD clinic












Gray = auto-calculated cell; does not represent a reporting burden












Table XX. PrEP in STD Clinics

HIV-Negative Persons1 Added for STD clinics: Already using PrEP Screened for PrEP Need2,3 Eligible for PrEP Referral4,5 Referred to PrEP Provider6,7 Linked to a PrEP Provider8,9 Added for STD Clinics: Prescribed PrEP at/by the STD clinic

N N N % N % N % N % N %
Age Group











<15 Years











15-19 Years











20-29 Years











30-65 Years











≥ 66 Years











Unknown











Test Setting
STD Clinic











Other Health Care Setting











Non-Heath Care Setting











Unknown











Gender
Male











Female











Transgender12











Unknown











Race and Hispanic Origin13
Hispanic or Latino











Not Hispanic or Latino American Indian or Alaska Native alone











Asian alone











Black or African American alone











Native Hawaiian or Pacific Islander alone











White alone











Two or more races











Unknown











Population Groups
MSM/IDU











MSM











PWID











Heterosexual males











Heterosexual females











Other











Unknown











Total











1 Includes HIV-negative persons who received HIV testing or PrEP services (e.g., screening, referral, linkage, prescription) that were in any way supported by PS20-2010 funds. Denominator for Column B

2,3 Screening for PrEP eligibility is the process of conducting an initial assessment regarding a person’s eligibility (e.g., behavioral risk screening) for pre-exposure prophylaxis (PrEP) and determining whether a more thorough evaluation is warranted. A person is screened if an initial assessment of eligibility for PrEP services is completed. For further discussion on PrEP screening, see Centers for Disease Control and Prevention: US Public Health Service: Preexposure prophylaxis for the prevention of HIV infection in the United States—2017 Update: a clinical practice guideline. https://www.cdc.gov/hiv/pdf/risk/prep/cdc-hiv-prep-guidelines-2017.pdf3Denominator is Column A (number of HIV-negative persons). All persons reflected in Column B should also be reflected in Column A.

4 Eligible for PrEP Referral refers to a person’s status with regard to whether or not he or she meets appropriate criteria for using PrEP; specifically, whether or not he or she is HIV-negative and at risk for HIV, as defined locally or by CDC guidelines for Prep

5Denominator is Column B (number of persons screened for PrEP). Persons reported as eligible for PrEP referral are those who have sexual or drug risk behaviors. These individuals should also be reflected in the counts reported for columns A-B.

6 Referral to a 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 provider’s agency, and what to expect from the referral process.

7 Denominator is Column C (number of persons eligible for PrEP). Persons who are referred to a PrEP provider should also be reflected in the counts reported for columns A-C.

8 Linkage to PrEP provider is the process through which a person at risk for becoming infected with HIV is helped to access a healthcare provider who offers evaluation and management for PrEP. Linked to a PrEP provider refers to the outcome of the referral or linkage of a PrEP eligible person to a PrEP provider, as indicated by the person’s attendance at the first appointment and verified through reviews of medical records or other data systems or self-report by the client.

9 Denominator is Column D (number of persons referred). Persons who are linked to a PrEP provider should also be reflected in the counts reported for columns A-D.

10 Prescribed PrEP refers to a person who has been adequately evaluated and received a prescription for PrEP. Prescription information may come from clinical records, pharmacy data, or self-report by client.

11 Denominator is Column E (number of persons linked to PrEP). Persons who are prescribed PrEP should also be reflected in the counts reported for columns A-E.

12 ‘Transgender’ includes all persons whose gender identity or expression is different from their sex assigned at birth. Transgender persons may self-identify as transgender female or transgender woman, transgender male or transgender man, or other gender non-binary person.

13Race and ethnicity are to be collected at the local level in accordance with OMB standards (https://www.govinfo.gov/content/pkg/FR-1997-10-30/pdf/97-28653.pdf) and reported to CDC in the aggregate using these categories. Hispanic or Latino persons can be of any race.

CDC Calculations for Percentages: Percentage of Persons Screened for PrEP (Column B)=(B#/A#))*100; Percentage of Persons Eligible for PrEP (Column C)=(C#/B#))*100; Percentage of Persons Referred for PrEP (Column D)=(D#/C#))*100; Percentage of Persons Linked to a PrEP Provider (Column E)=(E#/D#))*100; Percentage of Persons Prescribed PrEP (Column F)=(F#/E#)*100.


Sheet 11: DSTDP_Capacity

STD Clinic Service Capacity

Data Table for STD clinic capacity performance measures STD-3, STD-4, STD-5, and STD-6: Number of [X category] services provided by STD clinics

Gray = auto-calculated cell; does not represent a reporting burden

Clinic service capacity domains Did your clinic provide this service? Y/N
(in the reporting period)
Brief description of major service changes for this particular reporting period (if applicable)
Prevention and referrals

Risk assessment and education for pre-exposure prophylaxis (PrEP) for HIV prevention

Referral to PrEP providers

Linkage to PrEP providers

Risk assessment and education for non-occupational post-exposure prophylaxis (nPEP)

Referral or linkage to nPEP providers

Referral or linkage to HIV care for people with HIV, if indicated

Clinic capacity PM-STD-3: # of prevention and referral services offered routinely by STD clinics

Laboratory capacity

At time of patient visit: Test for HIV (rapid or laboratory)

Through clinical laboratory: Extragenital (pharynx and rectum) NAAT for gonorrhea and chlamydia

Through clinical laboratory: Fourth generation antigen/antibody HIV test

Through clinical laboratory: Laboratory tests needed for providing nPEP and PrEP, as per clinical protocol

Viral Load testing

Clinic capacity PM-STD-4: # laboratory services offered routinely by STD clinics

Treatment

On site provision (starter pack or 3 month supply): PrEP

On site provision (7 day or full course): nPEP

On site: treatment for acute or new diagnosis of HIV care

By prescription: PrEP

By prescription: nPEP

By prescription: treatment for acute or new diagnosis of HIV care

Clinic capacity PM-STD-5: # of treatment services offered routinely by STD clinics

Service models

Ongoing care for patients taking PrEP

STD express visit
Telemedicine

Provision or linkage to kits for self collection for GC/CT testing outside the clinic

Provision or linkage to self-testing kits for HIV testing outside the clinic

Clinic capacity PM-STD-6: # of service models offered routinely by STD clinics

Optional: Any other information about clinic capacity you wish to provide at this time.



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