Even in the earliest stages of infection, HIV can dramatically affect children’s growth and development and impair their immune systems. Damaged immune systems leave children vulnerable to bacterial infections in the lungs and ears and to viral infections such as chicken pox. Pneumococcal infections are the most common. Prompt evaluation and follow-up prophylactic treatment are essential.

Indications for prophylaxis based on immunologic status are as follows:

Formula: The total number of pediatric patients (birth to 13 years) with at least one HIV primary care visit in the past 12 months who received prophylactic therapy according to immunologic status, divided by the total number of pediatric patients (birth to 13 years) with at least one HIV primary care visit in the past 12 months who are eligible for prophylactic therapy based on immunologic status. Multiply by 100 to calculate percent. 

For further explanation of this indicator and/or criteria for exclusions, please view indicator definitions on the National HIVQUAL Project’s website.

Assess all patients weekly or at the frequency established by your quality improvement effort.  Identify your sample — all patients, birth to 13 years, with at least one HIV primary care visit in the past 12 months — and conduct clinical assessments of the patients’ medical records to determine whether they receive prophylactic therapy as indicated by their immunologic status. Use the table above as a guide.

Count the total number of prescribed patients, birth to 13 years, who receive prophylactic therapy according to their immunologic status. Divide by the total number of patients, birth to 13 years, with at least one HIV primary care visit in the past 12 months and who are eligible for prophylactic therapy based on immunologic status.

The National HIVQUAL Project’s Minimum Sample Table will help you determine the number of records to include in your sample. The Research Randomizer can generate a random number series to help you select which records to review.