Providers must have HIV-specific expertise to effectively manage the increasing complexity of HIV disease management. The literature suggests a positive correlation between the number of HIV+ patients seen by a provider and the quality of health care outcomes. It is therefore critical that HIV providers stay abreast of new antiretroviral (ARV) treatment regimens to treat patients based on state-of-the-art treatment guidelines.

All patients/clients should have a visit or consultation with an HIV specialist at least every four months. 

An HIV specialist is a provider experienced in direct ambulatory care of HIV-infected persons. This experience is defined by the following criteria:

• Management of antiretroviral therapy in at least 20 patients during the past year
• Ten or more hours annually of Continuing Medical Education (CME) activities that include information on the use of antiretroviral therapy in the ambulatory care setting
• Practitioners can also be certified as HIV specialists based on policies endorsed by major medical associations, medical societies, or local government that have been adopted by the clinic.

Formula:  The number of patients/clients with at least one HIV primary care visit during the past 12 months who also had a documented visitation or consultation with an HIV specialist during the last four months, divided by the total number of patients with at least one HIV primary care visit during the past 12 months. Multiply by 100 to calculate percent.

Greater than 90 percent of patients/clients will have at least one visit or consult with an HIV specialist every four months.

Assess a random number of patients monthly or at the frequency established by your quality improvement effort.  Count the number of patients/clients with at least one HIV primary care visit during the past 12 months who have also had a documented visit or consult with an HIV specialist during the past four-month period. Divide by the total number of patients/clients with at least one HIV primary care visit during the past 12 months.  Multiply by 100 to calculate percent.

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.