Date 16 Jul 2021

Item	Who	Notes	Action Items
Agenda Review
CDS Implementation Questions and Discussion

What is the entry point for the patient's entry into care? Mobile teams? Walk-ins?		There are workflows for patients who enter the system at different points, i.e., phone call, primary care visit, school-based clinic, pre-natal appt. Workflow is the action that people take Dataflow is what data is captured and that point.	Provide work and data flows - can be drawn on paper, put in visio, excel, etc. Make it clear who does the action. You can make notes on the existing workflows that were handed in.
Who is on the care team?
Who are the actors? What are the actions they take? When does the action stop?
What is not successful? Do we lose patients at some point in the workflow? Do we stop asking questions after the first two? Do we end up putting sexual history in free text?

Next Steps

Risk Assessment Instruments

AllianceChicago

HIV Management Form

HIV Testing

Sexual Risk Exposure Prophylaxis

Sexual Risk Assessment

STI Screening

El Rio

Fenway

Montefiore

Montefiore does not have a structured risk screener/questionnaire that people are using. Attempts in the past to implement a risk screener has not worked with respect to people using it (and challenges to actually integrating it into work-flows).

The couple of questions that do exist (which is used highly variably and filled out infrequently) are below:

OhioPCA

Lower Lights CHC

PrEP Screening

HIV Risk Assessment Form Date:______________

Name:____________________________________________ Date of Birth:______________

In the last 12 months, did you do any of the following:
1. Have vaginal or anal sex with a male *If No, skip to question 2.* If yes, did you have · Sex with a male without a condom: · Sex with a male IV drug user: · Sex with a male who is HIV positive:	No No No No	Yes Yes Yes Yes		Don’t Know Don’t Know Don’t Know Don’t Know		No Response No Response No Response No Response
2. Have vaginal or anal sex with a female *If No, skip to question 3.* If yes, did you have · Sex with a female without a condom: · Sex with a female IV drug user: · Sex with a female who is HIV positive:	No No No No	Yes Yes Yes Yes		Don’t Know Don’t Know Don’t Know Don’t Know		No Response No Response No Response No Response
3. Have vaginal or anal sex with a transgender person: *If No, skip to question 4.* If yes, did you have · Sex with a transgender person without a condom: · Sex with a transgender IV drug user: · Sex with a transgender person who is HIV positive:	No No No No	Yes Yes Yes Yes		Don’t Know Don’t Know Don’t Know Don’t Know		No Response No Response No Response No Response
4. Use injecting (IV) drugs: If yes, do you share injection drug equipment:	No No	Yes Yes		Don’t Know Don’t Know		No Response No Response
5. Did you do and/or experience any of the following:
Sex while intoxicated and/or high on drugs Sex with a person of unknown HIV status Sex with an anonymous partner Diagnosed with a sexually transmitted disease Oral sex Sores or lesions Bodily rashes	Unprotected vaginal/anal sex with an IV drug user Unprotected vaginal/anal sex with an HIV positive person Unprotected vaginal/anal sex in exchange for money, drugs, or something needed Unprotected vaginal/anal sex with a person who exchanges sex for drugs/money Unprotected sex with multiple sex partners Contact with Syphilis None of these
6. In the past 12 months how many sexual partners did you have?	0 1 2-5 6-10 10+ Don’t Know
7. In the last 12 months did you ask your partners of about HIV status:	Yes, every partner			Some partners			No, never
8. Who do your sexual partners have sex with:	Men		Women		Transgender persons			Don’t Know
9. Women Only: Did you have sex with a male who has sex with other males:	No	Yes		Don’t Know		No Response
10. Are you positive for Hep C	No	Yes		Don’t Know		No Response

HIV Prevention

2021-07-16 HIV ePrompt Follow-up to CDS Design Meeting