WHO Antenatal Care Guideline Implementation Guide
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WHO Antenatal Care Guideline Implementation Guide, published by World Health Organization (WHO). This guide is not an authorized publication; it is the continuous build for version 0.3.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/WorldHealthOrganization/smart-anc/ and changes regularly. See the Directory of published versions

: ANC.DT.29 HIV risk counselling - XML Representation

Active as of 2021-06-11

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<PlanDefinition xmlns="http://hl7.org/fhir">
  <id value="ANCDT29"/>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
    <table class="grid dict">
        
        <tr>
            <th scope="row"><b>Id: </b></th>
            <td style="padding-left: 4px;">ANCDT29</td>
        </tr>
        
        
        <tr>
            <th scope="row"><b>Url: </b></th>
            <td style="padding-left: 4px;"><a href="PlanDefinition-ANCDT29.html">ANC.DT.29 HIV risk counselling</a></td>
        </tr>
        
        
        <tr>
            <th scope="row"><b>Version: </b></th>
            <td style="padding-left: 4px;">0.3.0</td>
        </tr>
        
        
        <tr>
            <th scope="row"><b>Identifier: </b></th>
            <td style="padding-left: 4px;">
                
                
                <p style="margin-bottom: 5px;">
                    <b>value: </b> <span>ANC.DT.29</span>
                </p>
                
            </td>
        </tr>
        
        
        <tr>
            <th scope="row"><b>Name: </b></th>
            <td style="padding-left: 4px;">ANCDT29</td>
        </tr>
        
        
        <tr>
            <th scope="row"><b>Title: </b></th>
            <td style="padding-left: 4px;">ANC.DT.29 HIV risk counselling</td>
        </tr>
        
        
        
        <tr>
            <th scope="row"><b>Status: </b></th>
            <td style="padding-left: 4px;">active</td>
        </tr>
        
        
        <tr>
            <th scope="row"><b>Experimental: </b></th>
            <td style="padding-left: 4px;">false</td>
        </tr>
        
        
        <tr>
            <th scope="row"><b>Type: </b></th>
            <td style="padding-left: 4px;">
                
                    
                        
                        <p style="margin-bottom: 5px;">
                            <b>system: </b> <span><a href="http://terminology.hl7.org/5.5.0/CodeSystem-plan-definition-type.html">PlanDefinitionType</a></span>
                        </p>
                        
                        
                        <p style="margin-bottom: 5px;">
                            <b>code: </b> <span>eca-rule</span>
                        </p>
                        
                        
                    
                
                
            </td>
        </tr>
        
        
        
        <tr>
            <th scope="row"><b>Date: </b></th>
            <td style="padding-left: 4px;">2021-06-11 23:42:28-0600</td>
        </tr>
        
        
        <tr>
            <th scope="row"><b>Publisher: </b></th>
            <td style="padding-left: 4px;">World Health Organization (WHO)</td>
        </tr>
        
        
        <tr>
            <th scope="row"><b>Description: </b></th>
            <td style="padding-left: 4px;">If the woman has risk factors for contracting HIV, provide counselling to reduce risk of contracting HIV</td>
        </tr>
        
        
        
        
        <tr>
            <th scope="row"><b>Use Context: </b></th>
            <td style="padding-left: 4px;">
                <table class="grid-dict">
                    <tr><th><b>code</b></th><th><b>value</b></th><th><b>display</b></th></tr>
                    
                      <tr>
                        <td>task</td>
                        <td>ANC.B9.</td>
                        <td>Conduct laboratory tests and imaging</td>
                      </tr>
                    
                </table>
            </td>
        </tr>
        
        
        <tr>
            <th scope="row"><b>Jurisdiction: </b></th>
            <td style="padding-left: 4px;">001</td>
        </tr>
        
        
        
        
        
        
        
        

        
        <tr>
          <th scope="row"><b>Libraries: </b></th>
          <td style="padding-left: 4px;">
            <table class="grid-dict">
              
                <tr><td><a href="Library-ANCDT29.html">ANC.DT.29 HIV risk counselling</a></td></tr>
              
            </table>
          </td>
        </tr>
        

        
        <tr>
          <th scope="row"><b>Actions: </b></th>
          <td style="padding-left: 4px;">
            <table class="grid-dict">
              
                <tr>
                  <td>
                    <b> ANC.DT.29 HIV risk counselling:</b> <br/>
                    <b>When:</b> <i>named-event:</i> ANC.B9. Conduct laboratory tests and imaging<br/>
                    
                    
                      <b>Then:</b>
                      <table class="grid-dict">
                        
                          <tr>
                            <td>
                              If the woman lives in a setting with a generalized HIV epidemic, or her partner is HIV positive, or she injects drugs, or she is a sex worker, then she is at high risk for HIV – counselling should be given to provide prevention options

Provide comprehensive HIV prevention options: 
– STI screening and treatment (syndromic and syphilis)
– Condom promotion
– Risk reduction counselling
– Pre-exposure prophylaxis (PrEP) with emphasis on adherence
– Emphasize importance of follow-up ANC contact visits<br/>
                              
                              <b>If:</b> <i>applicability:</i> ((((((&amp;quot;HIV status&amp;quot; = &amp;quot;HIV negative&amp;quot;)
  AND (&amp;quot;Prevalence of HIV in pregnant women in the catchment area&amp;quot; &amp;gt; 1%))
  OR ((&amp;quot;HIV status&amp;quot; = &amp;quot;HIV negative&amp;quot;)
  AND (&amp;quot;Partner HIV status (reported)&amp;quot; = &amp;quot;HIV positive&amp;quot;)))
  OR ((&amp;quot;HIV status&amp;quot; = &amp;quot;HIV negative&amp;quot;)
  AND (&amp;quot;Partner HIV test result&amp;quot; = HIV positive&amp;quot;)))
  OR ((&amp;quot;HIV status&amp;quot; = &amp;quot;HIV negative&amp;quot;)
  AND (Partner HIV status (confirmed)&amp;quot; = &amp;quot;HIV positive&amp;quot;)))
  OR ((&amp;quot;HIV status&amp;quot; = &amp;quot;HIV negative&amp;quot;)
  AND (Current alcohol and/or other substance use&amp;quot; = &amp;quot;Injectable drugs&amp;quot;)))
  OR ((&amp;quot;HIV status&amp;quot; = &amp;quot;HIV negative&amp;quot;)
  AND (&amp;quot;Occupation&amp;quot; = &amp;quot;Employment that puts woman at increased risk for HIV (e.g. sex worker)&amp;quot;)) <i>(Should Conduct counselling on HIV risk)</i><br/>
                              
                                
                              
                            </td>
                          </tr>
                        
                          <tr>
                            <td>
                              Oral pre-exposure prophylaxis (PrEP) containing tenofovir disoproxil fumarate (TDF) should be offered as an additional prevention choice for pregnant women at substantial risk of HIV infection as part of combination prevention approaches.

See &amp;quot;PrEP offering framework&amp;quot; – a suggested prioritization framework for offering PrEP to pregnant and breastfeeding women (below).<br/>
                              
                              <b>If:</b> <i>applicability:</i> &amp;quot;Population incidence of HIV in the absence of PrEP&amp;quot; &amp;gt; 3 per 100 person-years <i>(Should Conduct counselling on pre-exposure prophylaxis (PrEP) for HIV prevention)</i><br/>
                              
                                
                              
                            </td>
                          </tr>
                        
                          <tr>
                            <td>
                              Encourage woman to find out the status of her partner(s) or to bring them during the next contact visit to get tested<br/>
                              
                              <b>If:</b> <i>applicability:</i> (&amp;quot;Partner HIV status (reported)&amp;quot; = &amp;quot;Inconclusive&amp;quot;)
  OR (&amp;quot;Partner HIV test conducted&amp;quot; = FALSE) <i>(Should Conduct counselling on HIV risk 2)</i><br/>
                              
                                <b>Then:</b>
                                <table class="grid-dict">
                                  
                                    <tr>
                                      <td>
                                        <b> Conduct counselling on HIV risk:</b> <br/>
                                        
                                        
                                        
                                          
                                        
                                      </td>
                                    </tr>
                                  
                                    <tr>
                                      <td>
                                        <b> Recommended partner HIV test:</b> <br/>
                                        
                                        
                                        
                                          
                                        
                                      </td>
                                    </tr>
                                  
                                </table>
                              
                            </td>
                          </tr>
                        
                      </table>
                    
                  </td>
                </tr>
              
            </table>
          </td>
        </tr>
        
    </table>
</div>
  </text>
  <url value="http://fhir.org/guides/who/anc-cds/PlanDefinition/ANCDT29"/>
  <identifier>
    <use value="official"/>
    <value value="ANC.DT.29"/>
  </identifier>
  <version value="0.3.0"/>
  <name value="ANCDT29"/>
  <title value="ANC.DT.29 HIV risk counselling"/>
  <type>
    <coding>
      <system
              value="http://terminology.hl7.org/CodeSystem/plan-definition-type"/>
      <code value="eca-rule"/>
    </coding>
  </type>
  <status value="active"/>
  <experimental value="false"/>
  <date value="2021-06-11T23:42:28-06:00"/>
  <publisher value="World Health Organization (WHO)"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="https://www.who.int"/>
    </telecom>
  </contact>
  <description
               value="If the woman has risk factors for contracting HIV, provide counselling to reduce risk of contracting HIV"/>
  <useContext>
    <code>
      <system
              value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>
      <code value="task"/>
      <display value="Workflow Task"/>
    </code>
    <valueCodeableConcept>
      <coding>
        <system
                value="http://fhir.org/guides/who/anc-cds/CodeSystem/activity-codes"/>
        <code value="ANC.B9."/>
        <display value="Conduct laboratory tests and imaging"/>
      </coding>
    </valueCodeableConcept>
  </useContext>
  <jurisdiction>
    <coding>
      <system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
      <code value="001"/>
    </coding>
  </jurisdiction>
  <library value="http://fhir.org/guides/who/anc-cds/Library/ANCDT29"/>
  <action>
    <title value="ANC.DT.29 HIV risk counselling"/>
    <trigger>
      <type value="named-event"/>
      <name value="ANC.B9. Conduct laboratory tests and imaging"/>
    </trigger>
    <action id="1">
      <title value="Conduct counselling on HIV risk"/>
      <description value="Conduct counselling on HIV risk"/>
      <textEquivalent
                      value="If the woman lives in a setting with a generalized HIV epidemic, or her partner is HIV positive, or she injects drugs, or she is a sex worker, then she is at high risk for HIV – counselling should be given to provide prevention options

Provide comprehensive HIV prevention options: 
– STI screening and treatment (syndromic and syphilis)
– Condom promotion
– Risk reduction counselling
– Pre-exposure prophylaxis (PrEP) with emphasis on adherence
– Emphasize importance of follow-up ANC contact visits"/>
      <documentation>
        <type value="citation"/>
        <label
               value="WHO ANC recommendations (2016): B.1.7, C.7 (2)
Pregnancy, childbirth, postpartum and newborn care guide (IMPAC) (2015): C6 (1)"/>
      </documentation>
      <condition>
        <kind value="applicability"/>
        <expression>
          <description
                       value="((((((&quot;HIV status&quot; = &quot;HIV negative&quot;)
  AND (&quot;Prevalence of HIV in pregnant women in the catchment area&quot; &gt; 1%))
  OR ((&quot;HIV status&quot; = &quot;HIV negative&quot;)
  AND (&quot;Partner HIV status (reported)&quot; = &quot;HIV positive&quot;)))
  OR ((&quot;HIV status&quot; = &quot;HIV negative&quot;)
  AND (&quot;Partner HIV test result&quot; = HIV positive&quot;)))
  OR ((&quot;HIV status&quot; = &quot;HIV negative&quot;)
  AND (Partner HIV status (confirmed)&quot; = &quot;HIV positive&quot;)))
  OR ((&quot;HIV status&quot; = &quot;HIV negative&quot;)
  AND (Current alcohol and/or other substance use&quot; = &quot;Injectable drugs&quot;)))
  OR ((&quot;HIV status&quot; = &quot;HIV negative&quot;)
  AND (&quot;Occupation&quot; = &quot;Employment that puts woman at increased risk for HIV (e.g. sex worker)&quot;))"/>
          <language value="text/cql-identifier"/>
          <expression value="Should Conduct counselling on HIV risk"/>
        </expression>
      </condition>
    </action>
    <action id="2">
      <title
             value="Conduct counselling on pre-exposure prophylaxis (PrEP) for HIV prevention"/>
      <description
                   value="Conduct counselling on pre-exposure prophylaxis (PrEP) for HIV prevention"/>
      <textEquivalent
                      value="Oral pre-exposure prophylaxis (PrEP) containing tenofovir disoproxil fumarate (TDF) should be offered as an additional prevention choice for pregnant women at substantial risk of HIV infection as part of combination prevention approaches.

See &quot;PrEP offering framework&quot; – a suggested prioritization framework for offering PrEP to pregnant and breastfeeding women (below)."/>
      <documentation>
        <type value="citation"/>
        <label
               value="WHO ANC recommendations (2016): C.7 (2)
Pre-exposure prophylaxis (PrEP) for HIV prevention (2017) (20)"/>
      </documentation>
      <condition>
        <kind value="applicability"/>
        <expression>
          <description
                       value="&quot;Population incidence of HIV in the absence of PrEP&quot; &gt; 3 per 100 person-years"/>
          <language value="text/cql-identifier"/>
          <expression
                      value="Should Conduct counselling on pre-exposure prophylaxis (PrEP) for HIV prevention"/>
        </expression>
      </condition>
    </action>
    <action id="3">
      <title value="Conduct counselling on HIV risk"/>
      <description value="Conduct counselling on HIV risk 2"/>
      <textEquivalent
                      value="Encourage woman to find out the status of her partner(s) or to bring them during the next contact visit to get tested"/>
      <documentation>
        <type value="citation"/>
        <label
               value="WHO ANC recommendations (2016): B.1.7 (2)
Consolidated guidelines on HIV testing services (2015) (6)"/>
      </documentation>
      <condition>
        <kind value="applicability"/>
        <expression>
          <description
                       value="(&quot;Partner HIV status (reported)&quot; = &quot;Inconclusive&quot;)
  OR (&quot;Partner HIV test conducted&quot; = FALSE)"/>
          <language value="text/cql-identifier"/>
          <expression value="Should Conduct counselling on HIV risk 2"/>
        </expression>
      </condition>
      <action>
        <title value="Conduct counselling on HIV risk"/>
      </action>
      <action>
        <title value="Recommended partner HIV test"/>
      </action>
    </action>
  </action>
</PlanDefinition>