| Variable Summary | |
| Category | Count |
|---|---|
| Total variables | 93 |
| Required | 14 |
| Optional | 79 |
| OCR-processed (scanned and extracted) | 86 |
| Handwritten only (scanned but not extracted) | 7 |
Data Dictionary
This section defines all variables collected on the HTS 001 Client Intake Form — their names, labels, types, formats, constraints, and OCR processing metadata. The form captures one client visit per physical form across two A4 pages.
Summary
Identifiers
Important
IDs link records across forms and across time. Errors in IDs break linkage. All identifier fields are documented here in addition to the section tables below.
The Client Code is pre-printed on each physical form by the ScanForm system before distribution. It encodes four segments (Batch, Bundle, Page, Check) separated by hyphens. The Check segment (2 alphanumeric characters) allows detection of transcription errors when the code is manually copied. Staff must never overwrite the printed code.
The Index Client Code links a newly tested client to the index case who nominated them for testing. Only one format (ScanForm or Legacy) should be completed per record.
Facility & Visit Information
Administrative metadata identifying when and where the visit took place. These fields are handwritten and are not OCR-extracted.
Referral, Setting & Modality
Captures how and where the client arrived for HTS. Modality codes are printed in a legend on the form.
Client Demographics
Core demographic information about the client.
Contact & Address
Client contact details for follow-up and partner notification.
Session Type & Index Testing
Captures the testing modality, whether the client was referred by an index case, and the index client’s identifier.
Pregnancy & Breastfeeding
Identifies pregnant or breastfeeding clients for linkage to PMTCT services.
Section A — Knowledge Assessment
Pre-test counselling assessment. Each item is scored 0 (No) or 1 (Yes). Mark exactly one oval per row.
Note
Decision rule: Test for HIV if Personal HIV Risk Assessment Score ≥ 1 and last HIV test was more than 3 months ago.
Section B — Personal HIV Risk Assessment
Risk assessment covering the last 3 months. Each item scored 0 or 1. All items are required.
Note
Decision rule: If Personal HIV Risk Assessment Score ≥ 1 and last HIV test > 3 months ago, proceed with HIV testing.
Section C — TB and Syndromic STI Screening
Clinical screening for TB symptoms and STI syndromes. Printed on page 2. Each item scored 0 or 1.
Clinical TB Screening
Note
Decision rule: If TB screening score ≥ 1, test for Xpert MTB/RIF or refer to TB service.
Syndromic STI Screening
Note
Decision rule: If STI screening score ≥ 1, follow syndromic STI management guidelines or refer.
Section D — Sex Partner Risk Assessment
Assesses HIV risk from sexual partners in the last 3 months. Header question: “Have you had sex with a partner who is HIV positive and falls in any of the categories below?” Each item scored 0 or 1.
Note
Decision rule: If HIV negative and Section D score ≥ 1, refer client for PrEP services.
Post-Test Counselling
Documents HIV test results, counselling activities completed, and commodities provided to the client.
Note
Decision rules printed on form:
- If HIV negative and Risk Assessment Score ≥ 1 or STI syndrome evidence: recommend re-testing after 3 months.
- If HIV negative and Section D score ≥ 1: refer client for PrEP services.
Recency, CD4, Syphilis & Hepatitis Testing
Additional diagnostic tests. Recency and CD4 apply to HIV-positive clients only.
Provider Sign-off
Administrative completion fields recorded by the HTS provider.
OCR Model Reference
The table below summarises all OCR models used on this form and the character sets they recognise.
| OCR Models Used in HTS 001 Client Intake Form | ||
| OCR Model | Characters / Values Detected | Used For |
|---|---|---|
| select_one_or_zero | Oval marked (X) or blank; maximum one X per question | All checkbox (oval) fields |
| int | Digits 0–9 | Age, scores, counts, Provider ID, CD4 |
| string | Letters A–Z | Client names |
| tokenwise_string_int | Letters A–Z, digits 0–9, spaces | Address, landmark, state, LGA of residence |
| date_dd | Integers 01–31 (2 boxes) | Day portion of dates |
| date_mm | Integers 01–12 (2 boxes) | Month portion of dates |
| two_digits_20 | Pre-printed '20' — detects century | Century portion of dates |
| date_nearby_yy | Current year ±1 (2 boxes) | Year portion of dates |
| int_range(0, 5) | Integers 0–5 | TB screening score, STI screening score |
| int_range(0, 6) | Integers 0–6 | Knowledge Assessment Score |
| int_range(0, 7) | Integers 0–7 | Sex Partner Risk Assessment Score |
| uncertain_when_not_in_lexicon (ng-hiv-referred-from-other) | Strings validated against ng-hiv-referred-from-other lexicon | Referred From — free-text specify |
| uncertain_when_not_in_lexicon (ng-hiv-setting-other) | Strings validated against ng-hiv-setting-other lexicon | Setting — free-text specify |
Tip
Verification behaviour: All OCR-processed fields use hide = "certain". Fields are shown to human verifiers in the ScanForm verification queue only when OCR confidence falls below the certainty threshold. Fields read with high confidence are hidden automatically, reducing verification workload.
Generated automatically from HTS 001 Client Intake Form v1.6 source files. Last updated: 2026-06-30.