This measure goes through an exhaustive and costly search (in terms of data retrieval) to identify women who are sexually active. In many EHR�s sexual activity is captured as part of the social/behavioral history, especially in the age cohort that is covered by this measure. But nowhere in this exhaustive search is there a criterion for a single SNOMED code that just means sexually active. So it is unclear to us whether we can look at this flag or if we are to ignore it. Common sense would say to include it. Also, probably all experts in this field would say that once a woman in this age group has a confirmed diagnosis of syphilis, gonorrhea, herpes, HIV, or chlamydia, or if they were already pregnant, then they are high risk and need to be screened every year at the very least until they are out of this age group (if not forever). But the criteria don't look for a history of these diseases, they look to see if it was active during this year.