Number of HIV-positive women who received antiretroviral therapy during pregnancy

Background

Given human resource constraints, community health workers can play a key role in ensuring enrollment in, adherence to, and retention of antiretroviral treatment for HIV. Prevention of mother-to-child transmission (PMTCT) programs must provide antiretroviral therapy (ART) to HIV-positive pregnant women, ensure early infant diagnosis at 4–6 weeks, and provide ART to infants exposed by 12 weeks to reduce the risk of vertical transmission to under 5 percent. In 2015, the World Health Organization recommended that all HIV-positive pregnant women be provided lifelong treatment, regardless of their CD4 count. (This strategy is called the Option B+ approach.) According to the Joint United Nations Programme on HIV/AIDS Global Plan of 2016, AIDS-related deaths decreased by 43 percent between 2009 and 2015 in the six priority countries where Option B+ was employed. Increased knowledge of HIV, mother-to-child transmission (MTCT), and PMTCT have led to increased uptake of PMTCT services, one area that community health workers have demonstrated influence. This information can be used by community HIV programs to assess progress in attempts to prevent mother-to-child transmission of HIV and inform strategic planning around resource allocation and coverage.

Numerator

Number of HIV-positive pregnant women who delivered and received ART to reduce the risk of mother-child-transmission during pregnancy or delivery during the reporting period

Unit of measure

Number

Calculation

Sum results across reporting period

Method of measurement

This information can be obtained through coordination with community-based organizations supporting HIV-positive pregnant women, to prevent vertical transmission of the virus. It can also be obtained by tracking HIV-positive pregnant women throughout the course of their pregnancy. Community workers are key to ensuring that pregnant women vulnerable to HIV are linked to HIV counseling and testing services to ensure that appropriate treatment is provided before and during delivery. This indicator includes HIV-positive pregnant women who were newly initiated on treatment during the current pregnancy or during labor, including maternal triple antiretroviral prophylaxis, and those already on ART before becoming pregnant. Even if a woman intends to discontinue therapy after breastfeeding, she can still be counted towards this indicator if she meets the above criteria.

Data source

This information can be collected through the antenatal client appointment diary, forms, or client and antenatal profiles and is often collected by programs that place particular emphasis on supporting pregnant women and mothers.

Disaggregation

  • Age
  • Category
    • Newly initiated on ART during current pregnancy
    • Already on ART before the pregnancy
    • Other
      • Maternal zidovudine (AZT)
      • Single dose nevirapine
      • Any other regimen not listed
      • Linked from ART

Data quality considerations

This indicator does not measure the quality of treatment services provided to the woman at facilities. This indicator also does not track adherence and whether women discontinued treatment because of side effects or other reasons. This indicator should not be used as a true measure of mother-to-child transmission. The overall number reported for this indicator should be equal to the sum of individuals in each disaggregation type. Only one type of age disaggregation should be used throughout; overlap should be avoided. Categories should be mutually exclusive.

Reporting frequency

Community workers should collect this information regularly, but they should monitor progress monthly with support from their supervisors. The indicator should be reported on a quarterly basis.

Data element

HIV-positive women on ART during pregnancy

Category

Prevention of Mother-to-Child Transmission, HIV Prevention

References

Prevention of mother-to-child transmission (PMTCT) of HIV. (2018). Retrieved from https://www.avert.org/professionals/hiv-programming/prevention/prevention-mother-child#footnoteref14_8xwktnq

The United States President’s Emergency Plan for AIDS Relief (PEPFAR). (2018). Monitoring, evaluation, and reporting (MER 2.0) indicator reference guide updated release (Version 2.2). Washington, DC: PEPFAR. Retrieved from https://www.pepfar.gov/documents/organization/263233.pdf

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