Number of people currently on antiretroviral therapy

How to use this indicator

There is evidence to suggest that HIV is best managed through community-based care and that the most effective programs ensure decentralization of ART services and long-term retention of patients in care. Models of service delivery engage community workers in the delivery of medicine, provision of social support and education, and linkage of patients to the facility level. ART should be provided to people living with HIV whose CD4+ counts are less than 500 cells per μL, HIV-infected pregnant women, HIV-discordant partners, people with certain medical conditions such as active tuberculosis and active hepatitis B, and people with severe or advanced HIV clinical disease. This indicator monitors the ongoing scale-up and uptake of ART programs and provides insight on the number of people currently on antiretroviral treatment for HIV at the community level. This allows tracking of progress in the HIV response and monitoring of the HIV services cascade—between when diagnosis is made and treatment is initiated at the community level.

Numerator

Number of adults and children currently receiving antiretroviral therapy (ART) during the reporting period

Unit of measure

Number

Calculation

Sum results across reporting period

Method of measurement

This indicator can be calculated by counting the number of adults and children who are currently taking ART in accordance with treatment protocols. The information can be collected through community monitoring tools and determined by asking members during community worker household visits for adherence counseling and management. People who stopped treatment temporarily and then started again at the time of inquiry should be counted as current users. People who start short term ART for prevention purposes (PREP) or an ART starter pack should not be counted for this indicator. People who should be counted towards this indicator include those who:

  • Initiated or transferred into treatment during the reporting period
  • HIV-positive pregnant women who newly initiated ART during pregnancy or were already taking ART before pregnancy for their own treatment during the reporting period (This indicator is also defined separately here.)

People should not be included if they died, stopped treatment, transferred out of care, or were lost to follow-up during the reporting period. Those lost to follow-up are people who have not received antiretroviral in the past 90 days after their most recent missed appointment or missed drug pickup. Current should be defined as the treatment status the last time the community worker visited the household during the reporting period.

Data source

Programs usually track this information using service provision forms, vulnerable children/adult service forms, vulnerable children enrollment registers, family folder profiles, and home visit tools.

Disaggregation

  • Age (<1 year, 1–4 years, 5–9 years, 10–14 years, and 15–19 years for children; 20–24 years, 25–49 years, and 50+ years for adults)
  • Sex
  • Key population type (sex workers, transgender people, men who have sex with men, people who inject drugs)
  • HIV status
  • Pregnancy/lactation status

Data quality considerations

Only one age disaggregation should be used for all types of disaggregation. If full age and sex disaggregations are not possible, then coarse disaggregate should be used (<1, <15 M, <15 F, 15+ M, 15+ F). The total number of people currently using ART should not be greater than the sum of each type of disaggregation. Age should be defined as the age of the person counted the last time he or she was visited during the reporting period.

Reporting frequency

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

Data element

Current ART use

Category

Vulnerable Children, Key Populations, Home-Based Care, Prevention of Mother-to-Child Transmission

References

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

World Health Organization. (2016). Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: Recommendations for a public health approach. Second edition. Retrieved from http://www.who.int/hiv/pub/arv/arv-2016/en/

Mukherjee, J. S., Barry, D., Weatherford, R. D., Desai, I. K., & Farmer, P. E. (2016). Community-based ART programs: Sustaining adherence and follow-up. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5106499/

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