Numerator
Number of adults and children currently receiving antiretroviral therapy (ART)
The current on ART count should equal the number of adults and children with HIV infection who ever started ART MINUS those patients who are not currently on treatment at the end of the reporting period.
Denominator
Changes to Indicator
- Age/sex disaggregates updated (MER 2.0 v2.1 to v2.2).
How to Use
This indicator measures the ongoing scale-up and uptake of ART and retention in ART programs as a critical step in the HIV service cascade and assesses progress towards coverage of ART for all eligible HIV-positive individuals when reviewed against the number of PLHIV that are estimated to be eligible for treatment. It allows us to track the response to the epidemic in specific geographic areas and among specific populations as well as at the national level.
How to Collect Data
This indicator should be collected from facility ART registers/databases, program monitoring tools, and drug supply management systems. Count the number of adults and children who are currently receiving ART in accordance with the nationally approved treatment protocol (or WHO/UNAIDS standards) at the end of the reporting period.
The current on ART count should equal the number of adults and children with HIV infection who ever started ART minus those patients who are not currently on treatment at the end of the reporting period.
- Patients on ART who initiated or transferred-in during the reporting period should be counted.
- Patients who have received enough ARVs to last to the end of the reporting period should be counted including those patients that pick up several months of antiretroviral drugs at one visit
- HIV-positive pregnant women who are eligible for and are receiving antiretroviral drugs for their own treatment are included. HIV-positive pregnant women initiating lifelong ART through PMTCT (Option B+) will count as "current" on ART under this indicator. These include HIV-infected pregnant women who:
- Have newly initiated ART during the current pregnancy
- Are already on ART at the beginning of the current pregnancy
Patients excluded from the Current on ART count are patients who died, stopped treatment, transferred out, or are lost to follow-up (LTFU). LTFU is defined as a patient who has not received ARVs in the last 90 days (three months) following their last missed appointment or missed drug pick-up. (Note: As models of service delivery change to reflect longer visit intervals for stable patients, it is important to emphasize the definition of LTFU applies to both missed visits or missed drug pick-up, but does not apply who have not received ARVs in the last 90 days (three months) following their last attended appointment or attended drug pick-up. As that interval between scheduled visits for stable patients maybe longer than 3 months.)
This indicator should be reported from both PEPFAR-supported sites in the private or public sector. Patients currently receiving treatment from mobile clinics can be reported in two ways. Firstly, if the mobile clinic is associated (receives commodities, reports to, is staff by) a nearby health facility, then these individuals should be reported by that facility. Secondly, if a mobile clinic is stationary for more than 2 reporting periods, it should be added to the PEPFAR facility list with geocodes and data should be reported for this mobile clinic directly.
For age /sex disaggregates: CURRENT is a state defined by treatment status when last seen, so it is expected that characteristics of these clients would be updated each time they are seen by a program. Age represents an individual's age at the end of the reporting period or when last seen at the facility. For example, a 14-year-old child will be counted as currently receiving treatment in the <15 age category at the end of reporting period "A". During reporting period "B" the child turns age 15 and so at the end of this reporting period the child will be counted under the 15+ age category.
DO NOT include: Patients who receive ARVs for post-exposure prophylaxis (PEP) or short-term ART only for prevention (PREP) should not be reported in this indicator.
Reporting Level
Facility
Reporting Frequency
Quarterly
How to Review for Data Quality
- Confirm that TX_CURR ≥ TX_NEW
- Only one age disaggregation type is used for age/sex: The number of individuals newly receiving ART must be disaggregated by age and sex. If possible, the full age/sex disaggregations should be used. If the full age/sex disaggregations are not possible, then, and only then, should the aggregated age/sex disaggregations be used, do NOT complete both age/sex disaggregations.
- Numerator ≥ subtotal of age/sex disaggregation: The total number of adults and children newly enrolled on ART should be greater or equal to the sum of the age/sex disaggregations
- Net new of TX_CURR between reporting periods should be less than TX_NEW in
Subnational Reporting
Data Entry Responsibility
Targets
How to Calculate the Annual Total
Use the result reported at Q4.
Data Elements and Disaggregates
| Numerator | Disaggregate Groups | Disaggregates |
|---|---|---|
| Number of adults and children currently receiving antiretroviral therapy (ART) | Age/Sex [Required] | <1, 1-9, 10-14 M, 10-14 F, 15-19 M, 15-19 F, 20-24 M, 20-24 F, 25-29 M, 25-29 F, 30-34 M, 30-34 F, 40-49 M, 40-49 F, 50+ M, 50+ F |
Disaggregate Descriptions & Definitions
Age/Sex: Age is defined as the age of the patient at the date of reporting, not the age at the date of initiation on ART.PEPFAR-Support Definition
Standard definition of DSD and TA-SDI used. Provision of key staff or commodities for PLHIV receiving ART include: the provision of key staff and/or commodities can include ongoing procurement of critical commodities, such as ARVs, or funding for salaries of HCW who deliver HIV treatment services. Staff who are responsible for the completeness and quality of routine patient records (paper or electronic) can be counted here; however, staff who exclusively fulfill MOH and donor reporting requirements cannot be counted.
Ongoing support for PLHIV receiving ART service delivery improvement includes: clinical mentoring and supportive supervision of staff at HIV sites providing ART, support for quality improvement activities, patient tracking system support, routine support of ART M&E and reporting, commodities consumption forecasting and supply management
Guiding Narrative Questions
- If the change in TX_CURR from the previous reporting period (TX_NET_NEW) is substantially different from TX_NEW, explain why (i.e., if you can, estimate or comment on the numbers of patients who died, transferred or were lost to follow-up).
- Please describe the reasoning for any net losses in treatment from the previous quarter.
