Antiretroviral therapy coverage among people with advanced HIV infections (percentage)
Rationale for use
As the HIV epidemic matures, increasing numbers of people are reaching advanced stages of HIV infection. Antiretroviral therapy (ART) has been shown to reduce mortality among those infected and efforts are being made to make it more affordable even in less developed countries. This indicator assesses the progress in providing ART to all people with advanced HIV infection.
Definition
Percentage of adults and children with advanced HIV infection receiving antiretroviral therapy according to nationally approved treatment protocol (or WHO/Joint UN Programme on HIV and AIDS standards) among the estimated number of people with advanced HIV infection..
Data sources
Health facility reports compiling data from facility registers, or reports from drug supply management systems, are used to obtain the number of people on antiretroviral therapy i.e. drugs received for the last month of the reporting period. External validation of country reported figures is carried out with data from pharmaceutical industry (if available).
Methods of estimation
The denominator of the coverage estimate is obtained from models that also generate the HIV prevalence, incidence and mortality estimates. The number of adults with advanced HIV infection who need to start treatment is estimated as the number of advanced HIV cases needing treatment in the current year times two, based on the assumption that adults with advanced HIV infection who need ART would die of AIDS in about 2 years in the absence of ART.
The total number of adults needing ART is calculated by adding the number of adults that need to start ART to the number of adults who are being treated in the previous year and have survived to the current year.
Disaggregation
By sex, age (children/adults), location (urban/rural, major regions/provinces), and socio-economic characteristics (e.g. education level, wealth quintile).
References
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Monitoring the Declaration of Commitment on HIV/AIDS: guidelines on construction of core indicators
Monitoring the Declaration of Commitment on HIV/AIDS: guidelines on construction of core indicators. Geneva, Joint United Nations Programme on HIV/AIDS, 2002. -
3 by 5 progress report
3 by 5 progress report. Geneva, World Health Organization and Joint United Nations Programme on HIV/AIDS, 2004. -
Towards universal access: scaling up priority HIV/AIDS interventions in the health sector
pdf, 4.45Mb
Towards universal access: scaling up priority HIV/AIDS interventions in the health sector. Progress Report, April 2007. Geneva, World Health Organization, 2007. -
Monitoring the Declaration of Commitment on HIV/AIDS
Monitoring the Declaration of Commitment on HIV/AIDS. Guidelines on Construction of core indicators. 2008 Reporting. Geneva, Joint United Nations Programme on HIV/AIDS (UNAIDS), 2007.
Comments
The accuracy of the reported number of people on antiretroviral therapy needs improvement as programme monitoring systems are still developing.
Although this indicator allows trends to be monitored over time, it does not attempt to distinguish between the different types of regimens available nor does it measure the cost, quality or effectiveness of such treatment.
Antiretrovirals for post exposure prophylaxis are not included in this indicator.