WHO Statistical Information System (WHOSIS)

HIV-infected pregnant women receiving antiretroviral therapy for PMTCT (percentage)

Rationale for use

In the absence of any preventive intervention, infants born to and breastfed by HIV-infected women have a 25–40% chance of acquiring HIV infection. This can happen during pregnancy, during labour and delivery, or after delivery via breastfeeding. The risk of mother-to-child transmission (MTCT) can be reduced through the complementary approaches of antiretroviral therapy for the mother and infant, implementation of safe delivery practices, and use of safer infant feeding practices. This indicator aims to measure the extent to which HIV-infected pregnant women are provided with antiretroviral drugs for preventing mother-to-child transmission (PMTCT) of HIV.

Definition

The number of HIV-infected pregnant women who received antiretroviral drugs for PMTCT in the last 12 months out of the estimated number of HIV-infected pregnant women.

Data sources

Health facility reports with data aggregated from registers are used to obtain the number of HIV-infected pregnant provided with antiretroviral drugs.

Methods of estimation

Unless otherwise noted, the denominator of this coverage estimate is based on country estimation models used to produce HIV prevalence, incidence and mortality estimates by the UNAIDS/WHO Working Group on Global HIV/AIDS and STI Surveillance. The estimated number of HIV-infected pregnant women is extracted from the country models, taking into account total fertility rates, background mortality and HIV sex and age distribution among women.

Disaggregation

By drug regimen, where appropriate and possible, to capture differential efficacy and enable better modelling of impact:

  • single drug prophylactic regimen
  • combination prophylactic regimen
  • highly active regimen for MTCT prophylaxis
  • antiretroviral therapy for HIV-positive pregnant women eligible for treatment
  • Single drug prophylactic regimen (estimated 10–14% transmission)
    – Single dose NVP
    – AZT alone
  • Combination prophylactic regimen (estimated 4–6% transmission)
    – AZT + SD NVP
    – AZT + SD NVP (+ 7 day postpartum AZT/3TC)
    – AZT + 3TC – AZT + 3TC + SD NVP
  • Highly active prophylactic regimen for MTCT prophylaxis (3% transmission as long as breastfeeding is not considered in the model and the regimen is not extended into the postpartum period)
    – AZT + 3TC + NRTI/NNRTI or PI
  • Antiretroviral therapy for HIV-positive pregnant women eligible for treatment (estimated <2% transmission)
    – Appropriate antiretroviral regimen

References

Database

Comments

In 2006, international guidelines were updated to recommend more efficacious regimens for PMTCT, and countries may be at different phases in adopting the newer recommendations. The indicator permits national monitoring of trends in the provision of antiretroviral drugs for PMTCT, but since different drug regimens for PMTCT are provided by countries, intercountry comparisons of aggregate estimates must be interpreted with caution and with reference to the regimens provided. This indicator captures the provision and not the actual adherence, consumption or uptake of antiretroviral drugs.

Antiretroviral drugs can be provided to HIV-infected women during pregnancy, during labour and shortly after delivery, and provision can take place at a number of sites. Countries should focus on compiling data for the numerator from patient registers at antenatal clinics, delivery sites, HIV care and treatment centres and postpartum care centres, as appropriate to their setting. HIV-infected pregnant women who are eligible for antiretroviral therapy and receive a treatment regimen will also benefit from the preventive effect of such therapy in reducing HIV transmission to their infants, and are thus included in the numerator.

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