UHC indicator GPW indicator

Antiretroviral therapy (ART) has been shown to reduce mortality among those infected and efforts are being made to make it more affordable within low- and middle-income countries. This indicator assesses the progress in providing antiretroviral combination therapy to all people living with HIV. As the HIV epidemic matures, increasing numbers of people are reaching advanced stages of HIV infection. Over recent years WHO has issued various updates in the ARV guidelines; the most recent update is the 2021 World Health Organization (WHO) Consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring: recommendations for a public health approach. The World Health Organization (WHO) recommends treatment for all people living with HIV. For reasons of comparability across countries and over time in the context of changing recommendations, this indicator relates to the number of people receiving ART as of proportion of the overall estimated number of people living with HIV. The ranges around the levels of people living with HIV who received ART are based on the uncertainty bounds around the estimates of people living with HIV.

The percentage of adults and children with HIV infection currently receiving antiretroviral combination therapy in accordance with the nationally approved treatment protocols (or WHO/UNAIDS standards) among the estimated number of adults and children with HIV infection. Numerator: Number of adults and children living with HIV who are currently receiving antiretroviral therapy in accordance with the nationally approved treatment protocol (or WHO/UNAIDS standards) at the end of the reporting period.

Denominator: Estimated number of adults and children living with HIV.

• Gender (female, male, other*)

• Age (0-14, 0–4, 5–9, 10–14, 10–19, 15+,15–24,15–49, 50+ years)

• Key populations (men who have sex with men, people living in prisons, people who inject drugs, sex workers, trans and gender diverse people)

• Cities and other administrative regions of epidemiologic importance

*The category of other includes trans and gender diverse people who choose an identity other than male or female.

Numerator: The number of adults and children with HIV infection who are currently receiving antiretroviral combination therapy can be obtained through data collected from facility-based antiretroviral therapy registers or drug supply management systems. These are then tallied and transferred to cross-sectional monthly or quarterly reports which can then be aggregated for national totals. Patients receiving antiretroviral therapy in the private sector and public sector should be included in the numerator where data are available. Antiretroviral therapy taken only for the purpose of prevention of mother-to-child transmission and post-exposure prophylaxis are not included in this indicator. HIV-infected pregnant women who are eligible for antiretroviral therapy and on antiretroviral therapy for their own treatment are included in this indicator.

Denominator: The denominator is generated by estimating the number of people living with HIV. A standard modelling method is recommended. The Estimation and Projection Package (EPP) and Spectrum software have been developed by the UNAIDS/WHO Reference Group on Estimates, Models and Projections.

Outcome

WHO, UNAIDS and UNICEF are responsible for reporting data for this indicator at the international level, and have been compiling country specific data since 2003.Predominant type of statistics: predicted Numerator: The data on people receiving antiretroviral therapy are collected through a joint international monitoring and reporting process with WHO, UNICEF and the UNAIDS Secretariat. For this purpose a joint data tool has been developed that contains Global AIDS monitoring (GAM) indicators. Data are also compiled from the most recent reports received by WHO and/or UNAIDS from health ministries or from other reliable sources in the countries, such as bilateral partners, foundations and nongovernmental organizations that are major providers of treatment services. In order to facilitate collaboration at country level, the country offices of WHO, UNICEF and the UNAIDS Secretariat, work jointly with national counterparts and partner agencies to collate and validate data in a single collaborative consultation process. In addition, at least once a year, international data reconciliation meetings are organized to review and validate data reported to WHO, UNICEF, the UNAIDS Secretariat, the Global Fund to Fight AIDS, Tuberculosis and Malaria; and the United States President’s Emergency Plan for AIDS Relief. Where discrepancies are identified between data reported to the different organizations, follow-up letters are sent to UNAIDS, UNICEF and WHO country offices to liaise with national authorities to seek clarification and resolve discrepancies. The estimates of antiretroviral therapy coverage presented here are calculated by dividing the estimated number of people receiving antiretroviral therapy as of December by the estimated number of people living with HIV in the same year (based on UNAIDS/WHO methods).  

Regional and global estimates are calculated as weighted averages of the country level indicator where the weights correspond to each country’s share of the total number of people living with HIV.

Coverage (%)

Annual

Annual

This indicator is different from the second 95 of the United Nations 95–95–95 targets: 95% of people who know their HIV-positive status should be accessing treatment by 2025. The denominator for the second 95 is people living with HIV who know their status whereas the denominator for this indicator is people living with HIV.

beusenbergm@who.int

Michel Beusenberg

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