This is the 11th quarterly HIV Program report after implementation of the 2011 Integrated Clinical HIV Guidelines in July 2011. A summary of the key achievements between April and June 2014 is provided below:

• Scale-up of integrated HIV services had reached the following number of sites:

  • 724 static (579 within and 145 outside of health facilities) and 188 outreach HTC sites

  *700 (static) ART sites

  *615 PMTCT sites (Option B+, all included in ART sites above)

  *647 Pre-ART sites

  • 629 sites with HIV-exposed child follow-up

• 435,976 persons were tested and counselled for HIV; 136,952 (31%) accessed HTC for the first time; 299,024 (69%) were repeat testers and 8,017 (3%) of these received confirmatory testing (after having tested positive in the past). This is equivalent to 27% confirmatory testing coverage among 29,260 patients initiating ART this quarter. 29,320 (7%) clients received a positive result for the first time.

• 18,999 (94%) of 20,160 blood units collected were screened for (at least) HIV, hepatitis B and syphilis.

• 120,022 (83%) of 144,408 women at ANC had their HIV status ascertained; 9,146 (8%) of these were HIV positive. 114,585 (95%) of 120,794 women at maternity had their HIV status ascertained; 8,407 (7%) of these were HIV positive.

• 29,260 patients started ART this quarter. This 15% increase from the previous quarter (25,363) was due to implementation of new ART eligibility criteria in April 2014.

• 505,123 patients were alive and on ART by end of June 2014. This means that 51% of the estimated 1 million HIV positive population was on ART. 1 Estimated ART coverage among people in need for treatment was 40% (43,931 / 110,000)for children (<15 years) and 81% (461,192 / 570,000) for adults.

• 77% of adults and 80% of children were retained alive on ART at 12 months after initiation.

• 436,724 (93%) of 469,613 patients on first line adult ART were on regimen 5A (TDF/3TC/EFV).

• 9,406 2 (76%) of an estimated 12,425 HIV infected pregnant women in Malawi were on ART this quarter. 4,882 (52%) of these were already on ART when getting pregnant and 4,524 (48%) started ART during pregnancy/delivery.

• An additional 1,427breastfeeding women started ART due to Option B+ (in WHO stage 1/2)

• 76%, 71% and 70% of women started under Option B+ were retained on ART at 6, 12 and 24 months after initiation, respectively.

• 7,743 (7%) of infants discharged alive from maternity were known to be HIV exposed, 7,190 (93%) of these received ARV prophylaxis (nevirapine). 5,427 (70%) were enrolled in exposed child follow-up before age 2 months.

• A total of 9,153 HIV exposed children and 7,285 pre-ART patients were enrolled for followup in HIV Care Clinics (HCC) during this quarter.