A summary of the key achievements between October and December 2013 is provided below:

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

  • 825 static (607 within and 218 outside of health facilities) and 534 outreach HTC sites

  • 689 (static) ART sites

  • 594 PMTCT sites (Option B+)

  • 634 Pre-ART sites

  • 612 sites with HIV-exposed child follow-up

• 374,456 persons were tested and counselled for HIV and 32,654 (9%) were HIV positive; 138,000 (37%) people tested for the first time.

• 18,648 (97%) of 19,172 blood units collected were screened for HIV, hepatitis B and syphilis.

• 129,368 (83%) of 156,528 women at ANC had their HIV status ascertained; 10,354 (8%) of these were HIV positive. 118,217 (91%) of 128,675 women at maternity had their HIV status ascertained; 9,066 (8%) of these were HIV positive.

• _ 23,334__ patients started ART during this quarter; this is a 10% decline from the previous quarter (25,551).

• 472,865 patients were alive and on ART by end of December 2013. This is equivalent to 79% coverage of the estimated 602,000 population in need of ART (all ages).1 Estimated ART coverage among children (<15 years) and adults was 48% and 84%, respectively.

• 78% of adults and 81% of children were retained alive on ART at 12 months after initiation.

• 381,477 (87%) of 424,961 on first line adult ART were on regimen 5A (TDF/3TC/EFV).

• The proportion of ART patients with documented side effects was 2%. This is a significant decline from 7% before transition to 5A.

• A total of 11,815 HIV positive pregnant women were on ART: 5,271 (45%) of these were already on ART when getting pregnant and 6,544 (57%) started ART during pregnancy/delivery. This is equivalent to 75% ART coverage among the estimated 15,750 HIV infected pregnant women in Malawi this quarter.

• An additional 1,721 breastfeeding women started ART due to Option B+ (in WHO stage 1/2)

• 5,798 (79%) of 7,952 women started under Option B+ were retained at 6 months after ART initiation; 5,280 (73%) of 8,012 were retained at 12 months after ART initiation; 7,452 (71%) of 11,714 were retained at 24 months after ART initiation. This confirms for the first time that a high proportion of women started under Option B+ remain on ART beyond the cessation of breastfeeding.

• 8,663 (8%) of infants discharged alive from maternity were known to be HIV exposed, 7,793 (90%) of these received ARV prophylaxis (nevirapine). 5,487 (63%) were enrolled in exposed child follow-up before age 2 months.

• A total of 9,207 HIV exposed children and 7,735 pre-ART patients were enrolled for followup in HIV Care Clinics (HCC) during this quarter.

• 117 medical staff were newly trained and certified in PMTCT/ART this quarter. This brings the total number trained in the 2011 ART/PMTCT guidelines to 6,162.