This is the 14th quarterly HIV Program report after implementation of the 2011 Integrated Clinical HIV Guidelines in July 2011. A summary of the key achievements between October and December 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

  • 713 (static) ART sites

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

  • 655 Pre-ART sites

  • 644 sites with HIV-exposed child follow-up

• 464,292 persons were tested and counselled for HIV; 139,602 (30%) accessed HTC for the first time; 324,690 (70%) were repeat testers and 9,854 (3%) of these received confirmatory testing (after having tested positive in the past). This is equivalent to 38% confirmatory testing coverage among 26,060 patients initiating ART this quarter. 28,465 (6%) clients received a positive result for the first time.

• 19,606 (97%) of 20,244 blood units collected were screened for (at least) HIV, hepatitis B and syphilis.

• 134,985 (89%) of 151,118 women at ANC had their HIV status ascertained; 10,550 (8%) of these were HIV positive. 129,821 (96%) of 138,024 women at maternity had their HIV status ascertained 9,785 (8%) of these were HIV positive.

• 26,060 patients started ART this quarter.

• 536,438 patients were alive and on ART by end of December 2014. This means that 54% of the estimated 1 million HIV positive population was on ART. 1 Estimated ART coverage among people in need for treatment was 42% (46,410 / 111,000) for children (<15 years) and 71% (489,775 / 687,000) for adults.

• 76% of adults and 77% of children were retained alive on ART at 12 months after initiation. Actual retention rates are thought to be about 10% higher due to misclassification of ‘silent transfers’ as defaulters in clinic-based survival/retention analysis. (see section 16.4)

• 470,048 (93%) of 504,494 patients on first line adult ART were on regimen 5A (TDF/3TC/EFV).

• 11,053 2 (85%) of an estimated 13,317 HIV infected pregnant women in Malawi were on ART this quarter. 6,288 (57%) of these were already on ART when getting pregnant and 4,765 (43%) started ART during pregnancy/delivery.

• An additional 1,593 breastfeeding women started ART due to Option B+ (in WHO stage 1/2)

• 78%, 72%, 68% and 71% of women started under Option B+ were retained on ART at 6, 12, 24 and 36 months after initiation, respectively.

• 8,851 (7%) of infants discharged alive from maternity were known to be HIV exposed, 8,305 (94%) of these received ARV prophylaxis (nevirapine). 7,006 (65%) were enrolled in exposed child follow-up before age 2 months.

• A total of 10,797 HIV exposed children and 6,483 pre-ART patients were enrolled for follow-up in HIV Care Clinics (HCC) during this quarter.