This is the 8th 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 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

  • 671 (static) ART sites

  • 588 PMTCT sites (Option B+)

  • 623 Pre-ART sites

  • 603 sites with HIV-exposed child follow-up

• 462,334 persons were tested and counselled for HIV and 37,852 (8%) were HIV positive; 156,875 (34%) people tested for the first time.

• 16,763 (98%) of 17,142 blood units collected were screened for HIV, hepatitis B and syphilis.

• 113,061 (77%) of 147,586 women at ANC had their HIV status ascertained; 9,282 (8%) of these were HIV positive. 108,861 (92%) of 118,402 women at maternity had their HIV status ascertained; 8,285 (8%) of these were HIV positive.

• 26,802 patients started ART during this quarter; this is similar to the previous quarter (26,881).

• 443,221 patients were alive and on ART by end of June 2013. This is equivalent to 74% coverage of the estimated 602,000 population in need of ART (all ages; 2013 Spectrum estimates based on current definition of eligibility for ART in Malawi).

• 105,326 (26%) of 408,013 on first line adult regimens were on ART regimen 5A (tenofovir / lamivudine / efavirenz).

• 80% of adults and 82% of children were retained alive on ART at 12 months after ART initiation.

A total of 11,452 HIV positive pregnant women were on ART: 4,343 (38%) of these were already on ART when getting pregnant and 7,109 (62%) started ART during pregnancy/delivery. This is equivalent to 73% ART coverage among the estimated 15,750 HIV infected pregnant women in Malawi this quarter. 6,910 (97%) of pregnant women started ART due to Option B+ (in WHO clinical stage 1 or 2) and 199 (3%) due to a low CD4 count and/or WHO clinical stage 3 or 4.

An additional 2,164 breastfeeding women started ART due to Option B+ (in WHO clinical stage 1 or 2).

5,941 (77%) of 7,709 women started under Option B+ were retained at 6 months after ART initiation; 5,778 (76%) of 7569 were retained at 12 months after ART initiation.

• 7,520 (7%) of infants discharged alive from maternity were known to be HIV exposed, 7,005 (93%) of these received ARV prophylaxis (nevirapine). 5,026 (67%) were enrolled in exposed child follow-up before age 2 months.

• A total of 10,277 HIV exposed children and 9,886 pre-ART patients were enrolled for followup in HIV Care Clinics (HCC) during this quarter.

• 112 medical staff were newly trained and certified in PMTCT/ART this quarter. This brings the total number trained in the 2011 guidelines to 5,823.

• About 300 staff (mainly HSAs) at 52 facilities received mentoring for collection of dried blood samples for Early Infant Diagnosis and documentation of results.

• 2,533 HTC providers were re-trained using the HTC Skills Intensive Training curriculum.

• A total of 61 staff at 46 sites in 4 districts received clinical mentoring during a total of 90 mentoring visits (mentoring program reports remained incomplete for this quarter).