This is the sixth 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 2012 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

  • 651 (static) ART sites

  • 585 PMTCT sites (Option B+)

  • 577 Pre-ART sites

  • 579 sites with HIV-exposed child follow-up

• 378,560 persons were tested and counselled for HIV and 33,718 (9%) were HIV positive; 143,906 (38%) people tested for the first time.

• 111,503 (68%) of 163,510 women at ANC had their HIV status ascertained; 9,891 (9%) of these were HIV positive. 117,730 (88%) of 132,755 women at maternity had their HIV status ascertained; 9,647 (8%) of these were HIV positive.

• 24,168 patients started ART during this quarter; this is a further decrease from the previous quarter (26,909). Some of this decline was probably due to a shortage of HIV test kits.

• 404,905 patients were alive and on ART by end of December 2012; 72,612 (19%) of 376,094 on first line adult regimens were on ART regimen 5A (tenofovir / lamivudine / efavirenz)

• 80% of adults and 81% of children were retained alive on ART at 12 months after ART initiation.

• A total of 10,882 HIV positive pregnant women were on ART: 4,211 (39%) of these were already on ART when getting pregnant and 6,671 (61%) started ART during pregnancy/delivery. 6,349 (95%) of pregnant women started ART due to Option B+ (in WHO clinical stage 1 or 2) and 322 (5%) due to a low CD4 count and/or WHO clinical stage 3 or 4.

• An additional 2,297 breastfeeding women started ART due to Option B+ (in WHO clinical stage 1 or 2).

• 5,701 (84%) of 6,815 women started under Option B+ were retained at 6 months after ART initiation (6-month retention outcomes were missing for 1,348 women registered, mainly at sites with electronic data systems).

• 9,082 (8%) of infants discharged alive from maternity were known to be HIV exposed, 8,174 (90%) of these received ARV prophylaxis. 5,397 (59%) were enrolled in exposed child followup before age 2 months.

• A total of 11,156 HIV exposed children and 8,774 pre-ART patients enrolled for follow-up in HIV Care Clinics (HCC) during this quarter.

• 658 health workers were trained in the new integrated PMTCT/ART curriculum during Q4 2012, bringing the total number trained in the 2011 guidelines to 5,297. 112 District PMTCT/ART coordinators were trained in developing plans for Elimination of Mother to Child Transmission.

• 30 TB Officers in the SE Zone were trained in ART/TB management.

• 60 HTC Counsellors received training in collecting dried blood spot specimens for Early Infant Diagnosis (EID).

• 100 facilities received mentoring for HIV Exposed Child Follow-Up and EID specimen collection.

• 598 Health workers at 92 facilities in the SE Zone and 227 health workers and support staff at 33 facilities in the N Zone received clinical mentoring in provision of PMTCT/ART.