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 July and September 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

  • 707 (static) ART sites

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

  • 654 Pre-ART sites

  • 638 sites with HIV-exposed child follow-up

• 550,425 persons were tested and counselled for HIV; 178,882 (32%) accessed HTC for the first time; 371,543 (68%) were repeat testers and 10,495 (3%) of these received confirmatory testing (after having tested positive in the past). This is equivalent to 35% confirmatory testing coverage among 29,893 patients initiating ART this quarter. 32,347 (6%) clients received a positive result for the first time.

• 15,528 (97%) of 16,034 blood units collected were screened for (at least) HIV, hepatitis B and syphilis.

• 135,958 (89%) of 153,514 women at ANC had their HIV status ascertained; 10,296 (8%) of these were HIV positive. 130,167 (95%) of 137,343 women at maternity had their HIV status ascertained; 9,893 (8%) of these were HIV positive.

• 29,893 patients started ART this quarter.

• 521,319 patients were alive and on ART by end of September 2014. This means that 52% of the estimated 1 million HIV positive population was on ART. 1 Estimated ART coverage among people in need for treatment1 was 41% (45,124 / 111,000) for children (<15 years) and 69% (476,195 / 687,000) for adults.

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

• 454,763 (93%) of 488,020 patients on first line adult ART were on regimen 5A (TDF/3TC/EFV).

• 11,283 2 (85%) of an estimated 13,317 HIV infected pregnant women in Malawi were on ART this quarter. 6,220 (52%) of these were already on ART when getting pregnant and 5,063 (48%) started ART during pregnancy/delivery.

• An additional 1,655 breastfeeding women started ART due to Option B+ (in WHO stage 1/2)

• 78%, 73%, 69% and 67% of women started under Option B+ were retained on ART at 6, 12, 24 and 36 months after initiation, respectively.

• 9,087 (7%) of infants discharged alive from maternity were known to be HIV exposed, 8,482 (93%) of these received ARV prophylaxis (nevirapine). 6,666 (73%) were enrolled in exposed child follow-up before age 2 months.

• A total of 10,613 HIV exposed children and 6,941 pre-ART patients were enrolled for followup in HIV Care Clinics (HCC) during this quarter.