This is the 9th 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
2013 is provided below:
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Scale-up of integrated HIV services had reached the following number of sites:
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825 static (607 within and 218 outside of health facilities) and 534 outreach HTC sites
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675 (static) ART sites
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590 PMTCT sites (Option B+)
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628 Pre-ART sites
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605 sites with HIV-exposed child follow-up
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405,278 persons were tested and counselled for HIV and 36,807 (9%) were HIV positive;
145,572 (36%) people tested for the first time.
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12,646 (95%) of 13,299 blood units collected were screened for HIV, hepatitis B and syphilis.
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128,022 (83%) of 153,561 women at ANC had their HIV status ascertained; 9,988 (8%) of
these were HIV positive. 122,392 (93%) of 132,279 women at maternity had their HIV status
ascertained; 9,337 (8%) of these were HIV positive.
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25,551 patients started ART during this quarter; this is similar to the previous quarter
(26,802).
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459,261 patients were alive and on ART by end of September 2013. This is equivalent to
74% coverage of the estimated 602,000 population in need of ART (all ages).1 Estimated ART
coverage among children (<15 years) and adults was 47% and 81%, respectively.
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78% of adults and 80% of children were retained alive on ART at 12 months after initiation.
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309,127 (73%) of 424,961 on first line adult ART were on regimen 5A (TDF/3TC/EFV).
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The proportion of ART patients with documented side effects declined from 7% to 2%
compared with the previous quarter.
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A total of 11,788 HIV positive pregnant women were on ART: 5,041 (43%) of these were
already on ART when getting pregnant and 6,747 (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. 6,429 (95%) of pregnant women
started ART due to Option B+ (in WHO clinical stage 1 or 2) and 318 (5%) due to a low CD4
count and/or WHO clinical stage 3 or 4.
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An additional 1,831 breastfeeding women started ART due to Option B+ (in WHO stage 1/2)
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6,057 (79%) of 7,677 women started under Option B+ were retained at 6 months after ART
initiation; 6,630 (72%) of 9,205 were retained at 12 months after ART initiation.
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8,564 (7%) of infants discharged alive from maternity were known to be HIV exposed, 7,941
(93%) of these received ARV prophylaxis (nevirapine). 5,734 (67%) were enrolled in exposed
child follow-up before age 2 months.
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A total of 10,258 HIV exposed children and 8,884 pre-ART patients were enrolled for followup
in HIV Care Clinics (HCC) during this quarter.
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162 medical staff were newly trained and certified in PMTCT/ART this quarter. This brings
the total number trained in the 2011 guidelines to 5,985.
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1,243 HTC providers were re-trained using the HTC Skills Intensive Training curriculum,
bringing the total number re-trained to 3,776.
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A total of 921 staff at 235 sites in 19 districts received clinical mentoring during. 104 staff
graduated, 250 were in intensive and 350 in continuation phase this quarter.