ICAP HIV Testing and Counseling indicators Initial s ummary of data, January-March 2010 quarter

1. ICAP HIV Testing and Counseling indicators Initial summary of data, January-March 2010 quarter ICAP

2. Background – HTC and ICAP • Most country teams collect & report data on HIV testing & counseling (HTC) to MOH and USG teams • Historically very limited data on HTC reported to ICAP-NY • Introduced draft HTC indicators for comment in early 2009 • HTC done as part of the TB, PMTCT and HEI programs not included (no double counting) • Indicators reported by point of service within each site – e.g., VCT, family planning, OPD

3. Flowchart of ICAP Data Indicator Proposal Procedures If approved If approved ICAP staff conceptualizes idea for potential new or revised indicator Development team is formed. Draft SOP is developed and piloted (two months) Staff submits New/Revised Indicator Proposal Form Staff reviews idea with M&E Director Review committee reviews proposal (2weeks) Country-specific input ICAP-wide input Draft SOP disseminated for two-week comment period Discussed during routine M&E call or Country Program call Comments/Concerns posted to Indicator workspace SOP finalized (1 month) URS Reporting Module (1-2 months) developed Data collection registers do not exist Data collection registers exist Training on final SOP and Implementation Develop data collection tools Data reported quarterly to ICAP-NY Data disseminated to country teams via URS, analysis databases and reports

4. ICAP HTC indicators

5. ICAP HTC indicatorsGender and age group – indicators #1-8 *Requires PCR testing, since maternal HIV antibodies may be detected in antibody testing

6. Reporting by points of service (POS) POS #1 POS #1 POS #2 POS #1 POS #2 POS #2 POS #3 POS #4 POS #3 Site A Site C Site B ICAP country team office ICAP-NY

7. PEPFAR Next Generation indicators • ICAP indicators are aligned with PEPFAR NGI

8. Data entry and dissemination • Data entered into the URS manually or via import tool • Summarized on URS HTC dashboard and in Summary Reports • Will include a summary table and narrative for HTC indicators in upcoming quarterly report to CDC-Atlanta • Added to master slides posted on ‘wiki’ data dissemination workspace • Core maps • Initial indicator reporting period: October-December 2009

9. Identifying points of service

10. HTC points of service (n=24)

11. Data entry and import

12. January-March 2010 HTC indicator data

13. Completeness of HTC indicator dataJanuary-March 2010

14. Reporting pediatric data • 5 countries reported data by age as specified in the ICAP HTC SOP: • 0-18 months • 18 months -14 years • 15+ years • Ethiopia and Kenya reported only 0-14 years and 15+ years • Rwanda reported patients aged 0-17 years and 18+ years

15. Number of sites supporting HIV counseling and testing, March 2007-March 2010 Source: ICAP URS March 2010 Note: Counseling and testing data was not reported until December 2009

16. 88% of HTC supported sites reported

17. % of patients provided HIV testing by POS by country

18. % of patients provided HIV testing by POS by country

19. % of patients provided HIV testing by POS by country

20. Total n=392,803

22. # testing: n=214,014 n=43,110 n=37,007 n=31,336 n=19,794 n=18,566 n=16,018 n=12,958

23. % of patients testing HIV-positive, by country # testing: n=12,958n=214,014 n=19,794 n=18,566 n=31,336 n=37,007 n=16, 018 n=43,110

24. % of patients testing HIV-positive, by country, and national HIV prevalence # testing: n=12,958n=214,014 n=19,794 n=18,566 n=31,336 n=37,007 n=16, 018 n=43,110

26. Cote d’Ivoire EthiopiaKenyaMoz.NG RwandaSouth Africa Tanzania # testing: n=12,958n=214,014 n=19,794 n=18,566 n=37,007 n=16, 018 n=43,110 n=31,336

27. 89% VCT 11% All PITC 100% All POS 49%All POS • 26% VCT • 18% Other 5% Outpt. 1% Inpt. 52% Outpt. 38% VCT 7% Inpt. 3% Other 78% VCT 9% Outpt. 9% Inpt. • 4% Other • 48% Outpt. • 23% Inpt. • 22% Other 7% VCT 62% Outpt. 35% VCT 3% Other 98% VCT 2% All PITC

28. 7% 8% 6% 4%

29. 4% 11% Countries reporting these data include TZ, MZ, SA, and CI

30. Counseling and testing uptake

31. % testing at VCT: 14% 74% 99% 89% 34% 36% Note: Clinic admission data not reported by Kenya and Nigeria

32. Enrollment in HIV care

33. (n= 4,303) (n= 3,529) (n= 4,705) (n=7,596) (n=4,327) (n=1,131) # HIV-positive: Note: HIV care enrollment data not reported by Kenya,or Rwanda

34. (n=16,617) (n=8,714) (n=2,668) (n=21,589) # HIV-positive: Note: HIV care enrollment data not reported by Kenya,or Rwanda

35. # HIV-positive: (n=12,397) (n=3,318) (n=619) (n=1,079) (n=7,923) Note: HIV care enrollment data not reported by Kenya,or Rwanda

36. Additional comments • Jan-Mar 2010 data largely consistent with data from Oct-Dec 2009 • Historical data from prior to October 2009 – coming soon from some countries • Some limitations: • Missing data on clinic/POS admissions and enrollment in HIV care from several countries • Not all countries report data by point of service

37. Routine dissemination

38. URS HTC dashboard

39. URS HTC summary reports

44. Summary / conclusions • ICAP supported almost 400,000 HIV tests during January-March 2010 • Reports from 1,337 points of service from within 691 sites • >99% of patients received their results • More than 27,000 (7%) patients tested HIV-positive • At least 16,899 (67%) HIV-positive patients linked into HIV care

45. Next steps • Historical data • Examine trends • Disseminate to country teams • Feedback – data/program improvement

46. Acknowledgements • ICAP-NY: Charon Gwynn, Sarah Gorrell, Suzue Saito, Frank Brathwaite, other staff providing input on SOP • M&E staff, ICAP country teams

47. Note: HIV care enrollment data not reported by Kenya,or Rwanda