Antiretroviral therapy coverage among people living with HIV in key populations (A–E)

Export Indicator

Percentage of the people living with HIV in a key population receiving antiretroviral therapy in the past 12 months
What it measures

This indicator is divided into five subindicators:

A. Antiretroviral therapy coverage among sex workers living with HIV

B. Antiretroviral therapy coverage among men who have sex with men living with HIV

C. Antiretroviral therapy coverage among people who inject drugs living with HIV

D. Antiretroviral therapy coverage among transgender people living with HIV

E. Antiretroviral therapy coverage among prisoners living with HIV

What it measures

Progress towards providing antiretroviral therapy to people living with HIV in key populations

Rationale

Antiretroviral therapy has been shown to reduce HIV-related morbidity and mortality among people living with HIV and to reduce the transmission of HIV. People living with HIV in key populations should be able to access mainstream services that provide antiretroviral therapy without fear of facing stigma or discrimination and to be able to receive care from health-care workers who have the clinical knowledge to meet their specific needs. Ideally, all of these mainstream services should meet the standards for becoming sensitized to the need of key populations. Accordingly, antiretroviral therapy coverage is a crucial way of assessing access to mainstream services.

In recent years, the guidelines on eligibility for antiretroviral therapy have changed several times. National guidelines do not always match global guidelines. As a result, antiretroviral therapy coverage has been reported using numerous definitions, including those based on global guidelines, or national guidelines, or both. When guidelines are modified to increase eligibility among people who are living with HIV, coverage estimates will decrease. To avoid multiple antiretroviral therapy coverage values, the number of key population members living with HIV receiving antiretroviral therapy will be presented in relation to the total number of key population members living with HIV.

This indicator will be aligned with the indicator on antiretroviral therapy coverage among all people living with HIV.

Numerator

Number of respondents living with HIV who report receiving antiretroviral therapy in the past 12 months

Denominator

Number of respondents living with HIV

Calculation

Numerator/denominator

Method of measurement

Biobehavioural surveys

Most treatment programmes do not collect behavioural risks in medical charts, so programme data are of limited use.

Measurement frequency

Annual

Disaggregation
  • A, C, D and E: Sex (female, male and transgender)
  • A-E: Age (<25 and 25+ years) 
  • A-E: Cities and other administrative areas of importance
 
Additional information requested

If there are subnational data available, please provide the disaggregation by administrative area, city, or site in the space provided. Submit the digital version of any available survey reports using the upload tool.

Strengths and weaknesses

This is a new indicator that recognizes the importance of antiretroviral therapy and the need to achieve equity in access to ART. This has not been a standard question in biobehavioural surveys. It is, however, increasingly asked in surveys, including household surveys. Treatment programmes do not collect data on risk behaviour and therefore do not comprise a routine source for this information. Data on treatment distribution permit measurement of the second 90 of the 90–90–90 target and provide information to advocate for equity for treatment access for all key population communities.

It remains unclear how many people will respond accurately to this question in a survey. Additional analysis and research is required to assess the validity of the responses and to improve the elicitation of valid responses in the future.

Further information

Global HIV Strategic Information Working Group. Biobehavioural survey guidelines for populations at risk for HIV. Geneva, Switzerland; http://www.who.int/hiv/pub/guidelines/biobehavioral-hiv-survey/en/

Tool to set and monitor targets for HIV prevention, diagnosis, treatment and care for key populations: supplement to the 2014 consolidated guidelines for HIV prevention, diagnosis, treatment and care for key populations. Geneva: World Health Organization; 2015 (http://www.who.int/hiv/ pub/toolkits/kpp-monitoring-tools/en).