Number of People Living with HIV/AIDS (PLHIV) reached with a minimum package of Prevention with PLHIV (PwP) interventions
The purpose of this indicator is to measure how well clinic/facility-based and community-based programs are reaching PLHIV with a minimum package of prevention interventions and services that includes evidenced based behavioral and biomedical interventions designed to protect the health of the infected person and reduce the spread of HIV to their sex partners and children.
Headquarter staff can use this information to plan and make decisions on how well PLHIV are being reached with PwP interventions. If a small percentage of the intended target population is being reached, then it would be recommended that activities are adjusted to improve reach. If a large percentage of the intended target population is being reached, then headquarter staff would want to take these lessons learned and disseminate them to other countries. The country can use the information to improve upon the quality of the program as well as scale-up successful models.
Prevention efforts with HIV positive persons (PwP) are part of a comprehensive prevention strategy and include both behavioral and biomedical interventions.
Number of People Living with HIV reached with a minimum package of PwP interventions
Total estimated number of PLHIV in the catchment area*
The numerator can be generated by counting the number of PLHIV who are reached with a minimum package of PwP interventions (see definition below).
The sexual partner(s) or family members of a PLHIV may also receive a service as part of the PwP intervention. While these services may contribute to the minimum standards that are required to count the PLHIV, only the PLHIV should be counted under this indicator. Do not additionally count the partner or family member.
Note: The service provided to the partner or family member may meet the defined criteria for another indicator and (if so) should be counted there, i.e. Testing and Counseling (#P11.1.D), CARE (#C1.1.D), or Early Infant Diagnosis (#C4.1.D).
Disaggregation: By setting: Number reached in a clinic/facility-based setting; NUmber reached in a community/home-based setting
Explanation of Numerator:
Minimum Package of PwP interventions required for the indicator: In order to count under this indicator, PLHIV must have received at last visit (in a clinic/facility-based or community/home-based program) the following interventions that constitute the minimum package of PwP:
• Assessment of sexual activity and provision of condoms (and lubricant) and risk reduction counseling (if indicated)
• Assessment of partner status and provision of partner testing or referral for partner testing
• Assessment for STIs and (if indicated) provision of or referral for STI treatment and partner treatment
• Assessment of family planning needs and (if indicated) provision of contraception or safer pregnancy counseling or referral for family planning services
• Assessment of adherence and (if indicated) support or referral for adherence counseling
• Assessment of need and (if indicated) refer or enroll PLHIV in community-based program such as home-based care, support groups, post-test-clubs, etc.
Description: All clinic/facility-based and community/home-based programs serving PLHIV should include a package of behavioral and biomedical prevention interventions that are consistent with the guidelines outlined in the PWP technical considerations. These interventions should be provided at each client encounter and delivered either onsite or (where specifically noted above) through a referral program in which the client is enrolled. Partners using referral sites must confirm that they are accessible and providing the referral service. All PLHIV should be provided with an adequate supply of condoms (and lubricant) and risk reduction counseling which addresses condom use, partner reduction, and alcohol reduction. All negative or unknown status partners of PLHIV should be tested at least every year; discordant couples should be identified and provided with appropriate prevention counseling and services. Regular screening and treatment for STIs should be part of routine care and prevention for PLHIV, and STI treatment for partners of PLHIV should also be provided. Provision of family planning counseling, contraceptive methods or safer pregnancy counseling should be provided to HIV–positive women and their partners as part of routine care to reduce unintended pregnancy and prevent maternal-to-child transmission. Adherence to ARVs and all medications is also important for maintaining low viral loads and reducing risk of transmission. Finally, all interventions delivered through clinics/facilities should be reinforced through community-based programs, and linkages and referrals from community programs to clinics should be incorporated into all community programs serving PLHIV.
Explanation of Denominator:
Catchment area: Geographic region from which persons come to receive HIV prevention services, or from which persons are being recruited into HIV prevention services. The size and population of this area can vary
Condom type: N/A
HIV status: N/A
Pregnancy status: N/A
Service Type: N/A
Time period: N/A
Type of orphan: N/A
Vulnerability status: N/A
This indicator provides information on the total number of unduplicated individuals that received a minimum package of PwP interventions according to the PwP technical considerations. The indicator will help the country teams to determine reach (if no denominator) and coverage (if denominator is also collected) to help country programs understand the extent and reach of evidence-based programs for further expansion.