3 by 5, Millenium Development Goals (MDG), US President's Emergency Plan for AIDS Relief (PEPFAR), N/A, Universal Access (UA), Additional Recommended Indicators, 2009 UN General Assembly Special Session on HIV/AIDS (UNGASS)
HIV Testing in the General Population
Percentage of women and men aged 15-49 who received an HIV test in the past 12 months and know their results
It measures progress in implementing HIV testing and counselling.
In order to protect themselves and to prevent infecting others, it is important for individuals to know their HIV status. Knowledge of one’s status is also a critical factor in the decision to seek treatment.
Number of respondents aged 15-49 who have been tested for HIV during the last 12 months and who know their results.
Number of all respondents aged 15-49.
The denominator includes respondents who have never heard of HIV or AIDS.
The introductory statement “I don't want to know the results, but…” allows for better reporting and reduces the risk of underreporting of HIV testing among people who do not wish to disclose their serostatus.
Knowledge of HIV test results in the past 12 months does not guarantee that a respondent knows their current HIV status. A respondent may have contracted HIV in the time since their last HIV test.
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EspañolPercentage of newly registered TB patients who are HIV positive
Percentage of newly registered TB patients who are HIV positive
Surveillance of HIV prevalence among TB patients will give information about the epidemics of both TB and HIV. In particular, it indicates the degree of overlap in the epidemics in any given setting and, when compared with the HIV prevalence in the general population, indicates the contribution of HIV to the TB epidemic in any given setting.
Total number of newly registered TB patients who are HIV positive over a given time period
Total number of newly registered TB patients (registered over the same given time period) who were tested for HIV and included in the surveillance system
Number and percentage of municipalities with at least one human rights network functioning
Number and percentage of municipalities with at least one human rights network functioning
A human rights network will at least include: a human rights ombudsperson office, human rights desk or accredited legal offices that permit people living with HIV and/or population groups most at risk who
believe that their human rights or fundamental freedoms have been violated to lodge a confidential petition and to start the necessary proceedings. Depending on the current policy and legal environment
Stigma and related human rights violations fuel the HIV epidemic. Stigma is literally a “mark” or “blemish” on someone or something. HIV is often viewed negatively, and social attitudes may be damaging to those infected or suspected of living with HIV. Discrimination is defined more in terms of legal and human rights: when a person loses a job because of the negative connotation or impression of HIV, overt discrimination has taken place. HIV is heavily stigmatized in most societies. A strengthened
human rights–based response to the epidemic will help to increase social cohesion and the community’s ability to respond to the epidemic. Programs aim to combat active discrimination by changing laws to
support people living with HIV and by ensuring that these laws are enforced. Mechanisms need to be in place to record, document and address cases of discrimination experienced by people living with HIV
and populations most at risk. An important step is to develop networks in which violations or complaints of human rights can be reported and handled.
Total number of municipalities with at least one human rights network functioning
Total number of municipalities surveyed
Number and percentage of enterprises implementing an HIV workplace program
Number and percentage of enterprises implementing an HIV workplace program
The workplace is a strategic venue for promoting HIV prevention within a country’s population. It is in employers’ best interest to maintain a healthy workforce, and encouraging their participation helps bring about normative practices within the world of work. This indicator permits monitoring the number of enterprises that are implementing some aspect of a workplace HIV program that addresses the prevention of HIV within the workforce.
Number of enterprises that are implementing an HIV workplace program
Total number of enterprises surveyed
Number and percentage of adults and children newly enrolled in HIV care who start on treatment for latent TB infection (isoniazid preventive therapy) among the total number of adults and children newly enrolled in HIV care over a given time period
Number and percentage of adults and children newly enrolled in HIV care who start on treatment for latent TB infection (isoniazid preventive therapy) among the total number of adults and children newly enrolled in HIV care over a given time period
Number of adults and children newly-enrolled in HIV care who started on treatment for latent TB infection (TB preventive therapy (TBPT), isoniazid preventative therapy(IPT)) expressed as a proportion of the total number of adults and children newly-enrolled in HIV care over a given time period.
To ensure that eligible people living with HIV are given treatment for latent TB infection and thus to reduce the incidence of TB among people living with HIV.
Number of adults and children newly enrolled (i.e. started) in HIV care (pre-ART and ART) who also start (i.e. given at least one dose) isoniazid preventive therapy treatment during the reporting period
HIV care includes pre-ART and ART.
Number of adults and children newly enrolled (i.e. started) in HIV care during the reporting period.
Treatment of latent TB infection will reduce the incidence of developing TB disease in People living with HIV who are infected with TB but who have no active TB disease. To include clients who are given at least one dose is relatively easy, even in resource- limited settings. This information is the minimum necessary to ensure that TB preventive therapy is being offered to HIV-positive clients without evidence of active TB. However, unless further data are collected, this indicator provides no information about how many clients adhere to or complete the TB preventive therapy course. Much greater resources are required to collect more complete data on adherence or completion, but programmes may wish to undertake periodic studies to establish, for example, adherence rates, and the accuracy of the screening questionnaire.
Additional considerations:
A pharmacy based TB preventive therapy (INH) register should record client attendance to collect further drug supplies (usually monthly). From this register, facilities would be able to report the number of new, and continuing cases and treatment completion on a quarterly basis. If such information is collected routinely, the indicator of choice would be 'the number of HIV-positive clients completing treatment of latent TB infection, as a proportion of the total number of HIV-positive clients started on such treatment".
From pilot testing sites it is apparent that 10–50% of clients who test HIV-positive can be expected to start TB preventive therapy; some will not meet the eligibility criteria, some will decline and some will drop out during the screening process. The proportion likely to start TB preventive therapy depends on the screening algorithm used (for example, using tuberculin skin test as a screening tool reduces the number that are eligible) and also on the type of facility at which HIV diagnosis is made.
Among hospital or clinical referrals, more sick patients would be ineligible for treatment of latent TB infection. Higher proportions would be expected from sites linked to PMTCT or stand-alone VCT centres. Most programmes would aim for at least 50% of people newly enrolled in HIV care starting IPT during the year.
Data utilization: If low value, explore reasons why and compare disaggregated data with the national average to identify places needing special attention and reasons for suboptimal coverage. Explore further available data on completion of TBPT/IPT.
TB/HIV-4, page 127
TB/HIV
HIV/TB Indicator #E3, pg 34
Number and percentage of adults and children enrolled in HIV care who had TB status assessed and recorded during their last visit among all adults and children enrolled in HIV care in the reporting period
Number and percentage of adults and children enrolled in HIV care who had TB status assessed and recorded during their last visit among all adults and children enrolled in HIV care in the reporting period
GFATM: This indicator assesses activity intended to reduce the impact of TB among people living with HIV. It demonstrates the level of implementation of the recommendation that people living with HIV be screened for TB at diagnosis and at all follow-up visits.
WHO: Number of adults and children enrolled in HIV care who had TB status assessed and recorded during their last visit.
This is a process indicator for an activity intended to reduce the impact of TB among people living with HIV. It will demonstrate the level of implementation of the recommendation that people living with HIV are screened for TB at diagnosis and at follow-up visits using their last visit as proxy measure.
Number of adults and children in HIV care, who had their TB status assessed and recorded during their last visit.
HIV care includes pre-ART and ART.
Total number of adults and children enrolled in HIV carea in the reporting period
TB status assessment among people living with HIV, followed by prompt referral for diagnosis and treatment, increases the chances of survival, improves quality of life and reduces transmission of TB in the community. TB status assessment identifies HIV-positive clients who show no evidence of active TB and would benefit from treatment with isoniazid for latent TB infection. The indicator does not measure the quality of intensified TB case-finding nor does it reveal whether those identified as suspects are investigated further or effectively for TB. However, it does emphasize the importance of intensified TB case-finding for people living with HIV at diagnosis and at every contact they have with HIV treatment and care services. Programmes should aim for a high value for this indicator (close to 100%) but should interpret it in conjunction with values of indicators related to the % of people in HIV care who are: a) on TB treatment and b) who were given treatment for latent TB infection, to ensure that appropriate action follows the screening process. A low value will demonstrate that Objective B - reducing the impact of TB among people living with HIV - is unlikely to be met.
Data utilization: See section on Strengths and Weaknesses for interpretation of data and further areas to explore. If low value, review disaggregated data and explore reasons why.
Other References: HIV/TB M&E Guide #B.1.1.1
TB/HIV-1, page 124
TB/HIV
HIV/TB Indicator #E4, pg 36
Percentage of orphaned and vulnerable children aged 5–17 years who report improvement in their emotional well-being
Percentage of orphaned and vulnerable children aged 5–17 years who report improvement in their
emotional well-being
For the purposes of this indicator, an orphan is defined as a child younger than 18 years who has lost
both parents. A child made vulnerable by HIV is younger than 18 years and fulfills any of the following:
-has lost one or both parents;
-has a chronically ill parent (regardless of whether the parent lives in the same household as the child);
This indicator is intended to measure psychosocial well-being among orphaned and most vulnerable
children, beyond material satisfaction.
Number of orphaned and vulnerable children aged 5–17 years reporting at least five elements
of the psychosocial well-being matrix at the time of the survey
Total number of orphans and vulnerable children aged 5–17 years
Percentage of orphaned and vulnerable children aged 5–17 years who have three basic material needs met
Percentage of orphaned and vulnerable children aged 5–17 years who have three basic material needs
met
For the purposes of this indicator, an orphan is defined as a child younger than 18 years who has lost
both parents. A child made vulnerable by HIV is younger than 18 years and fulfills any of the following:
-has lost one or both parents;
-has a chronically ill parent (regardless of whether the parent lives in the same household as the child);
The indicator is intended to measure progress towards meeting the material needs of orphans and
vulnerable children and improved the quality of their care as a result of various interventions targeted at
improving the livelihood conditions of orphans and vulnerable children and their households.
Number of orphaned and other most vulnerable children aged 5–17 years reporting having at
least three basic needs met
Total number of orphaned and vulnerable children aged 5–17 years
Number of adults and children living with HIV who receive care and support services outside facilities during the reporting period
Number of adults and children living with HIV who receive care and support services outside facilities
during the reporting period
Adults and children living with HIV should receive a comprehensive package of services (see below) to
improve the quality of life, extend life and delay the need for antiretroviral therapy. Care and support
programs can cover external support, including counseling, health care, help with household work,
companionship, financial support, legal services and access to shelter or other social services. The
goal should be to provide services in different domains and to provide these services using a holistic
approach, from the time of HIV diagnosis. Many of these services are provided outside the formal health
care system and take place at the household level and some at the community level. This indicator tracks information on the level of coverage and care and support provided outside facilities (at the household and community levels) to people living with HIV.
Number of adults and children living with HIV who received at least one service from the
essential package (regardless of the number of service provision episodes) outside a health facility during
the reporting period
Not applicable
Number and percentage of adults and children enrolled in HIV carea and eligible for co-trimoxazole prophylaxis (according to national guidelines) currently receiving co-trimoxazole prophylaxis
Number and percentage of adults and children enrolled in HIV carea and eligible for co-trimoxazole
prophylaxis (according to national guidelines) currently receiving co-trimoxazole prophylaxis
Co-trimoxazole prophylaxis is a simple and cost-effective intervention that reduces the risk of
opportunistic infections and mortality among children and adults living with HIV. WHO recommends
administration of co-trimoxazole for the following groups: adults living with HIV, including pregnant
women, children living with HIV and infants exposed to HIV.b The WHO guidelines offer countries a
choice of whether to provide co-trimoxazole broadly or according to disease stage.
Number of adults and children living with HIV enrolled in HIV carea and receiving co-trimoxazole prophylaxis
A. Number of adults and children living with HIV enrolled in HIV care who are eligible for
co-trimoxazole prophylaxis based on national guidelines. B. Estimated number of people living with HIV
in the country
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