Percentage of people diagnosed with HIV infection who need antiretroviral therapy and who receive it
The efficiency of providing antiretroviral combination therapy to all people diagnosed with HIV infection who are eligible for treatment.
Antiretroviral therapy (ART) has been shown to reduce mortality among people living with HIV and efforts are being made globally to scale-up ART. These efforts require prompt diagnosis of HIV infection, equitable policies and guidelines on ART eligibility and efficient delivery of therapy to those who need it.
Number of people diagnosed with HIV infection who are currently receiving antiretroviral therapy in accordance with the nationally-approved treatment protocol (or WHO/UNAIDS standards) at the end of the reporting period.
Explanation of Numerator
The numerator can be generated by counting the number of people receiving antiretroviral therapy at the end of the reporting period. The numerator should equal the number of people who ever started antiretroviral treatment minus those patients who are not currently on treatment at the end of the reporting period. Patients not currently on treatment at the end of the reporting period include those who died, stopped treatment or are lost to follow-up.
Antiretroviral therapy taken only for the purpose of prevention of mother-to-child transmission or post-exposure prophylaxis is not included in this indicator. HIV-infected pregnant women who are eligible for antiretroviral therapy and on antiretroviral therapy for their own treatment are included in this indicator.
Patients receiving antiretroviral therapy in the private sector and public sector should be included in the numerator.
Number of people diagnosed with HIV infection who are eligible for ART. Eligibility should be defined according to national guidelines, where available. Where national guidelines are not available, international guidelines should be used. Currently, these guidelines recommend treatment for any person with HIV with a CD4 count less than 350 cells/mm3 or any person with HIV with an AIDS-defining illness, such as tuberculosis, regardless of CD4 count.
Explanation of Denominator
The denominator can be generated by counting the number of people who meet eligibility criteria for antiretroviral therapy at the end of the reporting period. The denominator should exclude people known to have died since becoming eligible for treatment.
This indicator provides information about the efficiency of provision of antiretroviral treatment to those who have been diagnosed with HIV and who are considered to need treatment. It does not give information about those people living with HIV who might be in need of treatment but who have not yet been diagnosed. It is therefore important that this indicator be analysed alongside an indicator of the rate of late diagnosis.
In order to interpret data from this indicator, a clear understanding is needed of the national policy on eligibility for antiretroviral therapy.
This indicator is more appropriate for most of the countries in the European region than one using modelled estimates of the number of people with advanced HIV infection as these models are not applicable to high income countries.
ECDC (2010) Implementing the Dublin Declaration on Partnership to Fight HIV/AIDS in Europe and central Asia: 2010 Progress Report Section 3.1 Treatment and Care pp. 137-144. http://ecdc.europa.eu/en/publications/Publications/1009_SPR_Dublin_decla....
As for all indicators related to monitoring the Dublin Declaration on Partnership to Fight HIV/AIDS in Europe and central Asia, where a country does not have data for the indicator specified but has data for a similar indicator, the country is welcome to submit such data when reporting. When submitting alternate data, please provide as much detail as possible as to what information is being supplied.
Percentage of individuals currently on OST who have been on OST continuously for 6 months in the past 12 months
Patients in opioid substitution therapy should remain in treatment for an optimal period
Percentage of patients in opioid substitution therapy (OST) receiving recommended maintenance dose >60mg of methadone or 12mg of buprenorphine
Patients in opioid substitution therapy should receive the optimal maintenance dose.
Antiretroviral therapy for HIV-infected pregnant women eligible for treatment
Eligible HIV-infected pregnant women should receive ART for their own health
Number and percent of patients in HIV treatment programs who have a stable or improving clinical outcome using at least one of three wellness criteria:
i) Viral load
iii) Clinical indicators (stable or increasing weight; not advancing from one clinical stage to another; and having good functional status (able to work or continue regular activities of daily life).
Number and percentage of adults and children who keep scheduled appointments
Adults and children currently enrolled in ART should adhere to their treatment regimens.
Number and percentage of HIV-infected adults and children assessed for ART eligibility through either clinical staging or CD4 testing
HIV-infected adults should be assessed for ART eligibility through either clinical staging or CD4 testing.
Number and percent of people testing HIV positive and Number and percent of people testing positive who subsequently enroll in HIV care
Clients testing HIV positive should be enrolled in HIV care. Linkage between HIV testing and HIV care could be assessed using these two data points.
Proportion of the poorest households who received external economic support in the last 3 months
It measures progress in providing external economic support to poorest households affected by HIV and AIDS.
Economic support (with a focus on social assistance and livelihoods assistance) to poor and HIV-affected households remains a high priority in many comprehensive care and support programs. This indicator reflects the growing international commitment to HIV-sensitive social protection. It recognizes that the household should be the primary unit of analysis since many of the care and support services are directed to the household level. However, household data should be disaggregated to track whether or not households have orphans or an HIV-positive person. Tracking coverage of households with orphans and within the poorest quintile remains a developmental priority.
Number of the poorest households that received any form of external economic support in the last 3 months.
External economic support is defined as free economic help (Cash grants, assistance for school fees, material support for education, income generation support in cash or kind, food assistance provided at the household level, or material or financial support for shelter) that comes from a source other than friends, family or neighbours unless they are working for a community-based group or organization. This source is most likely to be the national government or a civil society organization.
Total number of poorest households.
Poorest households are defined as a household in the bottom wealth quintile. Countries should use the exact indicator definition and method of measurement for standardized progress monitoring and reporting at national and global levels. This will allow monitoring of changes over time and comparisons across different countries. However, countries can add or exclude other categories locally (for example, other wealth quintiles) depending on the country needs with respect to national program planning and implementation.
This indicator reflects new evidence of the need for a greater focus on wealth dimensions of vulnerability and the fact that that targeting on the basis of extreme poverty in high prevalence contexts ensures good coverage of poor households affected by HIV and AIDS . Proxy indicators of AIDS affectedness (such as “chronic illness’) have often been poorly associated with HIV, have weak associations with adverse developmental outcomes, and have proven difficult to define in household questionnaires.
This indicator demonstrates changing levels of economic support for the poorest households. In high prevalence contexts, in particular, the majority are likely to be HIV affected. The indicator also demonstrates changes in the composition of external support (e.g. cash, food, livelihoods) received by poor households.
The indicator does not measure directly economic support to HIV infected and affected households, which is difficult to establish during a survey, but implicitly suggests that households living in the bottom wealth quintile in high prevalence contexts are more likely to be negatively impacted by HIV and AIDS and in need of economic assistance. In order to keep measurement as simple as possible, the indicator does not attempt to identify the different sources of support to households but this should be partly captured in National AIDS Spending Assessments (NASA).
The collection of data through population-based surveys, particularly DHS and MICS, means that the indicator does not capture the status of people living outside of households such as street children, children in institutions and internally displaced populations. Separate surveys are needed to track coverage for such vulnerable populations.
For further information, please consult the following website:
Current school attendance among orphans and non-orphans (10-14 years old, primary school age, secondary school age)
It measures progress towards preventing relative disadvantage in school attendance among orphans versus non-orphans.
The indicator is split up in two parts so comparisons can be made between orphans and non orphans:
Part A: current school attendance rate of orphans aged 10-14 primary school age, secondary school age
Part B: current school attendance rate of children aged 10–14 primary school age, secondary school age both of whose parents are alive and who live with at least one parent
AIDS deaths in adults occur just at the time in their lives when they are forming families and bringing up children. Orphanhood is frequently accompanied by prejudice and increased poverty, factors that can jeopardize children’s chances of completing school education and may lead to the adoption of survival strategies that increase vulnerability to HIV. It is important therefore to monitor the extent to which AIDS support programmes succeed in securing the educational opportunities of orphaned children.
Part A: Number of children who have lost both parents and who attend school aged 10-14, primary school age, secondary school age
Part B: Number of children both of whose parents are alive, who are living with at least one parent and who attend school aged 10-14, primary school age, secondary school age
Explanation of Numerator
The definition of primary school age and secondary school age should be consistent with the UNESCO definition and as currently used for calculating other education-specific indicators such as net primary school enrolment/attendance rate and net secondary school enrolment/attendance rate for each country. The primary school age and secondary school age populations may vary slightly from country to country. Therefore this indicator uses the terms ‘primary school age’ and ‘secondary school age’ as currently applied in standard international measurements including in major survey programmes such as DHS or MICS to allow each country to apply its own national age ranges for primary and secondary school. The important point is to compare current school attendance of orphans and non-orphans across primary school and secondary school rather than by specific ages.
Part A: Number of children who have lost both parents
Part B: Number of children both of whose parents are alive who are living with at least one parent
The definitions of orphan/non-orphan used here—i.e., child aged 10–14 years as of the last birthday both of whose parents have died/are still alive—are chosen so that the maximum effect of disadvantage resulting from orphanhood can be identified and tracked over time. The age-range 10–14 years is used because younger orphans are more likely to have lost their parents recently so any detrimental effect on their education will have had little time to materialize. However, orphaned children are typically older than non-orphaned children (because the parents of younger children have often been HIV-infected for less time) and older children are more likely to have left school.
Typically, the data used to measure this indicator are taken from household-based surveys. Children not recorded in such surveys—e.g., those living in institutions or on the street—generally, are more disadvantaged and are more likely to be orphans. Thus, the indicator will tend to understate the relative disadvantage in educational attendance experienced by orphaned children.
This indicator does not distinguish children who lost their parents due to AIDS from those whose parents died of other causes. In countries with smaller epidemics or in the early stages of epidemics, most orphans will have lost their parents due to non-HIV-related causes. Any differences in the treatment of orphans according to the known or suspected cause of death of their parents could influence trends in the indicator. However, to date there is little evidence that such differences in treatment are common.
The indicator provides no information on actual numbers of orphaned children. The restrictions to double orphans and to 10–14 year-olds mean that estimates may be based on small numbers in countries with small or nascent epidemics.
For further information, please consult the following website: