ICAP Quarterly Master Slide Set April-June 2008

Site Census What: Ongoing, real-time inventory of all planned, current, and closed ICAP sites. Supported activities, funding source(s) and their targets are also captured Purpose: To have one up to date master list of sites, activities, funding sources, and targets that all ICAP staff can refer to for planning and evaluation

Number of ICAP-supported sites by activity, June 2008 (n=619) Number of sites

Number of ICAP-supported sites by country, June 2008 (n=619) Number of sites

Programmatic components funded at ICAP- supported care and treatment sites (n=332), June 2008 % care and treatment sites with activity Type of activity

Program and Facility Characteristics Tracking System (PFaCTS) What: Collects program and facility information on ICAP-supported care and treatment programs semi-annually Purpose: To describe the scope, diversity, and comprehensiveness of ICAP-supported care and treatment programs, and evaluate multi-level factors that influence program performance and patient-level outcomes

Location and type of ICAP-supported HIV care and treatment sites (n=296) n=166n=130 % sites

Proportion of ICAP-supported HIV care and treatment sites offering HIV-related services on site (n=303) % sites with service

Proportion of ICAP-supported HIV care and treatment sites offering HIV-related services on site by number of services offered (n=284)

Proportion of ICAP-supported HIV care and treatment sites offering ≥4 HIV-related services on site (n=257) ICAP Average =99% % sites with ≥4 services

Proportion of ICAP-supported HIV care and treatment sites offering on-site patient support services by type of service offered (n=303) % sites with service

Proportion of ICAP-supported HIV care and treatment sites offering on-site patient support services by number of services offered (n=248)

Proportion of ICAP-supported HIV care and treatment sites with ≥4 on-site patient support services (n=248) ICAP Average =29% % of sites with ≥ 4 services

Proportion of ICAP-supported HIV care and treatment sites with access to laboratory assays (n=303) % sites

Proportion of ICAP-supported HIV care and treatment sites with access to laboratory assays by number of assays (n=300)

Proportion of ICAP-supported HIV care and treatment sites with access to key HIV-related laboratory assays (n=277) ICAP Average =92% % sites

Proportion of ICAP-supported HIV care and treatment sites with access to PCR laboratory assays (n=283) ICAP Average =90% % sites

Mean number of health care providers per 1000 patients on ART at ICAP-supported HIV care and treatment sites (n=303) Number of providers per/1000 patients on ART

Mean number of outreach workers per 1000 patients on ART at ICAP-supported HIV care and treatment sites (n=163) ICAP Average =6.9 Number of outreach workers per/1000 patients on ART

Trend in proportion of ICAP-supported HIV care and treatment sites offering on-site patient support services (n=170)

Trend in proportion of ICAP-supported HIV care and treatment sites offering prevention services (n=224) Counseling regarding disclosure Education on behavior and safe sex Provision of condoms Referral for on-site screening for STIs Education on high-risk substance use Screening for drug and alcohol abuse

HIV care and treatment services

Proportion of ART patients in sub-Saharan Africa that initiated ART at an ICAP-supported site, December 2007 % of all patients on ART Sub-Saharan countries where ICAP works

Cameroon, Cote d’Ivoire, Kenya, Lesotho, Rwanda, S. Africa, Tanzania Uganda, Thailand Mozambique Ethiopia Cumulative enrollment at ICAP-supported HIV care and treatment programs (ever-supported) 522,399 in care 237,337 on ART Number of patients Number of facilities Nigeria, Swaziland, Zambia 362 sites

Cumulative pediatric enrollment in ICAP-supported HIV care and treatment programs (ever-supported) 58,505 in care 20,996 on ART Number of patients Number of facilities Cameroon, Cote d’Ivoire, Kenya, Lesotho, Rwanda, S. Africa, Tanzania Uganda, Thailand Mozambique Ethiopia Nigeria, Swaziland, Zambia 362 sites

Cumulative enrollment in ICAP-supported HIV care and treatment programs (currently supported) 442,668 in care 202,303 on ART Number of patients Number of facilities Cameroon, Cote d’Ivoire, Kenya, Lesotho, Rwanda, S. Africa, Tanzania Uganda, Thailand Mozambique Ethiopia Nigeria, Swaziland, Zambia 320 sites

Cumulative pediatric enrollment in ICAP-supported HIV care and treatment programs (currently supported) 297 sites 18,210 on ART Number of patients Number of facilities Cameroon, Cote d’Ivoire, Kenya, Lesotho, Rwanda, S. Africa, Tanzania Uganda, Thailand Mozambique Ethiopia Nigeria, Swaziland, Zambia 44,271 in care

Current and target cumulative enrollment in ICAP- supported care and treatment programs Number of patients

Current and target cumulative HIV care enrollment in ICAP-supported care and treatment programs by country Number of patients 3% of target 99% of target 66% of target 108% of target 76% of target 108% of target 87% of target 107% of target

Current and target cumulative ART enrollment in ICAP-supported care and treatment programs by country Number of patients 7% of target 98% of target 116% of target 48% of target 96% of target 101% of target 83% of target 89% of target

Cumulative enrollment in HIV care in ICAP-supported HIV care and treatment programs by country (n=442,668) Number of patients

Cumulative enrollment on ART at ICAP-supported HIV care and treatment programs by country (n=202,303) Number of patients

Cumulative and current enrollment in ART care at ICAP-supported HIV care and treatment programs (n= 190,378*) Number of patients ART patients retained in care Cumulative initiating ART Lost to follow up Reported dead ART patients retained in care * Excludes Zambia and Swaziland as no follow up data were reported for ART patients

Cumulative enrollment in ICAP-supported HIV care and treatment programs by ART status, age, and sex Total care enrollment (n=442,668) Total ART enrollment (n=202,303)

Proportion of patients ever enrolled in HIV care who initiated ART in ICAP-supported care and treatment programs* as of June 2008 n=528 n=35,158 n=57,559 n=30,476 n= 139,056 n=46,562 n=442,688 n=55,528 % patients initiating ART n=28,914 n=6,959 n=30,003 * Excludes Swaziland as no HIV care data were reported

Cumulative enrollment in ICAP-supported HIV care and treatment programs* by age and sex as of June 2008 n=240,365n=202,303 n=442,668 % patients * Excludes Swaziland as no HIV care data were reported

Cumulative HIV care enrollment of women and children in ICAP-supported HIV care and treatment programs as of June 2008 n=57,559 n=46,562 n=55,528 n=528 n=28,914 n=139,056 n=30,003 n=30,476 n=35,158 n=442,668 n=6,959 % patients in HIV care n=11,925

Cumulative ART enrollment by women and children in ICAP-supported HIV care and treatment programs as of June 2008 n=18,729 n=20,053 n=12,587 n=239 n=32,738 n=31,649 n=12,816 n=14,348 11, ,303 n=2,743 % patients on ART n=44,349

Cumulative pediatric HIV care enrollment in ICAP- supported HIV care and treatment programs* as of June 2008 n=2,280 n=947n=12,196 n=3,753 n=4,909 n=4,250n=3,095 n=5,386 n=17 n=43,431* % pediatric patients in HIV care n=6,898 * Excludes Swaziland as no pediatric breakdown were reported

Cumulative pediatric ART enrollment in ICAP-supported HIV care and treatment programs* as of June 2008 n=2,230 n=1,969 n=622 n=1,962 n=989 n=497 n=2,685 n=2,558 n=7 n=17,306 % pediatric patients on ART n=3,787 * Excludes Swaziland as no pediatric breakdown were reported

ART initiation among patients eligible for ART in ICAP- supported HIV care and treatment programs, April-June 2008 (n=25,485) % patients eligible for ART n=263 n=1,683 n=5,046 n=1,547n=3,273 n=2,305 n=2,808 n=25,485 n=5,576 n=2,984

Overall (Adults) n=123,484 Overall (Children) n=13,944 1 st line regimen d4T-3TC-NVP 67,795 (55%) 4,373 (31%) d4T-3TC-EFV28,484 (23%) 2,061 (15%) ZDV-3TC-NVP18,054 (15%) 3,341 (24%) ZDV-3TC-EFV 5,635 (5%) 834 (6%) Other * N/A 414 (3%) 2 nd line regimen 1,504 (1%) 188 (1%) Unknown regimen 2,012 (2%) 2,733 (20%) ART regimens distributed to adults in ICAP- supported HIV care and treatment programs, April-June 2008 * In South Africa, d4T-3TC-LPV/r is also prescribed as a first-line regimen for pediatric patients.

ART regimens distributed to adults in ICAP- supported HIV care and treatment programs, April-June 2008 Cote d’Ivoire n=355 Eth n=19,480 Kenya n=11,006 Lesotho n=7,000 Moz n=31,183 Nigeria n=10,773 Rwanda n=11,571 South Africa n=22,014 TZ n=10,046 Zambia n=54 1 st line regimen d4T- 3TC-NVP 259 (73%) 10,212 (52%) 8,992 (82%) 3,556 (51%) 25,731 (83%) 4,042 (38%) 4,637 (40%) 2,812 (13%) 7,521 (75%) 33 (61%) d4T- 3TC-EFV 62 (17%) 4,147 (21%) 1,139 (10%) 1,173 (17%) 2,201 (7%) 207 (2%) 788 (7%) 17,788 (81%) 979 (10%) 0 (0%) ZDV- 3TC-NVP 18 (5%) 3,319 (17%) 515 (5%) 1,208 (17%) 1,723 (6%) 5,553 (52%) 4,560 (39%) 250 (1%) 908 (9%) 0 (0%) ZDV- 3TC-EFV 2 (1%) 1,697 (9%) 140 (1%) 706 (10%) 91 (0%) 287 (3%) 1,176 (10%) 906 (4%) 630 (6%) 0 (0%) 2 nd line regimen 7 (2%) 60 (0%) 194 (2%) 357 (5%) 287 (1%) 0 (0%) 410 4% 179 (1%) 10 (0%) 0 (0%) Unknown regimen 7 (2%) 45 (0%) 26 (0%) 0 (0%) 1,150 (4%) 684 (6%) 0 (0%) 79 (0%) 0 (0%) 21 (39%)

Cote d’Ivoire n=7 Ethiopia n=1,549 Kenya n=1,589 Lesotho n=295 Moz n=2,962 Nigeria n=527 Rwanda n= 1,504 South Africa* n=2,289 Tanzania n=774 Zambia n=2,448 1 st line regimen d4T-3TC- NVP 5 (71%) 374 (24%) 5790 (36%) 139 (47%) 1,252 (42%) 26 (5%) 593 (39%) 35 (2%) 381 (49%) 989 (40%) d4T-3TC- EFV (8%) 98 (6%) 56 (19%) 97 (3%) 33 (6%) 118 (8%) 1,520 (66%) 16 (2%) 1 (0%) ZDV-3TC- NVP 2 (29%) 891 (58%) 745 (47%) 27 (9%) 345 (12%) 395 (75%) 589 (39%) 24 (1%) 323 (42%) 0 (0%) ZDV-3TC- EFV 2 (50%) 156 (10%) 131 (8%) 7 (2%) 7 (0%) 72 (14%) 185 (12%) 222 (10%) 54 (7%) 0 (0%) Other* 0 (0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) 414 (18%) 0 (0%) 0 (0%) 2 nd line regimen 0 (0%) 1 (0%) 20 (1%) 0 (0%) 90 (3%) 0 (0%) 16 (1%) 61 (3%) 0 (0%) 0 (0%) Unknown regimen 0 (0%) 5 (0%) 16 (1%) 66 (22%) 1,171 (40%) 1 (0%) 3 (0%) 13 (1%) 0 (0%) 1,458 (60%) ART regimens distributed to children in ICAP- supported HIV care and treatment programs, April-June 2008 * In South Africa, d4T-3TC-LPV/r is also prescribed as a first-line regimen for pediatric patients.

Proportion of patients with CD4 count at baseline, 6, and 12 months after ART initiation, as of June 2008 % patients with CD4 count

Average median CD4 count at baseline and 6 and 12 months after ART initiation, as of June 2008

Change in Median CD4 count (cells/µL) at 6 and12 months of ART, as of June 2008 Change in median CD4 count

Status of ART patients at ICAP-supported HIV care and treatment programs as of June 2008 (n=190,378*) Lost to follow-up 62% Reported dead 34% Stopped ART 4% 8.4 per 1,000 person- years 72.5 per 1,000 person- years per 1,000 person- years * Excludes Swaziland as no follow up data were reported for ART patients

Reasons for ART discontinuation in ICAP- supported HIV care and treatment programs as of June 2008 % patients n=34,762 n=4,838 n=6,285 n=8,508 n=1,446 n=6,299 n=3,564 n=1,132 n=1,446 n=3 n=182

Person-years on ART and discontinuation rates at ICAP- supported care and treatment programs Cumulative person-years on ART Cumulative events per 1,000 person-years

PMTCT services

Pregnant women counseled and tested in ICAP-supported PMTCT programs, January 2007 – June 2008

Pregnant women counseled and tested in ICAP-supported PMTCT programs January 2007 – June 2008

Pregnant women counseled and tested in ICAP-supported PMTCT programs over time

Pregnant women counseled and tested in ICAP-supported PMTCT programs by country, January June 2008 n=105,680 n=62,402 n=25,052 n=2,100 n=44,774 n=2,570

Type of ART prophylaxis at ICAP-supported PMTCT programs, January April 2008 n=921n=5657n=3405n=993n=412n=11433n=45

TB/HIV services

Proportion of HIV patients screened, screened positive and initiated TB treatment in ICAP-supported care and treatment programs as of June 2008 % patients n=119,030 n=1,097 n=15,522 n=13,450 n=24,427 n=18,926 n=34,495 New HIV patients n=60

Proportion of TB patients HIV tested, tested positive and started HIV care at ICAP-supported TB treatment programs as of June 2008 % patients New TB patients n=49,205 n=343 n=4,099 n=7,055 n=525 n=29,282 n=3,550 n=3,953

Proportion of newly enrolled HIV patients screened for TB at enrollment over time in ICAP-supported care and treatment programs n=8,685 n=13,950 n=17,563 n=19,085 New HIV patients n=23,992 n=24,702

Proportion of new TB patients tested for HIV over time in ICAP-supported TB treatment programs n=7,444 n=6,921 n=7,512 n=7,326 New TB patients

Counseling and Testing services

Cumulative number of individuals who received counseling and testing for HIV at ICAP-supported HIV care and treatment programs, as of June 2008