icap hiv testing and counseling indicators initial s ummary of data, january-march 2010 quarter
DESCRIPTION
ICAP HIV Testing and Counseling indicators Initial s ummary of data, January-March 2010 quarter. ICAP. Background – HTC and ICAP. Most country teams collect & report data on HIV testing & counseling (HTC) to MOH and USG teams Historically very limited data on HTC reported to ICAP-NY - PowerPoint PPT PresentationTRANSCRIPT
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ICAP HIV Testing and
Counseling indicators
Initial summary of data,January-March 2010
quarter
ICAP
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Background – HTC and ICAP• Most country teams collect & report data on HIV testing &
counseling (HTC) to MOH and USG teams• Historically very limited data on HTC reported to ICAP-NY• Introduced draft HTC indicators for comment in early 2009• HTC done as part of the TB, PMTCT and HEI programs
not included (no double counting) • Indicators reported by point of service within each site –
e.g., VCT, family planning, OPD
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Staff reviews idea with M&E
Director
Staff submits New/Revised
Indicator Proposal Form
Review committee reviews proposal
(2weeks)
Development team is formed. Draft SOP
is developed and piloted (two months)
Draft SOP disseminated for two-week comment period
SOP finalized (1 month)
ICAP staff conceptualizes idea for
potential new or revised indicator
Discussed during routine M&E call or Country Program call
Comments/Concerns posted to Indicator workspace
Training on final SOP and Implementation
Data reported quarterly to ICAP-NY
Develop data collection tools
If approved If approved
ICAP-wide input
Country-specific input
Data collection registers exist
Data collection registers do not exist
Data disseminated to country teams via URS, analysis databases and reports
URS Reporting Module (1-2 months) developed
Flowchart of ICAP Data Indicator Proposal Procedures
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ICAP HTC indicatorsNumber of clients…
1. attending/admitted to clinic 2. HIV pre-test counseled 3. HIV pre-test counseled and tested 4. HIV tested who received test results
5.who tested HIV positive among clients who received their results
6.who tested HIV negative among clients who received their results
7. who tested HIV positive among all clients tested8. who tested HIV positive and subsequently enrolled in HIV care
and treatment Also:
9. Number of health care workers who successfully completed an in-service training program for HTC (country-level)
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ICAP HTC indicatorsGender and age group – indicators #1-8
Females Males< 18 months* < 18 months* 18 months to <15 yrs
18 months to <15 yrs
15+ yrs 15+ yrs*Requires PCR testing, since maternal HIV antibodies may be detected in antibody testing
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Reporting by points of service (POS)
Site ASite B
Site C
POS #1
POS #3
POS #2 POS #1
POS #3POS #4
POS #2
POS #1POS #2
ICAP country team office
ICAP-NY
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PEPFAR Next Generation indicators
Indicator #P11.1.DEssential/reported
Number of individuals who received Testing and Counseling (T&C) service for HIV and received their test results
Disaggregation:Essential/reported By Sex: Male, FemaleEssential/reported By Age: <15, 15+Essential/not reported
By test result: Positive, Negative
Recommended By type of counseling: Individual, Couples*Recommended By MARP type: CSW, IDU, MSMIndicator #H2.3.DEssential/reported
Number of individuals trained in counseling and testing according to national and international standards
• ICAP indicators are aligned with PEPFAR NGI
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Data entry and dissemination• Data entered into the URS manually or via import tool• Summarized on URS HTC dashboard and in Summary
Reports• Will include a summary table and narrative for HTC
indicators in upcoming quarterly report to CDC-Atlanta• Added to master slides posted on ‘wiki’ data
dissemination workspace• Core maps• Initial indicator reporting period: October-December 2009
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Identifying points of service
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HTC points of service (n=24)All points of service OutreachVCT Eye unitOutpatient (general) Well baby clinicAdult outpatient Casualty / traumaPediatric outpatient Palliative care / hospiceInpatient (general) Reception / customer careAdult (male & female) inpatient Cervical cancer screeningAdult female inpatient STI clinic
Adult male inpatientHIV care/treatment (family testing)
Pediatric inpatient TB Clinic (family testing)Laboratory Blood Donation CenterFamily planning Other
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Data entry and import
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January-March 2010 HTC indicator data
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Completeness of HTC indicator dataJanuary-March 2010
Admission to venue
HIV counseling/
testingHIV test results
Enrollment in HIV care
Ethiopia Mozambique South Africa Cote d'Ivoire Tanzania Rwanda Nigeria Kenya
Key: Reported Did not
report
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Reporting pediatric data
• 5 countries reported data by age as specified in the ICAP HTC SOP:
1. 0-18 months2. 18 months -14 years3. 15+ years
• Ethiopia and Kenya reported only 0-14 years and 15+ years
• Rwanda reported patients aged 0-17 years and 18+ years
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Number of sites supporting HIV counseling and testing, March 2007-March 2010
Source: ICAP URS March 2010Note: Counseling and testing data was not reported until December 2009
0
100
200
300
400
500
600
700
800
Mar-07 Sep-07 Mar-08 Sep-08 Mar-09 Sep-09 Mar-10
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0
20
40
60
80
100
120
140
160
Sites supported vs. reporting HTC dataJan-Mar 2010
No. of sites supported
No. Of sites reporting
88% of HTC supported
sites reported
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% of patients provided HIV testing by POS by country
All POS, 100%
Nigeria
VCT, 99%
All PITC, 1%
Rwanda
VCT, 89%
All PITC, 11%
Mozambique
Outpatient (general), 58%
VCT, 36%
Family planning, 4%
Well baby clinic, 1%
Cote d'Ivoire
All POS41%
VCT34%
HIV care,13%
Other4%
Outpatient (general)3%
TB Clinic3%
Inpatient (general)1%
Peds inpatient1%
South Africa
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Adult outpatient, 58%
VCT, 14%
Pedi-atric
outpa-tient, 13%
Adult inpa-tient, 5%
Pe-di-
atric inpa-tient, 2%
Family planning, 3%Outreach, 1%
Casualty / trauma, 2%
STI clinic, 1%
Ethiopia
Outpatient (general)
41%
Family planning16%
Laboratory10%
Inpatient (general)
10%
Pediatric inpa-tient7%
VCT5%
Adult female inpatient
5%
Adult male inpatient5%
Casualty / trauma1%
Adult inpatient<1%
Kenya
% of patients provided HIV testing by POS by country
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VCT73%
Outpatient (general)9%
All points of service7%
Inpatient (general)2%
Adult female inpatient2%
Adult male inpatient1%
Pediatric inpatient2% Laboratory
1%Family planning
1%
Outreach0%
Pediatric outpatient0%
Adult outpatient0%
STI clinic0% TB Clinic
0%
Tanzania
% of patients provided HIV testing by POS by country
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0%
10%
20%
30%
40%
50%
60%
-
50,000
100,000
150,000
200,000
250,000
Number of patients provided HIV testing & counseling, by country
January-March 2010
# of patients provided HTC % of all patients provided HTC
Total n=392,803
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0%5%10%15%20%25%30%35%40%45%
-
20,000
40,000
60,000
80,000
100,000
120,000
140,000
Number of patients provided HTC, by point of service, and % of all patients receiving HTC
# patients receiving HTC % of all patients receiving HTC
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0%
20%
40%
60%
80%
100%
Percent receiving test results, by country
n=214,014 n=43,110 n=37,007 n=31,336 n=19,794 n=18,566 n=16,018 n=12,958# testing:
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% of patients testing HIV-positive, by country
Cote d'Ivoire Ethiopia Kenya Mozambique Nigeria Rwanda South Africa Tanzania0%
10%
20%
30%
40%
% positive Jan-March 2010# testing: n=12,958 n=214,014 n=19,794 n=18,566 n=31,336 n=37,007 n=16, 018 n=43,110
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% of patients testing HIV-positive, by country, and national HIV prevalence
Cote d'Ivoire Ethiopia Kenya Mozambique Nigeria Rwanda South Africa Tanzania0%
10%
20%
30%
40%
% positive Jan-March 2010 National prevalence# testing: n=12,958 n=214,014 n=19,794 n=18,566 n=31,336 n=37,007 n=16, 018 n=43,110
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02,0004,0006,0008,00010,00012,00014,000
0%5%
10%15%20%25%30%35%40%
VCT
Adul
t out
patie
ntAl
l PO
SPe
ds o
utpa
tient
Out
patie
nt-A
llAd
ult i
npati
ent
Fam
ily p
lann
ing
Pedi
atric
inpa
tient
Casu
alty
/ tr
aum
aO
utre
ach
Inpa
tient
-All
Labo
rato
ryAl
l PIT
CHI
V ca
re (f
amily
…Ad
ult f
emal
e …
STI c
linic
Adul
t mal
e in
patie
ntO
ther
PO
STB
clin
ic (f
amily
…W
ell b
aby
clin
ic
% and number testing HIV positive, by point of service
% testing HIV positive # testing HIV positive
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0%
5%
10%
15%
20%
25%
30%
35%
40%
45%VC
T
Out
patie
nt
Oth
er
VCT
Out
patie
nt
Inpa
tient
Oth
er
VCT
Out
patie
nt
Inpa
tient
Oth
er
VCT
All P
ITC
All P
OS
VCT
All P
ITC
VCT
Out
patie
nt
Inpa
tient
Oth
er
All P
OS
VCT
Out
patie
nt
Inpa
tient
Oth
er
Cote d'Ivoire Ethiopia Kenya Moz. NG Rwanda South Africa Tanzania
% HIV positive, by country and POS type
Cote d’Ivoire Ethiopia Kenya Moz. NG Rwanda South Africa Tanzania # testing: n=12,958 n=214,014 n=19,794 n=18,566 n=37,007 n=16, 018 n=43,110 n=31,336
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0
1000
2000
3000
4000
5000
6000
7000
8000
# testing HIV-positive by country and POS
All POS/PITC
Other
Inpatient
Outpatient
VCT
62% Outpt.35% VCT3% Other
52% Outpt.38% VCT7% Inpt.3% Other
48% Outpt.23% Inpt.22% Other7% VCT
89% VCT11% All PITC
98% VCT2% All PITC
100% All POS 49% All POS26% VCT18% Other5% Outpt.1% Inpt. 78% VCT
9% Outpt.9% Inpt.4% Other
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-
50,000
100,000
150,000
200,000
250,000
300,000
Females Males 0-14 yrs 15+ yrs
HIV testing by gender and age groupAll countries
Tested
HIV-positive
Note: among 2,816 patients
age 0-18 months testing in TZ,
MZ, SA, and CI, 320 (11%) tested
HIV-positive.7%
4%6%8%
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0
10000
20000
30000
40000
50000
60000
70000
80000
0-18 mos 18m-14y
Pediatric HIV testing
Tested
HIV-positive
Countries reporting these data include TZ, MZ, SA, and CI
11%4%
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Counseling and testing uptake
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0%20%40%60%80%
100%
Uptake of HIV counseling and testing 5 countries reporting patient admissions data
% counseled
% tested
Note: Clinic admission data not reported by Kenya and Nigeria
% testing at VCT: 14% 74% 99% 89% 34% 36%
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Enrollment in HIV care
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0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
Ethiopia Tanzania Nigeria Mozambique South Africa Cote d'Ivoire
% of patients testing HIV positive who enrolled in HIV care during the quarter
Note: HIV care enrollment data not reported by Kenya,or Rwanda (n= 4,303) (n= 3,529) (n= 4,705) (n=7,596) (n=4,327) (n=1,131)# HIV-positive:
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0%10%20%30%40%50%60%70%80%90%
Females Males 18m-14yrs 15+ yrs
% testing HIV positive who enrolled in HIV care during the quarter
(n=16,617) (n=8,714) (n=2,668) (n=21,589)# HIV-positive:
Note: HIV care enrollment data not reported by Kenya,or Rwanda
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0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
VCT Outpatient Inpatient Other All POS/PITC
Percent of patients testing HIV positive who enrolled in HIV care during the quarter
# HIV-positive: (n=12,397) (n=3,318) (n=619) (n=1,079) (n=7,923)
Note: HIV care enrollment data not reported by Kenya,or Rwanda
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Additional comments
• Jan-Mar 2010 data largely consistent with data from Oct-Dec 2009
• Historical data from prior to October 2009 – coming soon from some countries
• Some limitations: – Missing data on clinic/POS admissions and
enrollment in HIV care from several countries– Not all countries report data by point of service
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Routine dissemination
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URS HTC dashboard
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URS HTC summary reports
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Summary / conclusions• ICAP supported almost 400,000 HIV tests
during January-March 2010• Reports from 1,337 points of service from
within 691 sites• >99% of patients received their results• More than 27,000 (7%) patients tested HIV-
positive• At least 16,899 (67%) HIV-positive patients
linked into HIV care
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Next steps
• Historical data• Examine trends• Disseminate to country teams• Feedback – data/program improvement
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Acknowledgements
• ICAP-NY: Charon Gwynn, Sarah Gorrell, Suzue Saito, Frank Brathwaite, other staff providing input on SOP
• M&E staff, ICAP country teams
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02000400060008000100001200014000
0%10%20%30%40%50%60%70%80%90%
100%VC
T
Adul
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All P
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Peds
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Casu
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HIV
care
(fam
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Adul
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TB c
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Wel
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% of HIV positive testers who enrolled in HIV care during the quarter, and # HIV-positive
% in HIV care # testing HIV positive
Note: HIV care enrollment data not reported by Kenya,or Rwanda