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ICAP Quarterly Master Slide Set July-September 2007.

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Presentation on theme: "ICAP Quarterly Master Slide Set July-September 2007."— Presentation transcript:

1 ICAP Quarterly Master Slide Set July-September 2007

2 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

3 Source: ICAP Site Census, November 2007 Number of ICAP-supported sites by activity, September 2007 (n=409) Number of sites

4 Source: ICAP Site Census, November 2007 Number of ICAP-supported sites by country, September 2007 (n=409) Number of sites

5 Programmatic components funded at ICAP- supported care and treatment sites (n=243), September 2007 Source: ICAP Site Census, November 2007 % care and treatment sites with activity

6 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

7 Location and type of ICAP-supported HIV care and treatment sites (n=177) Source: PFaCTS, January 2007 12057 % sites

8 On-site HIV service infrastructure at ICAP- supported HIV care and treatment sites by type of service (n=177) Source: PFaCTS, January 2007 % sites with service

9 Number of on-site HIV service infrastructure* provided at ICAP-supported HIV care and treatment sites (n=177) Source: PFaCTS, January 2007 *Services include: VCT, TB treatment, PMTCT, Labor and delivery, and ART pharmacy.

10 On-site HIV service infrastructure* at ICAP- supported HIV care and treatment sites by country (n=177) Source: PFaCTS, January 2007 * Sites that have >=4 of the following on-site services are represented in the graph: VCT, TB treatment, PMTCT, Labor and delivery and ART pharmacy. ICAP Average =80% % sites with service

11 Type of patient support services available at ICAP- supported HIV care and treatment sites (n=177) Source: PFaCTS, January 2007 * Only counts those sites that provide adherence support by trained personnel. Other categories of adherence support activities are not represented here. % sites with service

12 Number of patient support services provided at ICAP- supported HIV care and treatment sites (n=177) Source: PFaCTS, January 2007 * Services include: ART adherence support, outreach program, peer educator program, food support for adults, food support for infants.

13 Comprehensiveness* of on-site patient support services at ICAP-supported HIV care and treatment sites (n=177) Source: PFaCTS, January 2007 * Comprehensiveness is defined as availability of >=4 of the following on-site patient-support services: ART adherence support, outreach program, peer educator program, food support for infants, and food support for adults. ICAP Average =20% % of sites with service

14 Laboratory test availability at ICAP-supported HIV care and treatment sites (n=177) Source: PFaCTS, January 2007 % sites with laboratory tests

15 Number of laboratory test services* available through ICAP-supported HIV care and treatment sites (n=177) Source: PFaCTS, January 2007 * Services include: CD4, CD4 percent, HIV-RNA, early infant diagnosis, LFT, and blood chemistry. ** No sites had access to all 6 laboratory test services.

16 Source: PFaCTS, January 2007 Availability of core HIV-related laboratory tests through ICAP-supported HIV care and treatment sites (n=177) * Comprehensiveness is defined as availability of >=4 of the following laboratory test services: Services include: CD4, CD4 percent, HIV-RNA, LFT, and blood chemistry. PCR laboratory tests are excluded. ICAP Average =86% % sites with laboratory tests

17 Source: PFaCTS, January 2007 Availability of PCR laboratory tests through ICAP- supported HIV care and treatment sites (n=177) ICAP Average =58% % sites with PCR tests

18 Mean number of health care providers per 1000 patients on ART at ICAP-supported HIV care and treatment sites (n=177) Source: PFaCTS, January 2007 Number of health care providers per/1000 patients on ART

19 Mean number of outreach workers per 1000 patients on ART at ICAP-supported HIV care and treatment sites (n=79)* Source: P-FaCTS, January 2007 *For sites with outreach programs ICAP Average =15.1

20 HIV care and treatment services

21 Kenya, Lesotho, Rwanda, S. Africa, Tanzania Mozambique Ethiopia Nigeria, Swaziland, Zambia Cumulative enrollment at ICAP-supported HIV care and treatment programs (ever-supported), July 2004 - September 2007* Source: ICAP URS, November 2007 326,859 150,562 *Includes all transitioned sites with data carried over.

22 Mozambique Ethiopia Cumulative pediatric enrollment in ICAP-supported HIV care and treatment programs (ever-supported), July 2004 - September 2007* 34,216 13,438 *Includes all transitioned sites with data carried over. Kenya, Lesotho, Rwanda, S. Africa, Tanzania Nigeria, Swaziland, Zambia Source: ICAP URS, November 2007

23 Kenya, Lesotho, Rwanda, S. Africa, Tanzania Mozambique Ethiopia Nigeria, Swaziland, Zambia Cumulative enrollment in ICAP-supported HIV care and treatment programs (currently supported), July 2004 - September 2007* 300,743 136,252 *Excludes all transitioned sites. Source: ICAP URS, November 2007

24 Kenya, Rwanda, S. Africa, Tanzania Mozambique Ethiopia Nigeria Cumulative pediatric enrollment in ICAP-supported HIV care and treatment programs (currently supported), July 2004 - September 2007 30,670 12,253 Source: ICAP URS, November 2007 *Excludes all transitioned sites.

25 Current, projected, and target cumulative enrollment in ICAP-supported care and treatment programs by ART status* Source: ICAP URS, November 2007 Number of patients * Targets were available for MCAP countries, including Ethiopia, Kenya, Mozambique, Nigeria, Rwanda, South Africa and Tanzania.

26 Current, projected and target cumulative HIV care enrollment in ICAP-supported care and treatment programs by country Source: ICAP URS, November 2007 Number of patients

27 Current, projected and target cumulative ART enrollment in ICAP-supported care and treatment programs by country Source: ICAP URS, November 2007 Number of patients

28 Cumulative and current enrollment in ART care at ICAP-supported HIV care and treatment programs, July 2004 - September 2007 Cumulative initiating ART ART patients retained in care Source: ICAP URS, November 2007 Lost to follow up Dead* Number of patients * Includes known deaths only.

29 Cumulative enrollment in HIV care in ICAP-supported HIV care and treatment programs by country, July 2004 - September 2007 (n=300,743) Number of patients

30 Cumulative enrollment on ART at ICAP-supported HIV care and treatment programs by country, July 2004 - September 2007 (n=136,252) Source: ICAP URS, November 2007 Number of patients

31 Cumulative enrollment in ICAP-supported HIV care and treatment programs by ART status, age, and sex, July 2004 – September 2007 Total care enrollment (n=300,743) Total ART enrollment (n=136,252) Source: ICAP URS, November 2007 Children <15 Men 15+ Women 15+ Children <15 Men 15+ Women 15+

32 Proportion of patients ever enrolled in HIV care who initiated ART in ICAP-supported care and treatment programs by country as of September 2007* n=40, 575 n=19,869n=29,169 n=13,098 n= 96,816 n=21,743 n=288,818 n=40,903 Source: ICAP URS, November 2007 % patients initiating ART n=4,635 n=22,010 *Data not available for Swaziland.

33 Cumulative enrollment in ICAP-supported HIV care and treatment programs by age and sex as of September 2007 Source: ICAP URS, November 2007 n=164,491n=136,252 N=300,743 % patients

34 Cumulative HIV care enrollment in ICAP-supported HIV care and treatment programs by age, sex, and country as of September 2007 Source: ICAP URS, November 2007 n=40,903 n=29,169 n=13,098 n=22, 010 n=19,869 n=96,816 n=40,575n=21,743 n=11,925 n=300,743 n=4,635 % patients in HIV care

35 Cumulative ART enrollment in ICAP-supported HIV care and treatment programs by age, sex, and country as of September 2007 Source: ICAP URS, November 2007 n=1,938n=14,161n=23,060 n=7,700 n=9,589 n=30,490 n=5,795n=8,721 n=11,925 n=136,252 n=22,873 % patients on ART

36 Cumulative pediatric HIV care enrollment in ICAP- supported HIV care and treatment programs by age and country as of September 2007* n=782 n=2,841n=1,255n=1,513 n=3,460n=9,757n=4,564 n=2,432n=3,220 n=29,824 Source: ICAP URS, November 2007 *Data not available for Swaziland. % pediatric patients in HIV care

37 Cumulative pediatric ART enrollment in ICAP-supported HIV care and treatment programs by age and country as of September 2007* n=846 n=667n=2,720n=1,850n=1,296 n=1,867 n=348 n=375n=1,442 n=11,411 Source: ICAP URS, November 2007 *Data not available for Swaziland. % pediatric patients on ART

38 ART eligibility and initiation among patients receiving HIV care in ICAP-supported HIV care and treatment programs during July-September 2007* *Data not available for Swaziland and Zambia. Source: ICAP URS, November 2007 % patients

39 ART regimens distributed to adults in ICAP- supported HIV care and treatment programs during July-September 2007* Overall n=86,485 Ethiopia n=15,058 Kenya n=5,528 Lesotho n=4,266 Mozambique n=22,670 Nigeria n=4,904 Rwanda n=9,932 South Africa n=17,098 Tanzania n=7,029 1 st line regimen d4T-3TC- NVP 40,887 (50%) 8,225 (55%) 4,743 (86%) 2,688 (49%) 13,641 (60%) 2,330 (48%) 4,487 (45%) 2,443 (14%) 5,018 (71%) d4T-3TC- EFV 20,528 (25%) 3,054 (20%) 595 (11%) 720 (13%) 1,383 (6%) 159 (3%) 783 (8%) 13,742 (80%) 812 (12%) ZDV-3TC- NVP 9,119 (11%) 2,309 (15%) 103 (2%) 580 (10%) 552 (2%) 2,179 (44%) 3,147 (32%) 152 (1%) 677 (10%) ZDV-3TC- EFV 3,496 (4%) 1,036 (7%) 41 (1%) 243 (4%) 35 (0.2%) 229 (5%) 1,097 (11%) 543 (3%) 515 (7%) 2 nd line regimen 981 (1%) 376 (2%) 21 (0.4%) 32 (1%) 106 (0.5%) 7 (0.1%) 337 (3%) 127 (1%) 7 (0.1%) Unknown regimen 7,208 (8%) 58 (0.4%) 25 (0.5%) 3 (0.1%) 6,953 (31%) 0 (0%) 81 (1%) 91 (1%) 0 (0%) *Data not available for Swaziland and Zambia. Source: ICAP URS, November 2007

40 Overall n=7,989 Ethiopia n=1,032 Kenya n=639 Lesotho n=252 Mozambique n=2,368 Nigeria n=300 Rwanda n=1,161 South Africa* n=1,702 Tanzania n=535 1 st line regimen d4T-3TC-NVP 2,128 (27%) 210 (20%) 311 (49%) 142 (22%) 690 (29%) 17 (6%) 514 (44%) 35 (2%) 209 (39%) d4T-3TC-EFV 1,462 (18%) 78 (8%) 61 (10%) 18 (3%) 52 (2%) 15 (5%) 124 (11%) 1,096 (64%) 18 (3%) ZDV-3TC-NVP 2,044 (26%) 557 (54%) 196 (31%) 77 (12%) 394 (17%) 204 (68%) 323 (28%) 29 (2%) 264 (49%) ZDV-3TC-EFV 639 (8%) 91 (9%) 37 (5%) 8 (1%) 13 (1%) 64 (21%) 175 (15%) 207 (12%) 44 (8%) Other ** 272 (3%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) 272 (16%) 0 (0%) 2 nd line regimen** 213 (3%) 0 (0%) 4 (1%) 0 (0%) 52 (2%) 0 (0%) 20 (2%) 48 (3%) 0 (0%) Unknown 1,231 (15%) 89 (9%) 30 (5%) 7 (1%) 1,167 (49%) 0 (0%) 5 (0.4%) 15 (1%) 0 (0%) ART regimens distributed to children in ICAP- supported HIV care and treatment programs during July-September 2007* * Data not available for Swaziland and Zambia. ** In South Africa, d4T-3TC-LPV/r is also prescribed as a first-line regimen for pediatric patients. Source: ICAP URS, November 2007

41 Completeness of CD4 count data at baseline and 6 months after ART initiation among multiple cohorts, July-September 2007* Source: ICAP URS, November 2007 *CD4 data available for a subset of ART patients, and data not available for Swaziland and Zambia. % patients with CD4 count

42 Completeness of CD4 count data at baseline and 12 months after ART initiation among multiple cohorts, July-September 2007* Source: ICAP URS, November 2007 *CD4 data available for a subset of ART patients, and data not available for Swaziland and Zambia. % patients with CD4 count

43 Weighted Average median CD4 count at baseline and 6 and 12 months after ART initiation among multiple cohorts, July-September 2007* **CD4 data available for a subset of ART patients, and data not available for Swaziland and Zambia. Source: ICAP URS, November 2007

44 Average median CD4 count (cells/µL) increase after 6 and12 months of ART in ICAP-supported care and treatment programs by country, July-September 2007* *CD4 data available for a subset of ART patients. Source: ICAP URS, November 2007

45 Net proportion of patients discontinuing ART at ICAP- supported HIV care and treatment programs as of September 2007* *Excludes patients who transferred out and unknowns. ** Includes known deaths only. Lost to follow-up 57% Dead** 38% Stopped ART 5% Source: ICAP URS, November 2007 10.5 per 1,000 person-years 79 per 1,000 person-years 119 per 1,000 person-years

46 Reasons for ART discontinuation in ICAP- supported HIV care and treatment programs by country as of September 2007* Excludes patients who transferred out. ** Includes known deaths only. Source: ICAP URS, November 2007 % patients

47 Cumulative person-years on ART, rates of stopped ART, death, and lost to follow up at ICAP-supported care and treatment programs, October 2004 – September 2007

48 PMTCT services

49 Pregnant women counseled and tested in ICAP-supported PMTCT programs, by quarter, April-September 2007 Source: ICAP URS, November 2007 Number of women

50 Pregnant women counseled and tested in ICAP-supported PMTCT programs, April-September 2007 Source: ICAP URS, November 2007 Number of women

51 HIV-infected pregnant women receiving ART prophylaxis in ANC at ICAP-supported PMTCT programs, April-September 2007 n=157 n=235 n=1,112n=829 n=339 n=2,672 Source: ICAP URS, November 2007 Number of women

52 TB/HIV services

53 Screening and treatment for active TB among HIV positive persons enrolled in ICAP-supported care and treatment programs, by country January-September 2007 Source: ICAP URS, November 2007 % all patients n=42,364 n=1,097 n=5,837 n=8,582n=8,102 n=7,695 n=11,051

54 HIV testing and linkages with care and treatment for TB patients enrolled in ICAP-supported TB treatment programs, by country January-September 2007 * Kenya did not report the number of new TB patients. The number represents the number who were tested. Source: ICAP URS, November 2007 % all patients New TB patients n=17,637 n=1,858 n=14,664 n=707n=408 n=2,768*

55 Proportion of new HIV patients screened at enrollment over time in ICAP-supported care and treatment programs, January 2007-September 2007 Source: ICAP URS, November 2007

56 Proportion of new TB patients tested for HIV over time in ICAP-supported TB treatment programs, January 2007-September 2007 Source: ICAP URS, November 2007

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