AIDS; b) support antiretrovirals (ARVs) for PMTCT and/or their own health as medically indicated for 85% of HIV-positive pregnant women in those countries; and c) ensure that the proportion of children receiving care and treatment meets their proportion of the HIV-infected individuals in each country” (OGAC, 2011b, p. 1). In order to accomplish these goals, PEPFAR not only supports efforts in partner countries but also works in concert with international partners, such as through its support of the UNICEF Inter-Agency Task Team and through PEPFAR’s contribution to the 2011 Global Plan Towards the Elimination of New HIV Infections Among Children by 2015 and Keeping Their Mothers Alive (OGAC, 2011c; UNAIDS, 2011). The centrality of PMTCT activities to PEPFAR’s overall prevention programming was reinforced as part of the recent “AIDS-Free Generation” goals articulated by the U.S. government (OGAC, 2012c).
PEPFAR’s Contribution to the Scale-Up and Coverage of PMTCT Services
Two centrally reported programmatic indicators requested and provided to the committee by OGAC serve to assess PEPFAR’s contribution to the scale-up and delivery of PMTCT services. These indicator data show that, in the 31 countries that are the focus of this evaluation, the number of pregnant women who received PEPFAR-supported HIV counseling and testing for PMTCT and who received their test results increased from approximately 600,000 in FY 2004 to more than 7.3 million in FY 2009. The number of pregnant women who received PEPFAR-supported antiretroviral prophylaxis for PMTCT increased from nearly 48,000 in FY 2004 to more than 600,000 in FY 2010.
The indicator for the number of pregnant women tested was no longer reported after 2009 as a result of the Next Generation Indicator revision process in 2009; instead, a revised indicator reports the number of pregnant women with known HIV status, including women who were tested for HIV and received their results, as well as pregnant women with already known HIV status who attended antenatal care (ANC) services (OGAC indicator P1.1D) (OGAC, 2009c). Rather than a count of HIV tests provided to pregnant women, this provides a measure of the pregnant women whose eligibility for PMTCT is known. Although not centrally reported, disaggregation by those who are HIV-positive is recommended at the program implementation level. Going forward, this could serve as a denominator to assess the coverage in PEPFAR-supported programs of pregnant women who receive ARC prophylaxis for PMTCT. However, this indicator was added too recently to provide an assessment of coverage over time for this evaluation.