TABLE 5-4 Number of HIV-Positive Pregnant Women Receiving ARV Prophylaxis for PMTCT (PEPFAR and National) (in Thousands)

Year Estimated # of HIV+ Pregnant Women (National) # HIV+ Pregnant Women Receiving ARV Prophylaxis for PMTCT (National) # HIV+ Pregnant Women Receiving ARV Prophylaxis for PMTCT (PEPFAR) PEPFAR Contribution to Overall PMTCT Services
2006 1,541.7 321.5 147.3 46%
2007 1,436.6 410.9 245.5 60%
2008 1,563.0 667.3 384.4 58%
2009 1,534.2 714.3 509.8 71%

NOTES: This figure represents data from the 31 countries identified as the focus of this evaluation (see Chapter 2). Several adjustments were made in order to compare the data from OGAC and UNAIDS.
SOURCE: Program monitoring indicators provided by OGAC; also UNAIDS, 2012a.

used as the denominator above, the national estimated number of HIV-positive pregnant women.

On average, more than half of all PMTCT services provided each year are supported by PEPFAR, and in 2009 PEPFAR contributed to supporting about 71 percent of all women receiving ARV for PMTCT in these partner countries (see Table 5-4).

Estimated and observed results from several studies conducted in PEPFAR partner countries have demonstrated not only successful efforts to scale up PMTCT services, but also a positive impact of PMTCT on the reduction of HIV transmission to infants, including in operational settings. Studies in Kenya, Swaziland, and Zambia have highlighted the feasibility and effectiveness of implementing PMTCT programs in underresourced settings (Azcoaga-Lorenzo et al., 2011; Bancheno et al., 2010; Stringer et al., 2003). In Nigeria, a retrospective review of records of 702 mother–infant pairs enrolled in PMTCT programs across six health facilities found that mothers who received ARVs were eight times less likely to transmit HIV to their children than those who did not receive treatment (Anoje et al., 2012). Another study in Haiti used mother–infant pair records from the primary HIV testing and treatment center in Port-au-Prince and found that in the group of those who completed the PMTCT program, MTCT was 9.2 percent, significantly lower than Haiti’s historical transmission rate of 27 percent (Deschamps et al., 2009). Additional studies of PMTCT program effectiveness in South Africa, Angola, and Zambia have found that these programs led to reduced vertical transmission rates in real settings that were consistent with the results of clinical trials using similar drug regimens (Coetzee et al., 2005; Colvin et al., 2007; Lussiana et al., 2012; Torpey et al., 2010). A recent population-based study evaluated PMTCT coverage and HIV-free infant survival in 26 communities throughout Côte d’Ivoire, South Africa, Cameroon, and Zambia using community surveys and testing to collect data on 7,985 infants. It found that community PMTCT coverage



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