ICAAP XI, Bangkok; Thailand
Improving the HIV Cascade of Services:
Advances in Reducing Loss to Follow Up between HIV Test...
HIV Treatment Cascade (2012)
Cascade of TB/HIV services (2012)
45,000

40,214

40,000

32,557

35,000

No.

30,000
25,000
20,000
15,000
10,000
5,000

1...
Cascade of PMTCT service (2011)
1600

1464

1400

1277

1200

1004

No.

1000

846

800
600
400

249

200
0
No. estimated
...
Coverage of elements of PMTCT

Samreth S et al. Uptake of interventions for preventing mother-to-child HIV transmission in...
Draft WPRO Framework on Cascade
Programme area

HIV testing (case-finding):
1. Uptake of HIV testing among
selected populations
1a. Uptake of HIV testing ...
Programme area

Core indicator

Linkage to care:
2. Link from HIV testing to care

Partial

3. Early enrollment in HIV car...
Programme area

Core indicator

Retention in pre-ART care:
4. Retention in pre-ART care

Partial
Programme area

Core indicator

Linkage to ART:
5. Linkage to ART (within 30
days of becoming eligible)

Partial

6. Cover...
Programme area

Core indicator

Lifelong ART:
7. Retention on ART
8. Viral suppression on ART

Partial
Not available
Ways Forward
• Develop National Framework on Cascades of HIV
services (incl. treatment, PMTCT, TB/HIV)
• Use assessment fi...
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Cascade of HIV Care, PMTCT and TB/HIV Services in Cambodia

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  • Based on available data from different sources, we have constructed this graph of HIV treatment cascade.
    Estimated number of PLHIV is from mathematical modelling.
    The number of diagnosed and reported HIV cases is not available while we have the number of new diagnosis each year.
    As you see at the right side, the number of VL testing was very low as we started to introduce VL in late 2012. Therefore, the number of VL suppressed was also very small.
  • Cascade of HIV Care, PMTCT and TB/HIV Services in Cambodia

    1. 1. ICAAP XI, Bangkok; Thailand Improving the HIV Cascade of Services: Advances in Reducing Loss to Follow Up between HIV Testing, Pre-ARV Care and Sustained Adherence to ARV WHO FHI360 Satellite, November 21, 2013 Cascade of HIV care, PMTCT and TB/HIV services in Cambodia Mean Chhi Vun, MD, MPH National Centre for HIV/AIDS, Dermatology and STD (NCHADS) Ministry of Health of Cambodia
    2. 2. HIV Treatment Cascade (2012)
    3. 3. Cascade of TB/HIV services (2012) 45,000 40,214 40,000 32,557 35,000 No. 30,000 25,000 20,000 15,000 10,000 5,000 1,657 1,267 No. HIV+ TB cases No. ART during TB treatment 0 No. new ly registered TB (ixcl.know n HIV+) No. HIV test results recorded (incl know n HIV+) Retention (12 months) No. receiving VL VL suppressed
    4. 4. Cascade of PMTCT service (2011) 1600 1464 1400 1277 1200 1004 No. 1000 846 800 600 400 249 200 0 No. estimated preg.w omen w ith HIV No. preg. Women diagnosed w ith HIV No. HIV+ preg. Women receiving ARV No. infants receiving ARV for PMTCT No. infants receiving EID
    5. 5. Coverage of elements of PMTCT Samreth S et al. Uptake of interventions for preventing mother-to-child HIV transmission in 11 operational districts in Cambodia. WPSAR Vol 3, No 3, 2012, doi: 10.5365/wpsar.2012.3.2.009.
    6. 6. Draft WPRO Framework on Cascade
    7. 7. Programme area HIV testing (case-finding): 1. Uptake of HIV testing among selected populations 1a. Uptake of HIV testing among key populations 1b. HIV testing among tuberculosis patients 1c. HIV screening among pregnant women 1d. Partner testing among people living with HIV who are newly enrolled in care 1e. Partner testing among antenatal women 1f. Early infant diagnosis Core indicator See sub-indicators Not available Available Available Partial Partial Available
    8. 8. Programme area Core indicator Linkage to care: 2. Link from HIV testing to care Partial 3. Early enrollment in HIV care services Partial
    9. 9. Programme area Core indicator Retention in pre-ART care: 4. Retention in pre-ART care Partial
    10. 10. Programme area Core indicator Linkage to ART: 5. Linkage to ART (within 30 days of becoming eligible) Partial 6. Coverage of ART Partial 6a. Treatment of TB/HIV coinfections 6b. Treatment of HIVinfected pregnant women Available Partial
    11. 11. Programme area Core indicator Lifelong ART: 7. Retention on ART 8. Viral suppression on ART Partial Not available
    12. 12. Ways Forward • Develop National Framework on Cascades of HIV services (incl. treatment, PMTCT, TB/HIV) • Use assessment findings to define national and sub-national indicators based on available data • Revise national recording/reporting tools and database to make essential data available to construct remaining indicators • Establish data analysis and utilization procedures at national and sub-national levels

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