HIV prevalence from antenatal clinics by age group

Export Indicator

HIV prevalence among women attending antenatal clinics in the general population
What it measures

Prevalence among pregnant women in the general population

Rationale

HIV prevalence data from antenatal clinics can reveal trends among pregnant women for the country. Once disaggregated by age and region, the results indicate where services for pregnant women are needed and can be used to understand trends in the HIV epidemic.

Numerator

Number of pregnant women who tested HIV positive (including those who already know their HIV positive status) who attended antenatal clinics

Denominator

Number of women tested for HIV at antenatal clinics (including those who already know their HIV positive status).

Calculation

Numerator/denominator

Method of measurement

Antenatal clinics in most countries provide routine HIV testing for pregnant women. Results should be aggregated through the health information system.

This indicator can be captured by collating the routine testing results of pregnant women attending antenatal clinics. It is important to disaggregate the results by five-year age groups to understand in which age groups increases and decreases are taking place. Given the large numbers of women tested through antenatal clinics it will be possible to consider also subnational trends.

Measurement frequency

Annual

Disaggregation

Age (15-19, 20-24, 25-29, 30-34, 35-39, 40-44, 45-49)

Additional information requested

Please provide subnational data disaggregated by administrative areas, as well as city-specific data for this indicator.

Please provide city-specific data for this indicator. Space has been created in the data entry sheet to provide information for the capital city, as well as one or two other key cities of high epidemiological relevance; for example, those that have the highest HIV burden or have committed to ending AIDS by 2030.

The data entry screen has separate space for these data. You may submit also the digital version of related reports using the upload tool.

Explanation of the numerator

The numerator for this indicator should be the summation of the number of women tested and found positive for HIV during antenatal services and the number of women with a known HIV-positive status when they enrolled in antenatal services. Ideally, these data would be the national total for all antenatal clinics.

Strengths and weaknesses

In previous surveillance guidance a sentinel survey was recommended from a selection of antenatal clinics. As HIV becomes more integrated into health systems, UNAIDS and WHO recommend data on HIV prevalence be obtained from routine testing, avoiding the need for anonymous testing (see guidelines below).

In many countries, women will have the option to not be tested for HIV. If a high proportion of women attending antenatal clinics choose not to be tested, the results will be less representative of the country. The proportion who opt not to be tested should be considered when analyzing the results.

If previously known HIV positive pregnant women do not attend routine antenatal clinics but use specialized services, the prevalence at antenatal clinics may underestimate the true prevalence among pregnant women. In such cases, the known HIV positive pregnant women could be added to the numerator as described above.

HIV prevalence data is useful for models of the HIV epidemic, such as Spectrum. When representative of all antenatal sites in the country and coverage is relatively high, this data helps identify important trends about pregnant women in the country.  However, trends among pregnant women are not necessarily representative of all women in the country (Eaton et al, STI 2014). Prevalence among pregnant women might be higher or lower than the general female population.

Increases in prevalence should be considered in conjunction with antiretroviral therapy scale-up.

Further information

Guidelines for conducting HIV surveillance based on routine programme data. Geneva, UNAIDS/World Health Organization, 2015.
http://www.unaids.org/en/resources/documents/2015/SurveillanceRoutineProgrammeData