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Cascade of HIV care, PMTCT and TB/HIV services
in Cambodia
Mean Chhi Vun, MD, MPHNational Centre for HIV/AIDS, Dermatology and STD (NCHADS)
Ministry of Health of Cambodia
ICAAP XI, Bangkok; ThailandImproving 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
HIV Treatment Cascade (2012)
Cascade of TB/HIV services (2012)
40,214
32,557
1,657 1,2670
5,000
10,000
15,000
20,000
25,000
30,000
35,000
40,000
45,000
No. new lyregistered TB(ixcl.know n
HIV+)
No. HIV testresults recorded
(incl know nHIV+)
No. HIV+ TBcases
No. ART duringTB treatment
Retention (12months)
No. receiving VL VL suppressed
No
.
Cascade of PMTCT service (2011)
1464
1277
1004846
249
0
200
400
600
800
1000
1200
1400
1600
No. estimatedpreg.w omen w ith HIV
No. preg. Womendiagnosed w ith HIV
No. HIV+ preg. Womenreceiving ARV
No. infants receivingARV for PMTCT
No. infants receivingEID
No
.
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.
Draft WPRO Framework on Cascade
Programme area Core indicatorHIV testing (case-finding):1. Uptake of HIV testing among
selected populationsSee sub-indicators
1a. Uptake of HIV testing among key populations
Not available
1b. HIV testing among tuberculosis patients
Available
1c. HIV screening among pregnant women
Available
1d. Partner testing among people living with HIV who are newly enrolled in care
Partial
1e. Partner testing among antenatal women
Partial
1f. Early infant diagnosis Available
Programme area Core indicator
Linkage to care:
2. Link from HIV testing to care Partial
3. Early enrollment in HIV care services
Partial
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. Coverage of ART Partial
6a. Treatment of TB/HIV co-infections
Available
6b. Treatment of HIV-infected pregnant women
Partial
Programme area Core indicator
Lifelong ART:
7. Retention on ART Partial
8. Viral suppression on ART Not available
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
