Table 1. PMTCT uptake scenarios.
Scenario | Care and Testinga | Drug Availabilityb | Retentionc | POPd |
Zimbabwe National PMTCT Program 2008 [23] | ANC: 94% [23]; HIV testing: 75% [37]; result return: 99% [36]; total: 70% ( = 94%×75%×99%) | 86% | Before delivery: 60% (mean of [11],[24],[43]–[47]) | To delivery: 36% [23] |
Postpartum: if ANC, 87% (mean of [11],[43],[44],[48]–[50]); if no ANC, 43% (assumption: 50%) | To 18 mo postpartum: 31% | |||
Zimbabwe National PMTCT Program 2009 [19] | ANC: 91% [36]; HIV testing: 87% [36]; result return: 99% [36]; total: 78% ( = 91%×87%×99%) | 82% | Before delivery: 87% [43] | To delivery: 56% [19] |
Postpartum: if ANC, 87% (mean of [11],[43],); if no ANC, 43% (assumption: 50%) | To 18 mo postpartum: 49% | |||
WHO target [37] | ANC: 100%; HIV testing: 80%; result return: 100%; total: 80% ( = 100%×80%×100%) | 100% | Before delivery: 100% | To delivery: 80% |
Postpartum: if ANC, 87% (mean of [11],[43],[44],[48]–[50]); if no ANC, 43% (assumption: 50%) | To 18 mo postpartum: 70% | |||
Optimal (95%) uptake | ANC: 100%; HIV testing: 95%; result return: 100%; total: 95% ( = 100%×95%×100%) | 100% | Before delivery: 100% | To delivery: 95% |
Postpartum: if ANC, 87% (mean of [11],[43],[44],[48]–[50]) | To 18 mo postpartum: 83% |
Proportion of pregnant women accessing ANC, HIV testing for those in ANC, and receipt of HIV test result for those tested.
Proportion of ANC sites with access to medications for PMTCT. This proportion is back-calculated in order to reach the reported POP for each scenario.
Of women offered ARVs for PMTCT, the proportion remaining in care during the antenatal period, used as a proxy for acceptance of and adherence to medications. Retention in care postpartum: Of all postpartum women, the proportion linking to HIV care by the 6-wk postpartum visit. Impacts on MTCT of loss to follow-up after 6 wk postpartum, in the absence of specific data, are incorporated into highest-risk transmission estimates.
Proportion of patients receiving care at all stages of the PMTCT cascade, defined as the product of (drug availability)×(care and testing)×(retention).