Table 1.
National and COE policies and practices related to first line ART, ART dispensing policy, and routine viral load
| Country | 1st line ART regimens | ART prescription/dispensing policy | Routine VL testing implementation. year started and frequency |
|---|---|---|---|
| Botswana |
2002: AZT-3TC (CBV)- EFV or NVP. 2008-2011: Child AZT-3TC-NVP (EFV if <3 yr). If neonatal sd-NVP & >6mo: AZT-3TC-LPV/r; Adolescent TDF-FTC (or 3TC)- EFV or NVP. 2012-2015: Child, Tx naïve <3 yr: AZT-3TC-NVP, Tx naïve >3 yr: AZT-3TC-EFV. If ≤3 yr & exposed to sdNVP: AZT-3TC-LPV/r. If >3 yr & exposed to sdNVP: AZT-3TC-EFV; Pre-Pubertal Adolescent (Tanner I-II) AZT-3TC-NVP or EFV. Post-Pubertal Adolescent (Tanner IV & V) TDF-FTC-NVP or EFV |
Monthly or 2 monthly with rare 3 monthly exceptions | 2003 every 3 months |
| Lesotho |
2010-2013: <3y or <10kg w no NNRTI exposure: AZT/ABC-3TC-NVP; <24 mo & NNRTI exposure: AZT /ABC-3TC-LPV/r; >3 yrs & >10 kg: AZT/ABC-3TC-EFV; >12 yrs & >35 kg: TDF -3TC-EFV. 2016: <3 yr: ABC-3TC-LPV/r; 3-9 yr or <35 kg: ABC-3TC-EFV; 10-19 yr & ≥35 kg: TDF-3TC-EFV. |
Variable prescription durations with monthly dispensing | 2016 every 6 months |
| Swaziland |
2006: D4T-3TC-NVP 2010: child: d4T-3TC-NVP; Adolescent TDF-3TC-EFV 2015: 5-12 yrs TDF + 3TC + EFV (adult FDC); 3-5 yrs NVP exposed- ABC + 3TC + LPV/r, NVP unexposed ABC + 3TC + EFV; <3 yrs ABC + 3TC + LPV/r |
MMP for stable patients after 6 to 9 months | 2015 6 mo and 12 mo after ART initiation then ever year if <10 yr & every 6 mo if 10-19 yr |
| Malawi |
Before 2010: d4T-3TC-NVP 2011-2013: <15 yr: AZT-3TC-NVP ; ≥15 yr: d4T-3TC-NVP 2014-2015: <15 yr: AZT-3TC-NVP ; ≥15 yr: TDF-3TC-EFV |
MMP for patients stable after 6 months of ART | 2014 6 mo after ART initiation then every 2 years |
| Uganda |
2003-2007: AZT/d4T-3TC-NVP or EFV; 2008-2011: Child d4T-3TC-NVP or EFV; (≥ 5 yrs): AZT-3TC- NVP or EFV 2012-2015: Child AZT-3TC-NVP or EFV. If exp to NVP during PMTCT: AZT-3TC-LPV/r; Adolescent TDF-3TC-NVP or EFV 2016: Child <3 yr: ABC-3TC-LPV/r. 3-10 yr (<35 kg): ABC-3TC-EFV; Adolescent TDF-3TC-EFV |
MMP with per patient exceptions | 2015 every 6 months |
| Tanzania |
2009-2014: <3 yr: AZT-3TC-NVP; ≥3 yr-15 yr: AZT-3TC-EFV or NVP; >15 yr: AZT-3TC-EFV 2015-2016: <3 yr: ABC-3TC-LPV/r; 3 yr to <35kg: ABC-3TC-EFV; >35 kg: TDF-3TC-EFV |
MMP for patients stable after 6 months ART | 2016 6 mo after ART initiation then every year |