Infants

The purpose of this framework is to provide operational guidance on monitoring and evaluation of pregnant and breastfeeding women receiving ART for life and their HEIs. This document is organized around a series of recommendations for the operationalization of monitoring, both routine (Section 1) and enhanced (Section 2), and the evaluation (Section 3) of programmes implementing lifelong ART for pregnant and breastfeeding women and their infants.

In 2014, only 50% of all HIV-exposed infants were tested by the second month of age. Innovative approaches such as use of assays at the point-of care and adding virological testing at birth could speed up identification and ART initiation. Operational research to fully inform how to implement such innovations remains critical.

The first WHO guidelines on HIV and Infant Feeding in 2010 recommended the use of antiretroviral drugs to prevent postnatal transmission of HIV through breastfeeding. Since then, almost all countries prioritised in the UNAIDS ‘Global Plan towards the elimination of new HIV infections among children by 2015 and keeping their mothers alive’ have adopted the approach of promoting and supporting breastfeeding and the provision of lifelong antiretroviral treatment as the strategy to optimise HIV-free survival among HIV-exposed, uninfected infants and children. The 2016 guidelines provide two recommendations and two guiding practice statements and they comment on the implications for: (1) routine monitoring and evaluation, and (2) conflict and emergency settings.

In this report, UNAIDS is announcing that 18.2 million people now have access to HIV treatment. The Fast-Track response is working. Increasing treatment coverage is reducing AIDS-related deaths among adults and children. But the life-cycle approach has to include more than just treatment. Tuberculosis (TB) remains among the commonest causes of illness and death among people living with HIV of all ages, causing about one third of AIDS-related deaths in 2015. These deaths could and should have been prevented.

The Double Dividend accelerates action towards ending paediatric HIV and AIDS and improving child survival. It provides evidence and emerging data to support initiatives that serve HIV exposed children and strengthen service delivery platforms.

Research commissioned by UNICEF through the OHTA Initiative Presented by Laurie Ackerman Gulaid, Consultant

2014 IATT Webinar Series

This presentation from the IATT Webinar Series in December 2014 summarizes research to support the scale up of lifelong ART for pregnant and breastfeeding women. It presents guiding principles, promising practices and key considerations for community-facility linkages.