ART Service Report

Step 1 — Basic Information

Select the reporting department, month, and year before proceeding.

Department *

Month *

Year *

Step 2 — HIV Testing Services (HTS)

VCT received result, PITC received result, PITC positive, and HCT by population group.

VCT — Received ResultClients receiving HIV test results at VCT — by age & sex

Age Group	Male	Female
< 1 year
1 – 4 years
5 – 9 years
10 – 14 years
15 – 19 years
20 – 24 years
25 – 29 years
30 – 34 years
35 – 39 years
40 – 44 years
45 – 49 years
≥ 50 years

PITC — Received ResultClients receiving HIV test results at PITC — by age & sex

Age Group	Male	Female
< 1 year
1 – 4 years
5 – 9 years
10 – 14 years
15 – 19 years
20 – 24 years
25 – 29 years
30 – 34 years
35 – 39 years
40 – 44 years
45 – 49 years
≥ 50 years

PITC — Tested PositiveClients testing positive for HIV at PITC — by age & sex

Age Group	Male	Female
< 1 year
1 – 4 years
5 – 9 years
10 – 14 years
15 – 19 years
20 – 24 years
25 – 29 years
30 – 34 years
35 – 39 years
40 – 44 years
45 – 49 years
≥ 50 years

HCT — Population GroupsHIV testing service — received result & tested positive by population group

Population Group	Received Result	Positive
Female commercial sex workers
Long distance drivers
Mobile / Daily labourers
OVC of PLHIV
Children of PLHIV
Prisoners
Partners of PLHIV
Other MARPs
General population

Step 3 — Index Testing & HIV Self-Test Kits

Index cases offered, contacts elicited, contacts tested, positive results — and HIV self-test kit distribution.

Index Cases — OfferedNumber of index cases offered index testing services — by age & sex

Age Group	Male	Female
< 1 year
1 – 4 years
5 – 9 years
10 – 14 years
15 – 19 years
20 – 24 years
25 – 29 years
30 – 34 years
35 – 39 years
40 – 44 years
45 – 49 years
≥ 50 years

Contacts ElicitedNumber of contacts elicited — by age & sex

Age Group	Male	Female
< 15 years
≥ 15 years

Contacts TestedNumber of contacts tested — by age & sex

Age Group	Male	Female
< 1 year
1 – 4 years
5 – 9 years
10 – 14 years
15 – 19 years
20 – 24 years
25 – 29 years
30 – 34 years
35 – 39 years
40 – 44 years
45 – 49 years
≥ 50 years

New Positive ContactsIndex case contacts — new positive results by age & sex

Age Group	Male	Female
< 1 year
1 – 4 years
5 – 9 years
10 – 14 years
15 – 19 years
20 – 24 years
25 – 29 years
30 – 34 years
35 – 39 years
40 – 44 years
45 – 49 years
≥ 50 years

Known Positive ContactsIndex case contacts — known positive by age & sex

Age Group	Male	Female
< 1 year
1 – 4 years
5 – 9 years
10 – 14 years
15 – 19 years
20 – 24 years
25 – 29 years
30 – 34 years
35 – 39 years
40 – 44 years
45 – 49 years
≥ 50 years

Self-Test Kits — Directly AssistedHIV self-test kits distributed — directly assisted, by age & sex

Age Group	Male	Female
15 – 19 years
20 – 24 years
25 – 29 years
30 – 34 years
35 – 39 years
40 – 44 years
45 – 49 years
≥ 50 years

Self-Test Kits — UnassistedHIV self-test kits distributed — unassisted

Male

Female

Step 4 — ART: Currently on Treatment

Children and adults currently on ART by age group, sex, and regimen line. Then pregnancy status.

ART FacilityDoes this health facility provide ART Treatment Service?

ART Treatment Service provided

ART ChildrenChildren currently on ART — by age group, sex & regimen line (1st / 2nd / 3rd)

Age / Regimen	Male	Female
<1 yr — 1st line
<1 yr — 2nd line
<1 yr — 3rd line
1–4 yr — 1st line
1–4 yr — 2nd line
1–4 yr — 3rd line
5–9 yr — 1st line
5–9 yr — 2nd line
5–9 yr — 3rd line
10–14 yr — 1st line
10–14 yr — 2nd line
10–14 yr — 3rd line

ART AdultsAdults currently on ART — by age group, sex & regimen line (1st / 2nd / 3rd)

Age / Regimen	Male	Female
15–19 yr — 1st line
15–19 yr — 2nd line
15–19 yr — 3rd line
20–24 yr — 1st line
20–24 yr — 2nd line
20–24 yr — 3rd line
25–29 yr — 1st line
25–29 yr — 2nd line
25–29 yr — 3rd line
30–34 yr — 1st line
30–34 yr — 2nd line
30–34 yr — 3rd line
35–39 yr — 1st line
35–39 yr — 2nd line
35–39 yr — 3rd line
40–44 yr — 1st line
40–44 yr — 2nd line
40–44 yr — 3rd line
45–49 yr — 1st line
45–49 yr — 2nd line
45–49 yr — 3rd line
≥50 yr — 1st line
≥50 yr — 2nd line
≥50 yr — 3rd line

Pregnancy StatusCurrently on ART by pregnancy status

Pregnant

Non-Pregnant

Step 5 — ART Regimen Types

Specific drug regimen codes for children by age group, adults 15–19, and adults ≥20 (with Male / Female-Pregnant / Female-Non-Pregnant breakdown).

Children <1 yr — Regimen TypesChildren currently on ART aged <1 year — by regimen code

1st Line:

4f = AZT + 3TC + LPV/r

4g = ABC + 3TC + LPV/r

4j = ABC + 3TC + DTG

4k = AZT + 3TC + DTG

4h = Other first line

2nd Line:

5e = ABC + 3TC + LPV/r

5f = AZT + 3TC + LPV/r

5m = ABC + 3TC + DTG

5n = AZT + 3TC + DTG

5j = Other Secondline

3rd Line:

6c = DRV/r + DTG + AZT + 3TC

6f = DRV/r + DTG + ABC + 3TC

6e = Other thirdline regimen

Children 1–4 yr — Regimen TypesChildren currently on ART aged 1–4 years — by regimen code

1st Line:

4d = AZT + 3TC + EFV

4f = AZT + 3TC + LPV/r

4g = ABC + 3TC + LPV/r

4j = ABC + 3TC + DTG

4k = AZT + 3TC + DTG

4L = ABC + 3TC + EFV

4h = Other first line

2nd Line:

5e = ABC + 3TC + LPV/r

5f = AZT + 3TC + LPV/r

5h = ABC + 3TC + EFV

5m = ABC + 3TC + DTG

5n = AZT + 3TC + DTG

5j = Other Secondline

3rd Line:

6c = DRV/r + DTG + AZT + 3TC

6f = DRV/r + DTG + ABC + 3TC

6g = DRV/r + ABC + 3TC + EFV

6h = DRV/r + AZT + 3TC + EFV

6e = Other thirdline regimen

Children 5–9 yr — Regimen TypesChildren currently on ART aged 5–9 years — by regimen code

1st Line:

4d = AZT + 3TC + EFV

4e = TDF + 3TC + EFV

4f = AZT + 3TC + LPV/r

4g = ABC + 3TC + LPV/r

4i = TDF + 3TC + DTG

4j = ABC + 3TC + DTG

4k = AZT + 3TC + DTG

4L = ABC + 3TC + EFV

4h = Other first line

2nd Line:

5e = ABC + 3TC + LPV/r

5f = AZT + 3TC + LPV/r

5g = TDF + 3TC + EFV

5h = ABC + 3TC + EFV

5i = TDF + 3TC + LPV/r

5m = ABC + 3TC + DTG

5n = AZT + 3TC + DTG

5o = TDF + 3TC + DTG

5j = Other Secondline

3rd Line:

6c = DRV/r + DTG + AZT + 3TC

6d = DRV/r + DTG + TDF + 3TC

6f = DRV/r + DTG + ABC + 3TC

6g = DRV/r + ABC + 3TC + EFV

6h = DRV/r + AZT + 3TC + EFV

6e = Other thirdline regimen

Children 10–14 yr — Regimen TypesChildren currently on ART aged 10–14 years — by regimen code

1st Line:

4d = AZT + 3TC + EFV

4e = TDF + 3TC + EFV

4f = AZT + 3TC + LPV/r

4g = ABC + 3TC + LPV/r

4i = TDF + 3TC + DTG

4j = ABC + 3TC + DTG

4k = AZT + 3TC + DTG

4L = ABC + 3TC + EFV

4h = Other first line

2nd Line:

5e = ABC + 3TC + LPV/r

5f = AZT + 3TC + LPV/r

5g = TDF + 3TC + EFV

5h = ABC + 3TC + EFV

5i = TDF + 3TC + LPV/r

5m = ABC + 3TC + DTG

5n = AZT + 3TC + DTG

5o = TDF + 3TC + DTG

5j = Other Secondline

3rd Line:

6c = DRV/r + DTG + AZT + 3TC

6d = DRV/r + DTG + TDF + 3TC

6f = DRV/r + DTG + ABC + 3TC

6g = DRV/r + ABC + 3TC + EFV

6h = DRV/r + AZT + 3TC + EFV

6e = Other thirdline regimen

Adults 15–19 yr — Regimen TypesAdults currently on ART aged 15–19 — by regimen code

1st Line:

1d = AZT + 3TC + EFV

1e = TDF + 3TC + EFV

1g = ABC + 3TC + EFV

1j = TDF + 3TC + DTG

1k = AZT + 3TC + DTG

1i = Other Specify

2nd Line:

2e = AZT + 3TC + LPV/r

2f = AZT + 3TC + ATV/r

2g = TDF + 3TC + LPV/r

2h = TDF + 3TC + ATV/r

2i = ABC + 3TC + LPV/r

2j = TDF + 3TC + DTG

2k = AZT + 3TC + DTG

2l = Other secondline

3rd Line:

3a = DRV/r + DTG + AZT + 3TC

3b = DRV/r + DTG + TDF + 3TC

3c = DRV/r + ABC + 3TC + DTG

3e = DRV/r + TDF + 3TC + EFV

3f = DRV/r + AZT + 3TC + EFV

3d = Other thirdline

Adults ≥20 yr — 1st Line Regimen TypesAdults ≥20 years on 1st line — Male / Female-Pregnant / Female-Non-Pregnant

⚠️ Each regimen is broken down into three columns: Male, Female-Pregnant, Female-Non-Pregnant.

Regimen	Male	Female — Pregnant	Female — Non-Pregnant
1d = AZT + 3TC + EFV
1e = TDF + 3TC + EFV
1g = ABC + 3TC + EFV
1j = TDF + 3TC + DTG
1k = AZT + 3TC + DTG
1i = Other Specify

Adults ≥20 yr — 2nd Line Regimen TypesAdults ≥20 years on 2nd line — Male / Female-Pregnant / Female-Non-Pregnant

Regimen	Male	Female — Pregnant	Female — Non-Pregnant
2e = AZT + 3TC + LPV/r
2f = AZT + 3TC + ATV/r
2g = TDF + 3TC + LPV/r
2h = TDF + 3TC + ATV/r
2i = ABC + 3TC + LPV/r
2j = TDF + 3TC + DTG
2k = AZT + 3TC + DTG
2l = Other secondline

Adults ≥20 yr — 3rd Line Regimen TypesAdults ≥20 years on 3rd line — Male / Female-Pregnant / Female-Non-Pregnant

Regimen	Male	Female — Pregnant	Female — Non-Pregnant
3a = DRV/r + DTG + AZT + 3TC
3b = DRV/r + DTG + TDF + 3TC
3c = DRV/r + ABC + 3TC + DTG
3e = DRV/r + TDF + 3TC + EFV
3f = DRV/r + AZT + 3TC + EFV
3d = Other thirdline

Step 6 — Newly Started on ART & 12-Month Retention

Adults and children newly started on ART, 12-month retention cohort, net cohort, and linkage outcomes.

Newly Started on ARTAdults and children newly started on ART — by age & sex

Children (<15 yrs): Male and Female-Non-Pregnant only. Adults (15+): Male, Female-Pregnant, and Female-Non-Pregnant.

Age Group	Male	Female — Pregnant	Female — Non-Pregnant
<1 yr		N/A
1–4 yr		N/A
5–9 yr		N/A
10–14 yr		N/A
15–19 yr
20–24 yr
25–29 yr
30–34 yr
35–39 yr
40–44 yr
45–49 yr
≥50 yr		N/A

12-Month Retention — Still on TreatmentAdults and children still on treatment at 12 months after initiating ART

Age Group	Male	Female — Pregnant	Female — Non-Pregnant
<1 yr		N/A
1–4 yr		N/A
5–9 yr		N/A
10–14 yr		N/A
15–19 yr
20–24 yr
25–29 yr
30–34 yr
35–39 yr
40–44 yr
45–49 yr
≥50 yr		N/A

Net CohortPersons on ART in original cohort including transferred in, minus transferred out

Age Group	Male	Female — Pregnant	Female — Non-Pregnant
<1 yr		N/A
1–4 yr		N/A
5–9 yr		N/A
10–14 yr		N/A
15–19 yr
20–24 yr
25–29 yr
30–34 yr
35–39 yr
40–44 yr
45–49 yr
≥50 yr		N/A

Linkage OutcomesLinkage outcome of newly identified HIV positive individuals in the reporting period

Linked to Care and Treatment

Known on ART

Lost to Follow-up

Referred

Died

Others

Step 7 — Viral Load & DSD Models

VL test results received, undetectable (<50 copies/ml), low-level viremia (50–1000 copies/ml), and differentiated service delivery model enrollment.

VL Test — Result ReceivedART patients with viral load test result received in the reporting period — by age & sex

Age Group	Male	Female — Pregnant	Female — Non-Pregnant
<1 yr		N/A
1–4 yr		N/A
5–9 yr		N/A
10–14 yr		N/A
15–19 yr
20–24 yr
25–29 yr
30–34 yr
35–39 yr
40–44 yr
45–49 yr
≥50 yr		N/A

Undetectable VL (<50 copies/ml)ART patients with undetectable viral load (<50 copies/ml) — by age & sex

Age Group	Male	Female — Pregnant	Female — Non-Pregnant
<1 yr		N/A
1–4 yr		N/A
5–9 yr		N/A
10–14 yr		N/A
15–19 yr
20–24 yr
25–29 yr
30–34 yr
35–39 yr
40–44 yr
45–49 yr
≥50 yr		N/A

Low Level Viremia (50–1000 copies/ml)ART patients with low level viremia — by age & sex

Age Group	Male	Female — Pregnant	Female — Non-Pregnant
<1 yr		N/A
1–4 yr		N/A
5–9 yr		N/A
10–14 yr		N/A
15–19 yr
20–24 yr
25–29 yr
30–34 yr
35–39 yr
40–44 yr
45–49 yr
≥50 yr		N/A

DSD — 3MMDTotal number of clients on 3-month multi-month dispensing (3MMD) — by age & sex

Note: 3MMD uses combined 25–49 yr age band.

Age Group	Male	Female
<1 yr
1–4 yr
5–9 yr
10–14 yr
15–19 yr
20–24 yr
25–49 yr
≥50 yr

DSD — ASM / 6MMDTotal number of clients on ASM (6-month multi-month dispensing) — by age & sex

Age Group	Male	Female
15–19 yr
20–24 yr
25–49 yr
≥50 yr

DSD — FTARTotal number of clients on Fast-Track ART Refill (FTAR) — by age & sex

Age Group	Male	Female
15–19 yr
20–24 yr
25–49 yr
≥50 yr

DSD — CAGTotal number of clients on Community ART Group (CAG) — by age & sex

Age Group	Male	Female
15–19 yr
20–24 yr
25–49 yr
≥50 yr

DSD — PCADTotal number of clients on Patient-Centered ART Delivery (PCAD) — by age & sex

Age Group	Male	Female
15–19 yr
20–24 yr
25–49 yr
≥50 yr

DSD — Other Types & TotalsOther DSD model enrollments

Total clients on Adolescent DSD

Total clients on KP DSD

Total clients on MCH DSD

Total clients on other types of DSD

Advanced HIV Disease Care ModelTotal number of clients on Advanced HIV Disease Care Model — by age & sex

Note: Uses combined 25–49 yr age band.

Age Group	Male	Female
<1 yr
1–4 yr
5–9 yr
10–14 yr
15–19 yr
20–24 yr
25–49 yr
≥50 yr

Step 8 — Prevention

Treatment interruption & restart, PrEP (new & current), PEP, STI syndromes, and family planning for PLHIV on ART.

Treatment InterruptionART clients that interrupted treatment — by category & age/sex (<15 / ≥15 M/F)

For each interruption category enter counts for <15 years Male, <15 years Female, ≥15 years Male, ≥15 years Female.

Lost after treatment <3 months:

<15 yr — Male

<15 yr — Female

≥15 yr — Male

≥15 yr — Female

Lost after treatment >3 months:

<15 yr — Male

<15 yr — Female

≥15 yr — Male

≥15 yr — Female

Transferred out:

<15 yr — Male

<15 yr — Female

≥15 yr — Male

≥15 yr — Female

Refused (stopped) treatment:

<15 yr — Male

<15 yr — Female

≥15 yr — Male

≥15 yr — Female

Died:

<15 yr — Male

<15 yr — Female

≥15 yr — Male

≥15 yr — Female

ART RestartART clients restarted ARV treatment in the reporting period

<15 yr — Male

<15 yr — Female

≥15 yr — Male

≥15 yr — Female

PrEP — New EnrollmentsNew individuals newly enrolled on PrEP — by age & sex and client category

Age Group	Male	Female
15–19 yr
20–24 yr
25–29 yr
30–34 yr
35–39 yr
40–44 yr
45–49 yr
≥50 yr

By client category:

Discordant Couple

Commercial sex workers

PrEP CurrentIndividuals that received oral PrEP during the reporting period — by age & sex and client category

Age Group	Male	Female
15–19 yr
20–24 yr
25–29 yr
30–34 yr
35–39 yr
40–44 yr
45–49 yr
≥50 yr

By client category:

Discordant Couple

Commercial sex workers

PEPPersons provided with post-exposure prophylaxis (PEP) — by exposure type

Occupational

Sexual violence

Other non-occupational

STI — HIV TestingSTI cases tested for HIV

Category	Male	Female
Number of STI cases tested for HIV
Number of STI cases tested positive for HIV

STI — By SyndromeTotal number of STI cases by syndrome

Syndrome	Count
Urethral Discharge
Persistent Urethral Discharge
Scrotal Swelling
Vaginal Discharge
PID (Pelvic Inflammatory Disease)
Non-vesicular genital ulcer disease (NVGUD)
Vesicular genital ulcer disease (VGUD)
Inguinal Bubo
Neonatal Conjunctivitis
Neonatal Herpes

FP for PLHIV on ARTNon-pregnant women living with HIV on ART aged 15–49 using modern family planning

By age:

10–14 years

15–19 years

20–24 years

25–29 years

30–49 years

By method:

Oral Contraceptives

Injectables

Implants

IUCD

Others

Step 9 — TB Screening, TPT & Malnutrition

TB screening for newly enrolled and previously on ART, TB Preventive Treatment (TPT) started/completed, and PLHIV malnutrition screening and food support.

TB Screening — Newly EnrolledNewly enrolled ART clients screened for TB — by age/sex and positivity

Category	<15 yr Male	<15 yr Female	≥15 yr Male	≥15 yr Female
Screened for TB
Screened Positive for TB

TB Screening — Previously on ARTPLHIVs previously on ART screened for TB — by age/sex and positivity

Category	<15 yr Male	<15 yr Female	≥15 yr Male	≥15 yr Female
Screened for TB
Screened Positive for TB

TPT — Started (this period)ART patients started on TB Preventive Treatment (TPT) — by regimen, <15/≥15, M/F

Regimen	<15 yr Male	<15 yr Female	≥15 yr Male	≥15 yr Female
Patients on 6H
Patients on 3HP
Patients on 3HR

TPT — 12 Months PriorART patients initiated on any course of TPT 12 months before the reporting period

Regimen	<15 yr Male	<15 yr Female	≥15 yr Male	≥15 yr Female
Patients on 6H (12mo prior)
Patients on 3HP (12mo prior)
Patients on 3HR (12mo prior)

TPT — CompletedART patients who completed a full course of TPT (started 12 months prior)

Regimen	<15 yr Male	<15 yr Female	≥15 yr Male	≥15 yr Female
Completed 6H
Completed 3HP
Completed 3HR

PLHIV — Malnutrition ScreeningPLHIV assessed/screened for malnutrition — by age group & sex

Category	<15 yr Male	<15 yr Female	≥15 yr Male	≥15 yr Female
Total screened for malnutrition
Found MAM (Moderate Acute Malnutrition)
Found SAM (Severe Acute Malnutrition)

MAM — Received Food SupportClinically undernourished PLHIV (MAM) who received therapeutic or supplementary food

<15 yr — Male

<15 yr — Female Non-Pregnant

≥15 yr — Male

≥15 yr — Female Pregnant

≥15 yr — Female Non-Pregnant

SAM — Received Food SupportClinically undernourished PLHIV (SAM) who received therapeutic or supplementary food

<15 yr — Male

<15 yr — Female Non-Pregnant

≥15 yr — Male

≥15 yr — Female Pregnant

≥15 yr — Female Non-Pregnant

Step 10 — Cervical Cancer, Hepatitis B & C, and Submit

Cervical cancer screening (VIA & HPV DNA) and treatment for PLHIV, Hepatitis B & C testing and treatment, then submit the full report.

CxCa — ScreeningPLHIV women screened for cervical cancer — by screening type

Screened by VIA

Screened by HPV DNA

VIA Screening ResultsVIA screening result — by age group

Result / Age Group	15–19 yr	20–24 yr	25–29 yr	30–49 yr	≥50 yr
Normal cervix
Precancerous lesion
Suspicious cancerous lesion

HPV DNA Test ResultsHPV DNA test positive — by age group

Result / Age Group	15–19 yr	20–24 yr	25–29 yr	30–49 yr	≥50 yr
HPV DNA Positive

CxCa — TreatmentTreatment of precancerous cervical lesion — by treatment type & age group

Treatment Type	15–19 yr	20–24 yr	25–29 yr	30–49 yr	≥50 yr
Treatment with Cryotherapy
Treatment with LEEP
Treatment with Thermal Ablation / Thermocoagulation

Hepatitis BPLHIV tested and positive for Hepatitis B — by age/sex (<15 / ≥15 M/F)

Category	<15 yr Male	<15 yr Female	≥15 yr Male	≥15 yr Female
Tested for Hepatitis B
Tested positive for Hepatitis B
Treated for Hepatitis B

Hepatitis CPLHIV tested and positive for Hepatitis C — by age/sex (<15 / ≥15 M/F)

Category	<15 yr Male	<15 yr Female	≥15 yr Male	≥15 yr Female
Tested for Hepatitis C
Tested positive for Hepatitis C
Treated for Hepatitis C