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6.1.1 Pregnant women counselled for HIV during ANC visit
Program Area: Mother to child transmission 
Definition: The percent of women who were counselled for HIV during antenatal visit for the most recent birth, of all women who were pregnant at any time in the two years preceding the survey. 
Numerator: The number of women respondents who were counselled for HIV during antenatal visit for the most recent birth in the last two years preceding the survey. 
Denominator: Total number of women respondents who were pregnant at any time in the two years preceding the survey. 
Measurement Tools:  
What It Measures: The principal active interventions to reduce mother to child infection depend on knowledge of HIV status. Knowledge of HIV status during pregnancy may also affect future reproductive choices. Ideally, women would learn their HIV status using VCT services before they choose to become pregnant. But the gap between this ideal and reality is often very wide. In practice, the first opportunity many women have to be counselled about HIV and to be offered tests may be at antenatal clinics that offer these services as a precursor to offering interventions to reduce transmission of HIV from mother to child.

To learn their HIV status in an antenatal care situation, women have to go through a number of steps. First, they must attend antenatal services. Then they must be counselled and offered an HIV test. Next they must accept a test. Finally, they must return to receive the test results. It is only after the post-test counselling that follows all of these steps that they will be able to take necessary decisions about therapy and infant feeding.

This indicator measures the percentage of women with a recent pregnancy who completed all of those steps. Data are collected in a general population survey, so the indicator gives an idea of the coverage of ANC-based counselling and testing country-wide, rather than just in specific pilot facilities. 

How to Measure It: In a general population survey, women are asked when their most recent child was born, and whether they received any antenatal care before that last birth. If so, they are asked whether clinic staff talked to them about HIV infection.  
Strengths and Limitations: This is a broad measure of service provision to give an idea of coverage on a national scale. However, few countries may have the resources to introduce counselling and voluntary testing for pregnant women country-wide. Those countries providing prevention services for pregnant, HIV-positive women typically start with pilot projects in a few antenatal clinics. Even if all women in pilot clinics are counselled and offered testing, the indicator will typically remain low for some time. It should be used in conjunction with Mother to Child Transmission Indicator 2.  
Use of Indicator: Core indicator for countries with generalised epidemics and strategies to reduce mother to child transmission of HIV 
SSO Code:  
The President's
Emergency Plan:
OVC: No 
MDG: No 

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