Progress towards the UNAIDS 95-95-95 targets in the Fifth Botswana AIDS Impact Survey (BAIS V 2021): a nationally representative survey

Mine, Madisa; Stafford, Kristen A; Laws, Rebecca L; Marima, Reson; Lekone, Phenyo; Ramaabya, Dinah; Makhaola, Kgomotso; Patel, Hetal K; Mapondera, Prichard; Wray-Gordon, Floris; Agbakwuru, Chinedu; Okui, Lillian; Matroos, Susan; Onyadile, Eden; Ngidi, Julia; Abimiku, Alash'le; Bagapi, Khuteletso; Nkomo, Bornapate; Bodika, Stephane M; Kim, Kaylee J; Moloney, Mirna; Mitchell, Andrew; Ehoche, Akipu; Ussery, Faith L; Hong, Steven Y; Keipeile, Stella; Matlhaga, Matshelo; Mathumo, Rapetse; Selato, Robert; Charurat, Manhattan E; Voetsch, Andrew C

doi:10.1016/s2352-3018(24)00003-1

Cited by 4 publications

(3 citation statements)

References 23 publications

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“…Second, our study only considered data from Uganda, and our results may not directly generalize to other settings. However epidemiological patterns reported here are typical of ESA, such as: expansive population pyramids [27], patterns in HIV prevalence by age and gender [44], and gender gaps in suppression levels [12,[33][34][35][36][37][38][39][40]. These observations suggests that the major contributions of individuals aged 25-34 to the burden of viraemia may generalize across the subcontinent.…”

Section: Discussionmentioning

confidence: 81%

“…For example, in inland communities, we found that young individuals aged 15-24 constituted approximately two fifths of the census-eligible population, but only one fifth of the population exhibiting viremia. In fact, the lower suppression levels commonly reported among young PLHIV [12,[33][34][35][36][37][38][39][40] are counterbalanced by the small absolute number of young PLHIV. This observation is typically missing from studies supporting prioritization of younger age-groups in ESA based on the UNAIDS targets 45 .…”

Section: Discussionmentioning

confidence: 99%

“…With the expansion of HIV testing and treatment services, many countries in ESA have either attained or are close to attaining the "95-95-95" targets at a population level [12,13]. Thus, determining novel effective methods to measure HIV epidemic control and direct future efforts to accelerate epidemic decline in such contexts is required.…”

Section: Introductionmentioning

confidence: 99%

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Age and gender profiles of HIV infection burden and viraemia: novel metrics for HIV epidemic control in African populations with high antiretroviral therapy coverage

Brizzi,

Kagaayi,

Ssekubugu

et al. 2024

Preprint

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Introduction: To prioritize and tailor interventions for ending AIDS by 2030 in Africa, it is important to characterize the population groups in which HIV viraemia is concentrating. Methods: We analysed HIV testing and viral load data collected between 2013-2019 from the open, population-based Rakai Community Cohort Study (RCCS) in Uganda, to estimate HIV seroprevalence and population viral suppression over time by gender, one-year age bands and residence in inland and fishing communities. All estimates were standardized to the underlying source population using census data. We then assessed 95-95-95 targets in their ability to identify the populations in which viraemia concentrates. Results: Following the implementation of Universal Test and Treat, the proportion of individuals with viraemia decreased from 4.9% (4.6%-5.3%) in 2013 to 1.9% (1.7%-2.2%) in 2019 in inland communities and from 19.1% (18.0%-20.4%) in 2013 to 4.7% (4.0%-5.5%) in 2019 in fishing communities. Viraemia did not concentrate in the age and gender groups furthest from achieving 95-95-95 targets. Instead, in both inland and fishing communities, women aged 25-29 and men aged 30-34 were the 5-year age groups that contributed most to population-level viraemia in 2019, despite these groups being close to or had already achieved 95-95-95 targets. Conclusions: The 95-95-95 targets provide a useful benchmark for monitoring progress towards HIV epidemic control, but do not contextualize underlying population structures and so may direct interventions towards groups that represent a marginal fraction of the population with viraemia.

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

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Age and gender profiles of HIV infection burden and viraemia: novel metrics for HIV epidemic control in African populations with high antiretroviral therapy coverage

Brizzi,

Kagaayi,

Ssekubugu

et al. 2024

Preprint

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Evidence with 95-95-95 that ambitious is feasible

Maheu-Giroux,

Mishra

2024

The Lancet HIV

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Reaching for 90:90:90 in Correctional Facilities in South Africa and Zambia: Virtual Cross-Section of Coverage of HIV Testing and Antiretroviral Therapy During Universal Test and Treat Implementation

Hoffmann,

Herce,

Chimoyi

et al. 2024

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background People in correctional settings are a key population for HIV epidemic control. We sought to demonstrate scale-up of universal test and treat (UTT) in correctional facilities in South Africa and Zambia through a virtual cross-sectional analysis. Methods We used routine data on two dates: at the start of UTT implementation (time 1, T1) and one year later (time 2, T2). We obtained correctional facility census lists for the selected dates and matched HIV testing and treatment data to generate virtual cross-sections of HIV care continuum indicators. Results In the South African site, there were 4,193 and 3,868 people in the facility at times T1 and T2; 43% and 36% were matched with HIV testing or treatment data, respectively. At T1 and T2, respectively, 1803 (43%) and 1,386 (36%) had known HIV status, 804 (19%) and 845 (21%) were known to be living with HIV, and 60% and 56% of those with known HIV were receiving antiretroviral therapy (ART). In the Zambian site, there were 1,467 and 1,366 people in the facility at times T1 and T2; 58% and 92% were matched with HIV testing or treatment data, respectively. At T1 and T2, respectively, 857 (59%) and 1263 (92%) had known HIV status, 277 (19%) and 647 (47%) were known to be living with HIV, and 68% and 68% of those with known HIV were receiving ART. Conclusions: This virtual cross-sectional analysis identified gaps in HIV testing coverage and ART initiation not clearly demonstrated by prior cohort-based studies.

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Progress towards the UNAIDS 95-95-95 targets in the Fifth Botswana AIDS Impact Survey (BAIS V 2021): a nationally representative survey

Cited by 4 publications

References 23 publications

Age and gender profiles of HIV infection burden and viraemia: novel metrics for HIV epidemic control in African populations with high antiretroviral therapy coverage

Age and gender profiles of HIV infection burden and viraemia: novel metrics for HIV epidemic control in African populations with high antiretroviral therapy coverage

Evidence with 95-95-95 that ambitious is feasible

Reaching for 90:90:90 in Correctional Facilities in South Africa and Zambia: Virtual Cross-Section of Coverage of HIV Testing and Antiretroviral Therapy During Universal Test and Treat Implementation

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