Towards achieving the fast-track targets and ending the epidemic of HIV/AIDS in Ethiopia: Successes and challenges

Abstract

Background: Ethiopia has adopted the global plan to end the epidemic of HIV/AIDS. The aim of this study was to assess the progress made towards achieving this plan. Methods: A review and analysis of national population-based surveys, surveillance, and routine programme data was executed. The data analysis was conducted using Excel 2016 and Stata 14 (StataCorp LP, College Station, TX, USA). Results: Between 2011 and 2016, the number of HIV-related deaths dropped by 58%, while that of new HIV infections dropped by only 6%. Discriminatory attitudes declined significantly from 77.9% (95% confidence interval (CI) 77.3-78.4%) in 2011 to 41.5% (95% CI 40.6-42.4%) in 2016. Around 79% of adult people living with HIV (PLHIV) were aware of their HIV status; 90% of PLHIV who were aware of their HIV status were taking antiretroviral treatment (ART) and 88% of adult PLHIV on ART had viral suppression in 2016. The proportion of people aged 15-49 years who had ever been tested for HIV and had received results increased from 39.8% (95% CI 39.2-40.4%) in 2011 to 44.8% (95% CI 44.2-45.4%) in 2016. This proportion was very low among children below age 15 years at only 6.2% (95% CI 5.9-6.5%). Among regions, HIV testing coverage varied from 13% to 72%. Female sex workers had lower coverage for HIV testing (31%) and ART (70%) than the national average in the adult population. International funding for HIV dropped from more than US$ 1.3 billion in 2010-2012 to less than US$ 800 million in 2016-2018. Conclusions: Ethiopia is on track to achieve the targets for HIV testing, ART, viral suppression, and AIDSrelated deaths, but not for reductions in new HIV infections, discriminatory attitudes, and equity. Ending the epidemic of HIV/AIDS requires a combined response, including prevention and treatment, tailored to key populations and locations, as well as increased funding.

Modelling the impact of migrants on the success of the HIV care and treatment program in Botswana

“…Other models focusing on India and the USA have also failed to demonstrate 90% HIV incidence reduction by 2030 if Fast-Track targets are met [35,36]. Our finding are also consistent with analysis of population-based surveys, surveillance, and routine program data used in Ethiopia that demonstrated that for HIV testing, ART, viral suppression, and AIDS-related deaths Fast-Track targets will be reached, but not targets for reductions in new HIV infections based on progress made between 2011 and 2016 [37].…”

What causes non-adherence among some individuals on long term antiretroviral therapy? Experiences of individuals with poor viral suppression in Uganda

“…The missed ART refill appointments could be due to either busy work schedules, lack of transport fares or could even have been used to mask either perceived or experienced stigma [44]. These challenges are likely to affect more people, as increasing numbers are diagnosed as living with HIV as universal treatment access is rolled out in the effort to reach the UNAIDS 2020 targets [45].…”

Spatial clustering and socio-demographic determinants of HIV infection in Ethiopia, 2015–2017

“…Ethiopia is one of the HIV high burden countries that has adopted the 90-90-90 fast-track targets (Joint United Nations Programme on HIV/AIDS, 2014). A recent study indicated that progress towards achieving the 2020 targets are on track: 79% PLHIV know their status, 90% PLHIV are on ART, and 88% of PLHIV have suppressed viral loads (Assefa et al, 2019). However, the prevalence of HIV and incidence of new infections remain high (Girum et al, 2018).…”