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Delays in linkage to care after HIV diagnosis pose the biggest barrier to treatment access
Keith Alcorn, 2017-02-08 17:20:00

Following individuals through the cascade of care, from HIV diagnosis to treatment and undetectable viral load, rather than taking snapshots of performance, has led researchers on a major South African study to pinpoint linkage to care after testing HIV positive as the biggest weakness of treatment programmes seeking to achieve the UNAIDS 90-90-90 targets, an article in the journal The Lancet HIV reports.

The study, carried out through the Africa Health Research institute in the Hlabisa district of KwaZulu-Natal province in South Africa, found that less than half of the population with HIV in the district had linked to care within eight years, despite the fact that 82% were aware of their HIV infection.

As well as raising questions about how to improve linkage to care, the findings also highlight weaknesses in the ways that countries and treatment programmes are reporting treatment cascade data. Treatment cascades have become a popular way of reporting programme outcomes and have become enshrined in the UNAIDS 90-90-90 target, which aims to achieve 90% of people with HIV diagnosed, 90% of people diagnosed on treatment and 90% of people on treatment with undetectable viral load. Treatment cascades report the proportions of people who reach each stage and help to identify areas of health system weakness.