Less than half of adolescent girls and young women with HIV in some of the countries with the highest burden of HIV in sub-Saharan Africa have a fully suppressed viral load on antiretroviral treatment, well below the average for the population as a whole, findings from national surveys published this month in Mortality and Morbidity Weekly Reports show.
Despite sustained efforts to reduce HIV incidence among adolescent girls and young women, the prevalence of HIV remains much higher among adolescent girls and young women aged 15 to 24 than their male peers in sub-Saharan Africa. National surveys have found an especially high prevalence in this age group in Lesotho and Swaziland, where between one in ten and one in seven young women aged 15-24 was living with HIV in 2016 or 2017.
Population-based HIV Impact Assessment (PHIA) surveys are household surveys that are being carried out by national ministries of health with funding from the President’s Emergency Plan for AIDS Relief. The surveys are designed to measure HIV incidence, prevalence and viral load suppression so as to monitor national and regional progress towards the 90-90-90 targets for HIV diagnosis, treatment and viral suppression. Ideally, if 90% of people with HIV are diagnosed, 90% of diagnosed people are on treatment and 90% of people on treatment have fully suppressed viral load, 73% of all people with HIV should have suppressed viral load (below 1000 copies/ml).
A fully suppressed viral load is the aim of antiretroviral treatment. Maintaining a fully suppressed viral load prevents HIV disease progression, prevents the development of drug resistance and prevents sexual transmission of HIV. Achieving very high levels of viral suppression should minimise AIDS-related deaths and greatly reduce HIV incidence.