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Progress towards 90-90-90 targets in southern Africa: find the men!
Keith Alcorn, 2016-07-20 09:40:00

Studies of treatment cascade performance in South Africa and Namibia show large variations between districts and highlight the need for up-to-date information on performance to guide programming, advocacy and funding, according to presentations at the 21st International AIDS Conference in Durban, South Africa, on Tuesday.

In particular, the studies emphasised the low rates of HIV diagnosis among men in the region, and low rates of viral suppression, especially among men.

Treatment cascades report the progress of a population towards the goal of viral suppression. Full suppression of viral load benefits the individual by preventing illness, death and treatment failure, and benefits the community by preventing HIV transmission. In order to achieve viral suppression, people need to be diagnosed with HIV, linked to care, started on treatment, retained in care and virally suppressed. Treatment cascades may report performance of a treatment programme on all of these measures, but most commonly report the numbers diagnosed, treated and virally suppressed – the three 90s set out by UNAIDS in the 90-90-90 target.

The 90-90-90 target calls on countries to achieve the following goals:

  • 90% of people living with HIV diagnosed by 2020
  • 90% of diagnosed people on antiretroviral treatment by 2020
  • 90% of people in treatment with fully suppressed viral load by 2020

Southern Africa is the region with the highest prevalence of HIV, and some of the world’s largest treatment programmes, so efforts to achieve the 90-90-90 targets are critically dependent on performance in this region. Research groups working in South Africa and Namibia reported on efforts to monitor the cascade, and local performance, highlighting several common problems across the region, at a Tuesday session during the 21st International AIDS Conference.

The studies used different methodologies, underlining the need for greater consensus on how to measure and report cascade performance in order to make valid comparisons between countries and populations.

Source:1