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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
- 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.