On estimating the number of people with known HIV positive status

Abstract

Objective: In 2014, the Joint United Nations Program on HIV and AIDS (UNAIDS) and partners set the '90-90-90 targets' . Many countries are facing the challenge of estimating the first 90. Our objective was to propose an alternative modelling procedure, and to discuss its usefulness for taking into account duplication. Results:For deduplication, we identified two important ingredients: the probability for an HIV+ person of being re-tested during the period and average number of HIV+ tests. Other adjusted factors included: the false positive probability; the death and emigration probabilities. The uncertainty of the adjusted estimate was assessed using the plausibility bounds and sensitivity analysis. The proposed method was applied to Cameroon for the period 1987-2016. Of the 560,000 people living with HIV estimated from UNAIDS in 2016; 504,000 out to know their status. The model estimates that 380,464 [379,257, 381,674] know their status (75.5%); thus 179,536 who do not know their status should be sought through the intensification of testing. These results were subsequently used for constructing the full 2016 Cameroon HIV cascade for identifying programmatic gap, prioritizing the resources, and guiding the strategies of the 2018-2022 National Strategy Plan and funding request.

Progress towards controlling the HIV epidemic in urban Ethiopia: Findings from the 2017–2018 Ethiopia population-based HIV impact assessment survey

“…Among HIV-positive adults in EPHIA, 79% knew that they were HIV positive. This was similar to the awareness level estimated by another study in Ethiopia [20], but lower than the 2020 UNAIDS global estimate for eastern and southern Africa [4], which reported an awareness level of 87%. The PHIA surveys in several other countries [21] as well as other small-scale studies in Africa [22,23] showed that countries in the continent were at various stages of progress towards achieving the first 90 target.…”

“…The targets were widely promoted and adopted by countries and international implementing partners [3]. By 2020, though only a few countries had taken sufficient action to achieve the targets, much of the complex reality of the HIV epidemic was increasingly understood and countries were in a better position to identify gaps and develop strategies to reach PLHIV who were left behind [4]. A comprehensive approach would be required to fill the gaps and achieve the next set of UNAIDS 95-95-95 testing and treatment targets; 95% of people living with HIV know their HIV status, 95% of PLHIV who know their status are on treatment, and 95% of people on treatment have suppressed viral loads, thereby reducing the annual number of new HIV infections among adults to 200,000 or fewer; and achieving zero discrimination by 2030 [5].…”

Client and healthcare worker experiences with differentiated HIV treatment models in Eswatini

“…The Kingdom of Eswatini has made remarkable progress scaling up HIV testing, prevention, and treatment services. Although the country has among the world’s highest HIV prevalence, 26.8% among adults in 2021 [ 1 ], Eswatini was one of the first countries to achieve the UNAIDS 95-95-95 epidemic control goals [ 2 ] and has reduced HIV incidence from 2.4% in 2011 to 0.5% in 2020 [ 1 , 3 ]. Universal access to antiretroviral therapy (ART) is a cornerstone of the national HIV strategy, and the number of people on ART grew from approximately 60,000 in 2010 to over 200,000 in 2020 [ 4 ].…”