Progress towards the UNAIDS 95-95-95 targets in the Fifth Botswana AIDS Impact Survey (BAIS V 2021): a nationally representative survey

Mine, Madisa; Stafford, Kristen A; Laws, Rebecca L; Marima, Reson; Lekone, Phenyo; Ramaabya, Dinah; Makhaola, Kgomotso; Patel, Hetal K; Mapondera, Prichard; Wray-Gordon, Floris; Agbakwuru, Chinedu; Okui, Lillian; Matroos, Susan; Onyadile, Eden; Ngidi, Julia; Abimiku, Alash'le; Bagapi, Khuteletso; Nkomo, Bornapate; Bodika, Stephane M; Kim, Kaylee J; Moloney, Mirna; Mitchell, Andrew; Ehoche, Akipu; Ussery, Faith L; Hong, Steven Y; Keipeile, Stella; Matlhaga, Matshelo; Mathumo, Rapetse; Selato, Robert; Charurat, Manhattan E; Voetsch, Andrew C

doi:10.1016/s2352-3018(24)00003-1

Cited by 7 publications

(3 citation statements)

References 23 publications

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“…Second, our study only considered data from Uganda, and our results may not directly generalize to other settings. However epidemiological patterns reported here are typical of ESA, such as: expansive population pyramids [27], patterns in HIV prevalence by age and gender [44], and gender gaps in suppression levels [12,[33][34][35][36][37][38][39][40]. These observations suggests that the major contributions of individuals aged 25-34 to the burden of viraemia may generalize across the subcontinent.…”

Section: Discussionmentioning

confidence: 81%

“…For example, in inland communities, we found that young individuals aged 15-24 constituted approximately two fifths of the census-eligible population, but only one fifth of the population exhibiting viremia. In fact, the lower suppression levels commonly reported among young PLHIV [12,[33][34][35][36][37][38][39][40] are counterbalanced by the small absolute number of young PLHIV. This observation is typically missing from studies supporting prioritization of younger age-groups in ESA based on the UNAIDS targets 45 .…”

Section: Discussionmentioning

confidence: 99%

“…With the expansion of HIV testing and treatment services, many countries in ESA have either attained or are close to attaining the "95-95-95" targets at a population level [12,13]. Thus, determining novel effective methods to measure HIV epidemic control and direct future efforts to accelerate epidemic decline in such contexts is required.…”

Section: Introductionmentioning

confidence: 99%

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Age and gender profiles of HIV infection burden and viraemia: novel metrics for HIV epidemic control in African populations with high antiretroviral therapy coverage

Brizzi,

Kagaayi,

Ssekubugu

et al. 2024

Preprint

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Introduction: To prioritize and tailor interventions for ending AIDS by 2030 in Africa, it is important to characterize the population groups in which HIV viraemia is concentrating. Methods: We analysed HIV testing and viral load data collected between 2013-2019 from the open, population-based Rakai Community Cohort Study (RCCS) in Uganda, to estimate HIV seroprevalence and population viral suppression over time by gender, one-year age bands and residence in inland and fishing communities. All estimates were standardized to the underlying source population using census data. We then assessed 95-95-95 targets in their ability to identify the populations in which viraemia concentrates. Results: Following the implementation of Universal Test and Treat, the proportion of individuals with viraemia decreased from 4.9% (4.6%-5.3%) in 2013 to 1.9% (1.7%-2.2%) in 2019 in inland communities and from 19.1% (18.0%-20.4%) in 2013 to 4.7% (4.0%-5.5%) in 2019 in fishing communities. Viraemia did not concentrate in the age and gender groups furthest from achieving 95-95-95 targets. Instead, in both inland and fishing communities, women aged 25-29 and men aged 30-34 were the 5-year age groups that contributed most to population-level viraemia in 2019, despite these groups being close to or had already achieved 95-95-95 targets. Conclusions: The 95-95-95 targets provide a useful benchmark for monitoring progress towards HIV epidemic control, but do not contextualize underlying population structures and so may direct interventions towards groups that represent a marginal fraction of the population with viraemia.

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