Progress towards the UNAIDS 90‐90‐90 targets among persons aged 50 and older living with HIV in 13 African countries

Introduction Achieving optimal HIV outcomes, as measured by global 90‐90‐90 targets, that is awareness of HIV‐positive status, receipt of antiretroviral (ARV) therapy among aware and viral load (VL) suppression among those on ARVs, respectively, is critical. However, few data from sub‐Saharan Africa...

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Published inJournal of the International AIDS Society Vol. 25; no. S4; pp. e26005 - n/a
Main Authors Farley, Shannon M., Wang, Chunhui, Bray, Rachel M., Low, Andrea Jane, Delgado, Stephen, Hoos, David, Kakishozi, Angela N., Harris, Tiffany G., Nyirenda, Rose, Wadonda, Nellie, Li, Michelle, Amuri, Mbaraka, Juma, James, Kancheya, Nzali, Pietersen, Ismela, Mutenda, Nicholus, Natanael, Salomo, Aoko, Appolonia, Ngugi, Evelyn W., Asiimwe, Fred, Lecher, Shirley, Ward, Jennifer, Chikwanda, Prisca, Mugurungi, Owen, Moyo, Brian, Nkurunziza, Peter, Aibo, Dorothy, Kabala, Andrew, Biraro, Sam, Ndagije, Felix, Musuka, Godfrey, Ndongmo, Clement, Shang, Judith, Dokubo, Emily K., Dimite, Laura E., McCullough‐Sanden, Rachel, Bissek, Anne‐Cecile, Getaneh, Yimam, Eshetu, Frehywot, Nkumbula, Tepa, Tenthani, Lyson, Kayigamba, Felix R., Kirungi, Wilford, Musinguzi, Joshua, Balachandra, Shirish, Kayirangwa, Eugenie, Ayite, Ayiyi, West, Christine A., Bodika, Stephane, Sleeman, Katrina, Patel, Hetal K., Brown, Kristin, Voetsch, Andrew C., El‐Sadr, Wafaa M., Justman, Jessica J.
Format Journal Article
LanguageEnglish
Published Geneva John Wiley & Sons, Inc 01.09.2022
John Wiley and Sons Inc
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Abstract Introduction Achieving optimal HIV outcomes, as measured by global 90‐90‐90 targets, that is awareness of HIV‐positive status, receipt of antiretroviral (ARV) therapy among aware and viral load (VL) suppression among those on ARVs, respectively, is critical. However, few data from sub‐Saharan Africa (SSA) are available on older people (50+) living with HIV (OPLWH). We examined 90‐90‐90 progress by age, 15–49 (as a comparison) and 50+ years, with further analyses among 50+ (55–59, 60–64, 65+ vs. 50–54), in 13 countries (Cameroon, Cote d'Ivoire, Eswatini, Ethiopia, Kenya, Lesotho, Malawi, Namibia, Rwanda, Tanzania, Uganda, Zambia and Zimbabwe). Methods Using data from nationally representative Population‐based HIV Impact Assessments, conducted between 2015and 2019, participants from randomly selected households provided demographic and clinical information and whole blood specimens for HIV serology, VL and ARV testing. Survey weighted outcomes were estimated for 90‐90‐90 targets. Country‐specific Poisson regression models examined 90‐90‐90 variation among OPLWH age strata. Results Analyses included 24,826 HIV‐positive individuals (15–49 years: 20,170; 50+ years: 4656). The first, second and third 90 outcomes were achieved in 1, 10 and 5 countries, respectively, by those aged 15–49, while OPLWH achieved outcomes in 3, 13 and 12 countries, respectively. Among those aged 15–49, women were more likely to achieve 90‐90‐90 targets than men; however, among OPLWH, men were more likely to achieve first and third 90 targets than women, with second 90 achievement being equivalent. Country‐specific 90‐90‐90 regression models among OPLWH demonstrated minimal variation by age stratum across 13 countries. Among OLPWH, no first 90 target differences were noted by age strata; three countries varied in the second 90 by older age strata but not in a consistent direction; one country showed higher achievement of the third 90 in an older age stratum. Conclusions While OPLWH in these 13 countries were slightly more likely than younger people to be aware of their HIV‐positive status (first 90), this target was not achieved in most countries. However, OPLWH achieved treatment (second 90) and VL suppression (third 90) targets in more countries than PLWH <50. Findings support expanded HIV testing, prevention and treatment services to meet ongoing OPLWH health needs in SSA.
AbstractList INTRODUCTIONAchieving optimal HIV outcomes, as measured by global 90-90-90 targets, that is awareness of HIV-positive status, receipt of antiretroviral (ARV) therapy among aware and viral load (VL) suppression among those on ARVs, respectively, is critical. However, few data from sub-Saharan Africa (SSA) are available on older people (50+) living with HIV (OPLWH). We examined 90-90-90 progress by age, 15-49 (as a comparison) and 50+ years, with further analyses among 50+ (55-59, 60-64, 65+ vs. 50-54), in 13 countries (Cameroon, Cote d'Ivoire, Eswatini, Ethiopia, Kenya, Lesotho, Malawi, Namibia, Rwanda, Tanzania, Uganda, Zambia and Zimbabwe). METHODSUsing data from nationally representative Population-based HIV Impact Assessments, conducted between 2015and 2019, participants from randomly selected households provided demographic and clinical information and whole blood specimens for HIV serology, VL and ARV testing. Survey weighted outcomes were estimated for 90-90-90 targets. Country-specific Poisson regression models examined 90-90-90 variation among OPLWH age strata. RESULTSAnalyses included 24,826 HIV-positive individuals (15-49 years: 20,170; 50+ years: 4656). The first, second and third 90 outcomes were achieved in 1, 10 and 5 countries, respectively, by those aged 15-49, while OPLWH achieved outcomes in 3, 13 and 12 countries, respectively. Among those aged 15-49, women were more likely to achieve 90-90-90 targets than men; however, among OPLWH, men were more likely to achieve first and third 90 targets than women, with second 90 achievement being equivalent. Country-specific 90-90-90 regression models among OPLWH demonstrated minimal variation by age stratum across 13 countries. Among OLPWH, no first 90 target differences were noted by age strata; three countries varied in the second 90 by older age strata but not in a consistent direction; one country showed higher achievement of the third 90 in an older age stratum. CONCLUSIONSWhile OPLWH in these 13 countries were slightly more likely than younger people to be aware of their HIV-positive status (first 90), this target was not achieved in most countries. However, OPLWH achieved treatment (second 90) and VL suppression (third 90) targets in more countries than PLWH <50. Findings support expanded HIV testing, prevention and treatment services to meet ongoing OPLWH health needs in SSA.
Achieving optimal HIV outcomes, as measured by global 90‐90‐90 targets, that is awareness of HIV‐positive status, receipt of antiretroviral (ARV) therapy among aware and viral load (VL) suppression among those on ARVs, respectively, is critical. However, few data from sub‐Saharan Africa (SSA) are available on older people (50+) living with HIV (OPLWH). We examined 90‐90‐90 progress by age, 15–49 (as a comparison) and 50+ years, with further analyses among 50+ (55–59, 60–64, 65+ vs. 50–54), in 13 countries (Cameroon, Cote d'Ivoire, Eswatini, Ethiopia, Kenya, Lesotho, Malawi, Namibia, Rwanda, Tanzania, Uganda, Zambia and Zimbabwe). Using data from nationally representative Population‐based HIV Impact Assessments, conducted between 2015and 2019, participants from randomly selected households provided demographic and clinical information and whole blood specimens for HIV serology, VL and ARV testing. Survey weighted outcomes were estimated for 90‐90‐90 targets. Country‐specific Poisson regression models examined 90‐90‐90 variation among OPLWH age strata. Analyses included 24,826 HIV‐positive individuals (15–49 years: 20,170; 50+ years: 4656). The first, second and third 90 outcomes were achieved in 1, 10 and 5 countries, respectively, by those aged 15–49, while OPLWH achieved outcomes in 3, 13 and 12 countries, respectively. Among those aged 15–49, women were more likely to achieve 90‐90‐90 targets than men; however, among OPLWH, men were more likely to achieve first and third 90 targets than women, with second 90 achievement being equivalent. Country‐specific 90‐90‐90 regression models among OPLWH demonstrated minimal variation by age stratum across 13 countries. Among OLPWH, no first 90 target differences were noted by age strata; three countries varied in the second 90 by older age strata but not in a consistent direction; one country showed higher achievement of the third 90 in an older age stratum. While OPLWH in these 13 countries were slightly more likely than younger people to be aware of their HIV‐positive status (first 90), this target was not achieved in most countries. However, OPLWH achieved treatment (second 90) and VL suppression (third 90) targets in more countries than PLWH <50. Findings support expanded HIV testing, prevention and treatment services to meet ongoing OPLWH health needs in SSA.
Abstract Introduction Achieving optimal HIV outcomes, as measured by global 90‐90‐90 targets, that is awareness of HIV‐positive status, receipt of antiretroviral (ARV) therapy among aware and viral load (VL) suppression among those on ARVs, respectively, is critical. However, few data from sub‐Saharan Africa (SSA) are available on older people (50+) living with HIV (OPLWH). We examined 90‐90‐90 progress by age, 15–49 (as a comparison) and 50+ years, with further analyses among 50+ (55–59, 60–64, 65+ vs. 50–54), in 13 countries (Cameroon, Cote d'Ivoire, Eswatini, Ethiopia, Kenya, Lesotho, Malawi, Namibia, Rwanda, Tanzania, Uganda, Zambia and Zimbabwe). Methods Using data from nationally representative Population‐based HIV Impact Assessments, conducted between 2015and 2019, participants from randomly selected households provided demographic and clinical information and whole blood specimens for HIV serology, VL and ARV testing. Survey weighted outcomes were estimated for 90‐90‐90 targets. Country‐specific Poisson regression models examined 90‐90‐90 variation among OPLWH age strata. Results Analyses included 24,826 HIV‐positive individuals (15–49 years: 20,170; 50+ years: 4656). The first, second and third 90 outcomes were achieved in 1, 10 and 5 countries, respectively, by those aged 15–49, while OPLWH achieved outcomes in 3, 13 and 12 countries, respectively. Among those aged 15–49, women were more likely to achieve 90‐90‐90 targets than men; however, among OPLWH, men were more likely to achieve first and third 90 targets than women, with second 90 achievement being equivalent. Country‐specific 90‐90‐90 regression models among OPLWH demonstrated minimal variation by age stratum across 13 countries. Among OLPWH, no first 90 target differences were noted by age strata; three countries varied in the second 90 by older age strata but not in a consistent direction; one country showed higher achievement of the third 90 in an older age stratum. Conclusions While OPLWH in these 13 countries were slightly more likely than younger people to be aware of their HIV‐positive status (first 90), this target was not achieved in most countries. However, OPLWH achieved treatment (second 90) and VL suppression (third 90) targets in more countries than PLWH <50. Findings support expanded HIV testing, prevention and treatment services to meet ongoing OPLWH health needs in SSA.
Introduction: Achieving optimal HIV outcomes, as measured by global 90?90?90 targets, that is awareness of HIV?positive status, receipt of antiretroviral (ARV) therapy among aware and viral load (VL) suppression among those on ARVs, respectively, is critical. However, few data from sub?Saharan Africa (SSA) are available on older people (50+) living with HIV (OPLWH). We examined 90?90?90 progress by age, 15?49 (as a comparison) and 50+ years, with further analyses among 50+ (55?59, 60?64, 65+ vs. 50?54), in 13 countries (Cameroon, Cote d'Ivoire, Eswatini, Ethiopia, Kenya, Lesotho, Malawi, Namibia, Rwanda, Tanzania, Uganda, Zambia and Zimbabwe). Methods: Using data from nationally representative Population?based HIV Impact Assessments, conducted between 2015and 2019, participants from randomly selected households provided demographic and clinical information and whole blood specimens for HIV serology, VL and ARV testing. Survey weighted outcomes were estimated for 90?90?90 targets. Country?specific Poisson regression models examined 90?90?90 variation among OPLWH age strata. Results: Analyses included 24,826 HIV?positive individuals (15?49 years: 20,170; 50+ years: 4656). The first, second and third 90 outcomes were achieved in 1, 10 and 5 countries, respectively, by those aged 15?49, while OPLWH achieved outcomes in 3, 13 and 12 countries, respectively. Among those aged 15?49, women were more likely to achieve 90?90?90 targets than men; however, among OPLWH, men were more likely to achieve first and third 90 targets than women, with second 90 achievement being equivalent. Country?specific 90?90?90 regression models among OPLWH demonstrated minimal variation by age stratum across 13 countries. Among OLPWH, no first 90 target differences were noted by age strata; three countries varied in the second 90 by older age strata but not in a consistent direction; one country showed higher achievement of the third 90 in an older age stratum. Conclusions: While OPLWH in these 13 countries were slightly more likely than younger people to be aware of their HIV?positive status (first 90), this target was not achieved in most countries. However, OPLWH achieved treatment (second 90) and VL suppression (third 90) targets in more countries than PLWH <50. Findings support expanded HIV testing, prevention and treatment services to meet ongoing OPLWH health needs in SSA.
Introduction Achieving optimal HIV outcomes, as measured by global 90‐90‐90 targets, that is awareness of HIV‐positive status, receipt of antiretroviral (ARV) therapy among aware and viral load (VL) suppression among those on ARVs, respectively, is critical. However, few data from sub‐Saharan Africa (SSA) are available on older people (50+) living with HIV (OPLWH). We examined 90‐90‐90 progress by age, 15–49 (as a comparison) and 50+ years, with further analyses among 50+ (55–59, 60–64, 65+ vs. 50–54), in 13 countries (Cameroon, Cote d'Ivoire, Eswatini, Ethiopia, Kenya, Lesotho, Malawi, Namibia, Rwanda, Tanzania, Uganda, Zambia and Zimbabwe). Methods Using data from nationally representative Population‐based HIV Impact Assessments, conducted between 2015and 2019, participants from randomly selected households provided demographic and clinical information and whole blood specimens for HIV serology, VL and ARV testing. Survey weighted outcomes were estimated for 90‐90‐90 targets. Country‐specific Poisson regression models examined 90‐90‐90 variation among OPLWH age strata. Results Analyses included 24,826 HIV‐positive individuals (15–49 years: 20,170; 50+ years: 4656). The first, second and third 90 outcomes were achieved in 1, 10 and 5 countries, respectively, by those aged 15–49, while OPLWH achieved outcomes in 3, 13 and 12 countries, respectively. Among those aged 15–49, women were more likely to achieve 90‐90‐90 targets than men; however, among OPLWH, men were more likely to achieve first and third 90 targets than women, with second 90 achievement being equivalent. Country‐specific 90‐90‐90 regression models among OPLWH demonstrated minimal variation by age stratum across 13 countries. Among OLPWH, no first 90 target differences were noted by age strata; three countries varied in the second 90 by older age strata but not in a consistent direction; one country showed higher achievement of the third 90 in an older age stratum. Conclusions While OPLWH in these 13 countries were slightly more likely than younger people to be aware of their HIV‐positive status (first 90), this target was not achieved in most countries. However, OPLWH achieved treatment (second 90) and VL suppression (third 90) targets in more countries than PLWH <50. Findings support expanded HIV testing, prevention and treatment services to meet ongoing OPLWH health needs in SSA.
Audience Academic
Author Chikwanda, Prisca
El‐Sadr, Wafaa M.
Mugurungi, Owen
Getaneh, Yimam
Low, Andrea Jane
Aibo, Dorothy
Kakishozi, Angela N.
Voetsch, Andrew C.
Kayigamba, Felix R.
Asiimwe, Fred
Justman, Jessica J.
Ndagije, Felix
Shang, Judith
Musinguzi, Joshua
Juma, James
Hoos, David
Nkurunziza, Peter
Pietersen, Ismela
Harris, Tiffany G.
Wadonda, Nellie
Nkumbula, Tepa
Delgado, Stephen
Tenthani, Lyson
Aoko, Appolonia
Balachandra, Shirish
Moyo, Brian
Kirungi, Wilford
Kabala, Andrew
Bissek, Anne‐Cecile
Dimite, Laura E.
Kancheya, Nzali
Patel, Hetal K.
Wang, Chunhui
McCullough‐Sanden, Rachel
Amuri, Mbaraka
Ayite, Ayiyi
Eshetu, Frehywot
Sleeman, Katrina
Natanael, Salomo
Nyirenda, Rose
Biraro, Sam
Dokubo, Emily K.
Musuka, Godfrey
Mutenda, Nicholus
Kayirangwa, Eugenie
Farley, Shannon M.
Bray, Rachel M.
Bodika, Stephane
Li, Michelle
Lecher, Shirley
Ward, Jennifer
Brown, Kristin
Ndongmo, Clement
West, Christine A.
Ngugi, Evelyn W.
AuthorAffiliation 19 CDC Addis Ababa Ethiopia
7 Ministry of Health Community Development Gender, Elderly and Children through The National AIDS Control Program (NACP) Dodoma Tanzania
9 CDC Windhoek Namibia
10 Ministry of Health and Social Services Windhoek Namibia
13 CDC Kampala Uganda
20 Uganda Ministry of Health Kampala Uganda
6 CDC Dar es Salaam Tanzania
14 CDC Harare Zimbabwe
18 Ethiopia Public Health Institute Addis Ababa Ethiopia
2 Department of Epidemiology Mailman School of Public Health Columbia University New York City New York USA
17 Cameroon Ministry of Public Health Yaounde Cameroon
22 CDC Kigali Rwanda
4 US Centers for Disease Control and Prevention (CDC) Lilongwe Malawi
16 CDC Yaounde Cameroon
5 CDC Mbabane Eswatini
21 CDC Abidjan Cote d'Ivoire
3 Malawi Ministry of Health Lilongwe Malawi
23 CDC Atlanta Georgia USA
8 CDC Lusaka Zambia
15 Zimbabwe Ministry of Health and Child Care Hararre Zimbabwe
12 CDC Maseru Lesotho
11 CDC Nairobi Kenya
1 ICAP at Columbia University New York City New York USA
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– name: 19 CDC Addis Ababa Ethiopia
– name: 2 Department of Epidemiology Mailman School of Public Health Columbia University New York City New York USA
– name: 18 Ethiopia Public Health Institute Addis Ababa Ethiopia
– name: 6 CDC Dar es Salaam Tanzania
– name: 17 Cameroon Ministry of Public Health Yaounde Cameroon
– name: 13 CDC Kampala Uganda
– name: 14 CDC Harare Zimbabwe
– name: 8 CDC Lusaka Zambia
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– name: 23 CDC Atlanta Georgia USA
– name: 5 CDC Mbabane Eswatini
– name: 11 CDC Nairobi Kenya
– name: 21 CDC Abidjan Cote d'Ivoire
– name: 1 ICAP at Columbia University New York City New York USA
– name: 7 Ministry of Health Community Development Gender, Elderly and Children through The National AIDS Control Program (NACP) Dodoma Tanzania
– name: 22 CDC Kigali Rwanda
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  organization: Columbia University
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  givenname: Godfrey
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  organization: ICAP at Columbia University
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  surname: Shang
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  organization: CDC
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  email: hoz2@cdc.gov
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  surname: Balachandra
  fullname: Balachandra, Shirish
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  organization: CDC
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  surname: Kayirangwa
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  organization: CDC
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  surname: Ayite
  fullname: Ayite, Ayiyi
  email: pvq4@cdc.gov
  organization: CDC
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  givenname: Christine A.
  surname: West
  fullname: West, Christine A.
  email: bwj2@cdc.gov
  organization: CDC
– sequence: 49
  givenname: Stephane
  surname: Bodika
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Snippet Introduction Achieving optimal HIV outcomes, as measured by global 90‐90‐90 targets, that is awareness of HIV‐positive status, receipt of antiretroviral (ARV)...
Abstract Introduction Achieving optimal HIV outcomes, as measured by global 90‐90‐90 targets, that is awareness of HIV‐positive status, receipt of...
Introduction: Achieving optimal HIV outcomes, as measured by global 90?90?90 targets, that is awareness of HIV?positive status, receipt of antiretroviral (ARV)...
Introduction: Achieving optimal HIV outcomes, as measured by global 90‐90‐90 targets, that is awareness of HIV‐positive status, receipt of antiretroviral (ARV)...
Achieving optimal HIV outcomes, as measured by global 90‐90‐90 targets, that is awareness of HIV‐positive status, receipt of antiretroviral (ARV) therapy among...
IntroductionAchieving optimal HIV outcomes, as measured by global 90‐90‐90 targets, that is awareness of HIV‐positive status, receipt of antiretroviral (ARV)...
INTRODUCTIONAchieving optimal HIV outcomes, as measured by global 90-90-90 targets, that is awareness of HIV-positive status, receipt of antiretroviral (ARV)...
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SubjectTerms Acquired immune deficiency syndrome
Age groups
ageing
AIDS
AIDS (Disease)
AIDS research
Antiretroviral agents
Care and treatment
Demographic aspects
Demographics
Evaluation
Health status indicators
HIV
HIV epidemiology
HIV infection
HIV testing
Households
Human immunodeficiency virus
Laboratories
Older people
older PLHIV
PHIA
Population
Public health administration
Self report
UNAIDS goals
Women
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Title Progress towards the UNAIDS 90‐90‐90 targets among persons aged 50 and older living with HIV in 13 African countries
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https://pubmed.ncbi.nlm.nih.gov/PMC9522983
Volume 25
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