Botswana already has exceeded one benchmark in the UNAIDS 90-90-90 campaign and should reach the other two before the 2020 goal, showing that the treatment target is achievable even in resource-constrained settings with a high HIV burden, researchers said.
The target of the UNAIDS campaign is that by 2020, 90% of all HIV patients will know their status, 90% of those patients will receive sustained ART, and 90% of those patients on ART will achieve viral suppression.
Botswana has already achieved 96.5% viral suppression among HIV patients receiving ART — a “remarkable” achievement, the researchers wrote in The Lancet HIV.
“This is significant work as it provides further evidence that the UNAIDS 90-90-90 treatment target is both realistic and achievable,” Michel Sidibé, UNAIDS executive director, said in a news release.
‘Great progress’ made in Botswana
The researchers made their calculations based on the results of questionnaires and blood samples submitted by residents aged 16 to 64 years (n = 12,610) in 30 rural and peri-urban communities in Botswana from Oct. 30, 2013, to Nov. 24, 2015.
They found that 29% of the participants were infected with HIV. Among them, 83.3% knew their HIV status (95% CI, 81.4-85.2) and 87.4% of those patients were receiving ART (95% CI, 85.8-89), including 95% of those eligible by national guidelines and 73% of all infected patients. Patients with a viral load of no more than 400 copies/mL comprised 96.5% of the participants (95% CI, 96-97).
Further, 70.2% of all HIV-infected people in the survey had virologic suppression, close to the UNAIDS target of 73%, the researchers reported.
“By now, we hoped to have an HIV vaccine. That hasn’t happened,” researcher Max Essex, PhD, chair of both the Harvard T.H. Chan School of Public Health AIDS Initiative and the Botswana Harvard AIDS Institute Partnership, said in the release. “Ironically, treatment of HIV-infected persons may be our most effective, efficient way to prevent new infections. These results show that Botswana has made great progress in reducing the number of people who are infectious to others.” – by Gerard Gallagher
Disclosure: Essex reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.