BOSTON — Although HIV infection is still prevalent in Lesotho, the country has reached one part of the Joint United Nations Programme on AIDS 90-90-90 goal, and it is close to reaching another, according to researchers.
Officials must keep supporting prevention and treatment programs in the African enclave to control the HIV epidemic, which has infected roughly a quarter of the country’s adult population, the researchers said in a presentation at CROI.
The UNAIDS 90-90-90 goal challenges each country to meet three objectives by 2020 — to have 90% of its people who have HIV know of their infection status, 90% of those who know their status on ART, and 90% of those on ART achieving viral suppression. Among other efforts toward that goal, Lesotho in 2016 became the first country in sub-Saharan Africa to institute the Test and Start program, which aims to put all people with HIV on ART.
That year, the researchers conducted a nationwide survey to assess HIV prevalence and viral suppression among people aged 15 to 59 years. In all, 11,682 participants gave interviews and submitted blood samples.
Overall, 25.6% of these participants — 30.4% of women and 20.8% of men — had HIV.
“This means that there are an estimated 306,000 adults living with HIV/AIDS in Lesotho,” researcher Kyaw Thin, MBBS, DCH, MSc, a research coordinator with the Lesotho Health Ministry Research Coordination Unit, said at a CROI press conference. “This is the second highest prevalence globally after Swaziland.”
The proportion of adults with viral suppression regardless of ART use was 67.6% — or 70.6% of women and 63.4% of men. Of participants who tested positive in the survey, 77.2% said they had already known their HIV status, including 81.5% of women and 71% of men.
Two other measures either met or were close to meeting UNAIDS 90-90-90 goals. Of those who said they knew they had HIV, 90.2% also said they used ART. And of those who reported ART use, 88.3% had achieved viral suppression.
The researchers said the data show that Lesotho has made clear progress toward the UNAIDS goal and that its national HIV response has been effective. They pointed out disparities between men and women in that progress, however, and encouraged more testing to uncover further unknown HIV cases, especially among men and youth.
“Among HIV-positive individuals, young men and women were much less likely to be aware of their positive status compared to older age groups,” Thin said. “Strengthening of testing and treatment strategies for HIV, especially in young women and men, will be essential to achieve 90-90-90 targets.” – by Joe Green
Thin K, et al. Abstract 91. Presented at: Conference on Retroviruses and Opportunistic Infections; March 4-7, 2018; Boston.
Disclosure: Thin reports no relevant financial disclosures.