To achieve 95-95-95 targets we must reach men and youth: High level of knowledge of HIV status, ART coverage, and viral suppression in the Botswana Combination Prevention Project through universal test and treat approach.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2021
2021
Historique:
received:
09
12
2020
accepted:
06
07
2021
entrez:
10
8
2021
pubmed:
11
8
2021
medline:
24
11
2021
Statut:
epublish
Résumé
Increasing HIV treatment coverage is crucial to reducing population-level HIV incidence. The Botswana Combination Prevention Project (BCPP) was a community randomized trial examining the impact of multiple prevention interventions on population-level HIV incidence and was conducted from October 2013 through June 2017. Home and mobile campaigns offered HIV testing to all individuals ≥ age 16. All identified HIV-positive persons who were not on antiretroviral therapy (ART) were referred to treatment and tracked to determine linkage to care, ART status, retention in treatment, and viral suppression. Of an estimated total of 14,270 people living with HIV (PLHIV) residing in the 15 intervention communities, BCPP identified 13,328 HIV-positive persons (93%). At study start, 10,703 (80%) of estimated PLHIV knew their status; 2,625 (20%) learned their status during BCPP, a 25% increase with the greatest increases occurring among men (37%) and youth (77%). At study start, 9,258 (65%) of estimated PLHIV were on ART. An additional 3,001 persons started ART through the study. By study end, 12,259 had initiated and were retained on ART, increasing coverage to 93%. A greater increase in ART coverage was achieved among men (40%) compared to women (29%). Of the 11,954 persons who had viral load (VL) test results, 11,687 (98%) were virally suppressed (HIV-1 RNA ≤400 copies/mL). Overall, 82% had documented VL suppression by study end. Knowledge of HIV-positive status and ART coverage increased towards 95-95 targets with universal testing, linkage interventions, and ART. The increases in HIV testing and ART use among men and youth were essential to reaching these targets. NCT01965470.
Sections du résumé
BACKGROUND
Increasing HIV treatment coverage is crucial to reducing population-level HIV incidence.
METHODS
The Botswana Combination Prevention Project (BCPP) was a community randomized trial examining the impact of multiple prevention interventions on population-level HIV incidence and was conducted from October 2013 through June 2017. Home and mobile campaigns offered HIV testing to all individuals ≥ age 16. All identified HIV-positive persons who were not on antiretroviral therapy (ART) were referred to treatment and tracked to determine linkage to care, ART status, retention in treatment, and viral suppression.
RESULTS
Of an estimated total of 14,270 people living with HIV (PLHIV) residing in the 15 intervention communities, BCPP identified 13,328 HIV-positive persons (93%). At study start, 10,703 (80%) of estimated PLHIV knew their status; 2,625 (20%) learned their status during BCPP, a 25% increase with the greatest increases occurring among men (37%) and youth (77%). At study start, 9,258 (65%) of estimated PLHIV were on ART. An additional 3,001 persons started ART through the study. By study end, 12,259 had initiated and were retained on ART, increasing coverage to 93%. A greater increase in ART coverage was achieved among men (40%) compared to women (29%). Of the 11,954 persons who had viral load (VL) test results, 11,687 (98%) were virally suppressed (HIV-1 RNA ≤400 copies/mL). Overall, 82% had documented VL suppression by study end.
CONCLUSIONS
Knowledge of HIV-positive status and ART coverage increased towards 95-95 targets with universal testing, linkage interventions, and ART. The increases in HIV testing and ART use among men and youth were essential to reaching these targets.
CLINICAL TRIAL NUMBER
NCT01965470.
Identifiants
pubmed: 34375343
doi: 10.1371/journal.pone.0255227
pii: PONE-D-20-38769
pmc: PMC8354449
doi:
Banques de données
ClinicalTrials.gov
['NCT01965470']
Types de publication
Journal Article
Research Support, U.S. Gov't, P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0255227Subventions
Organisme : CGH CDC HHS
ID : U2G GH000073
Pays : United States
Organisme : CGH CDC HHS
ID : U2G GH000419
Pays : United States
Organisme : CGH CDC HHS
ID : U01 GH000447
Pays : United States
Organisme : CGH CDC HHS
ID : U2G GH001911
Pays : United States
Organisme : PEPFAR
Pays : United States
Déclaration de conflit d'intérêts
There are no competing interests declared by the authors. Lisa Block, Gene Ussery, and James Miller were employed by Northrup Grumman during this study. However, there are no patents, products in development or marketed products to declare. This does not alter our adherence to PLOS ONE policies on sharing data and materials.
Références
N Engl J Med. 2019 Jul 18;381(3):207-218
pubmed: 31314965
N Engl J Med. 2019 Jul 18;381(3):230-242
pubmed: 31314967
MMWR Morb Mortal Wkly Rep. 2018 Jun 15;67(23):663-667
pubmed: 29902168
Curr Opin HIV AIDS. 2019 Nov;14(6):442-448
pubmed: 31449090
PLoS One. 2019 Nov 25;14(11):e0225076
pubmed: 31765394
N Engl J Med. 2019 Jul 18;381(3):219-229
pubmed: 31314966
Lancet HIV. 2020 Jun;7(6):e422-e433
pubmed: 32504575
AIDS. 2011 Jul 31;25(12):1515-22
pubmed: 21505307
N Engl J Med. 2000 Mar 30;342(13):921-9
pubmed: 10738050
PLoS One. 2012;7(11):e51192
pubmed: 23250272
Lancet HIV. 2016 May;3(5):e221-30
pubmed: 27126489
MMWR Morb Mortal Wkly Rep. 2015 Nov 27;64(46):1281-6
pubmed: 26605861
J Int AIDS Soc. 2018 Jan;21(1):
pubmed: 29314658
PLoS One. 2018 Aug 10;13(8):e0197904
pubmed: 30096139