A community in Eshowe in KwaZulu-Natal has already achieved the UNAIDS 90-90-90 goal for managing HIV and AIDS — a year ahead of target.
The strategy is aimed at getting 90% of people who are HIV positive to know their status, 90% of people living with HIV on treatment, and suppress the viral load of 90% of people on antiretroviral (ARV) treatment so the virus becomes undetectable. HIV cannot be transmitted sexually if it’s undetectable.
Doctors Without Borders (MSF) recently released findings from a survey of its community-based HIV/TB project in Eshowe, which has results of 90-94-95.
This means that 90% of people living with HIV know their status, 94% of them are on ARVs, and 95% of people on treatment have a suppressed viral load.
South Africa has long been the global epicentre of the HIV and AIDS pandemic with the highest rates of HIV infection in the world.
At least 7.9 million people out of a population of 58 million are HIV positive. Meanwhile, KwaZulu-Natal has the largest number of HIV infections, with more than 2.1 million people in the province living with the virus.
“We’ve shown that it’s possible to reach 90-90-90 in an area with one of the highest HIV infection rates in the country, where one in four people is living with HIV,” said the MSF project lead Dr. Liesbet Ohler.
“Importantly, we have ensured 94% of people who tested HIV positive started treatment, including people who are much less likely to test for HIV and link to care, such as men,” Ohler added.
The survey, which sampled 3,286 people aged 15 to 59 years, is a follow-up to a 2013 one conducted by MSF in Eshowe. The 2018 survey found that HIV awareness has increased by 14%, which the MSF calls “significant”.
The number of people who started treatment also went up by 24% between 2013 and 2018, while men are more aware about HIV testing and treatment.
“Among men, there were striking increases in knowledge of HIV status, from 68% to 83%, and on treatment, from 68% to 87%,” MSF says in the statement. The number of new infections has decreased from 1.2% in 2013 to 0.2% in 2018.
The statement adds: “The proportion of those living with HIV who were virally suppressed increased from 56% (2013) to 84% (2018), signifying a dramatic reduction in the number of people with the potential to transmit HIV.”
South Africa’s national results for the 90-90-90 target is estimated to be 85-71-86.
MSF’s medical coordinator for South Africa Dr. Laura Trivino says the survey results are not yet a sign of victory against HIV and AIDS in KwaZulu-Natal, and that girls remain more vulnerable to infections compared to other groups.
“While incidence decreased among women aged 15-29 years from 2.9% to 1.2%, this figure remains high and points to the continued risk faced by adolescent girls and young women,” said Trivino.
“Difficulties remain in reaching men, who overall achieve poorer treatment outcomes across the cascade,” she added. “More than half of young men aged 15 to 29 years diagnosed with HIV are still not on treatment.”
But she added that it’s hoped the “findings will help focus our collective energies on reaching these groups who remain the most vulnerable to HIV.”