Survey across seven African countries finds young women and teenage girls less than halfway to 2020 goals for HIV control

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Fewer than half of the adolescent girls and young women living with HIV who were tested for the virus as part of door-to-door surveys across communities in seven African countries were already aware of their infection, according to findings released by the U.S. Centers for Disease Control and Prevention. That’s far short of the 2020 goal of 90 percent of people living with HIV being aware of their infection that UNAIDS has projected will be necessary achieve to gain control of the pandemic. The survey found the percent of adolescent girls and young women surveyed living with the virus was 3.4 percent  — more than double the rate for adolescent boys and young men. Among the girls and young women living with HIV, viral load testing showed that the virus was suppressed — protecting their health and preventing transmission  — in fewer than half as well.

UNAIDS 90-90-90 goals — of 90 percent of all people living with the virus aware of their infection, 90 percent of those aware of their infection to be receiving treatment, and for treatment in 90 percent of those receiving treatment to be effective and consistent enough to suppress the virus — aim for 73 percent of all people living with HIV to be virally suppressed by 2020, effectively limiting transmissions of the virus.

Instead, the surveys, conducted between 2015 and 2017 across communities in Lesotho, Malawi, Swaziland, Uganda, Tanzania, Zambia and Zimbabwe found that just 46 percent of girls and young women who tested positive for the virus indicated they were aware of their infection, and just 45 percent were virally suppressed. The encouraging news, the authors of the report in the CDC Morbidity and Mortality Weekly Report write, is the high proportion of viral suppression among those aware of their infection. This indicates that efforts to link and retain young women and teenage girls in care have been successful, they note. Needed, they add, are new interventions to link that population to testing services and same-day treatment initiation. One limitation to that finding, the authors note, is that information on whether survey participants already knew they had the virus depended on their willingness to say so — and some may have been reluctant to.

The findings are among those from the Population-based HIV Impact Assessment, or PHIA surveys, funded by the U.S. President’s Emergency Plan for AIDS Relief, and conducted by ICAP at Columbia University with the support of local health ministries.

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